In late 2019, an outbreak of
pneumonia caused by
severe acute respiratory syndrome coronavirus 2 (
SARS-CoV-2) initiated in Wuhan, Hubei province,
China. The major clinical symptoms described for
coronavirus disease (COVID-19) include respiratory distress and
pneumonia in severe cases, and some
patients may experience gastrointestinal impairments. In accordance,
viral RNA or live infectious
virus have been detected in
feces of
patients with COVID-19. Binding of
SARS-CoV-2 to the
angiotensin‐converting
enzyme 2 (ACE2) is a vital pathway for the
virus entry into
human cells, including those of the
respiratory mucosa, esophageal
epithelium as well as the absorptive
enterocytes from
ileum and
colon. The interaction between
SARS-CoV-2 and ACE2 receptor may decrease the receptor expression and disrupt the function of B0AT1 transporter influencing the
diarrhea observed in COVID-19
patients. In this context, a fecal-oral
transmission route has been considered and points out a
role for the
digestive tract in
disease transmission and severity. Here, in order to further understand the impact of COVID-19 in
human physiology, the cellular and molecular mechanisms of SARS-CoV-2 infection and
disease severity are discussed in the context of gastrointestinal disturbances.