• Kishan P Patel, Puja A Patel, Rama R Vunnam, Alexander T Hewlett, Rohit Jain, Ran Jing, and Srinivas R Vunnam.
• Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
• J. Clin. Virol. 2020 Jul 1; 128: 104386.

AbstractThere is an increasing number of confirmed cases and deaths caused by the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contributing to the Coronavirus disease 2019 (COVID-19) pandemic. At this point, the need for further disease characterization is critical. COVID-19 is well established as a respiratory tract pathogen; however, recent studies have shown an increasing number of patients reporting gastrointestinal manifestations such as diarrhea, nausea, vomiting, and abdominal pain. The time from onset of gastrointestinal symptoms to hospital presentation is often delayed compared to that of respiratory symptoms. It has been noted that SARS-CoV-2 RNA can be detected in fecal matter for an extended period of time, even after respiratory samples have tested negative and patients are asymptomatic. In this article, SARS-CoV-2 and its disease COVID-19 will be reviewed with consideration of the latest literature about gastrointestinal symptomatology, the mechanisms by which the virus may inflict damage, and the possibility of viral replication contributing to a fecal-oral route of transmission.Copyright © 2020 Elsevier B.V. All rights reserved.

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