• Peijie Zhong, Jing Xu, Dong Yang, Yue Shen, Lu Wang, Yun Feng, Chunling Du, Yuanlin Song, Chaomin Wu, Xianglin Hu, and Yangbai Sun.
• Department of Musculoskeletal Surgery, Fudan University Shanghai Cancer Center, 200032, Shanghai, China.
• Signal Transduct Target Ther. 2020 Nov 2; 5 (1): 256.

AbstractCoronavirus disease-2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The infection is spreading globally and poses a huge threat to human health. Besides common respiratory symptoms, some patients with COVID-19 experience gastrointestinal symptoms, such as diarrhea, nausea, vomiting, and loss of appetite. SARS-CoV-2 might infect the gastrointestinal tract through its viral receptor angiotensin-converting enzyme 2 (ACE2) and there is increasing evidence of a possible fecal-oral transmission route. In addition, there exist multiple abnormalities in liver enzymes. COVID-19-related liver injury may be due to drug-induced liver injury, systemic inflammatory reaction, and hypoxia-ischemia reperfusion injury. The direct toxic attack of SARS-CoV-2 on the liver is still questionable. This review highlights the manifestations and potential mechanisms of gastrointestinal and hepatic injuries in COVID-19 to raise awareness of digestive system injury in COVID-19.

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