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Impact of COVID-19 infection on the gastrointestinal tract

The intestine is the target organ for infection with the SARS-CoV-2 coronavirus. The intestinal epithelium supports the replication of SARS-CoV-2. Blockade of the ACE-2 receptors in SARS-CoV-2 leads to impaired absorption of amino acids in the small intestine, which leads to depletion of the amino acid store. Mechanisms of damage to the pancreas include direct cytopathic effects of SARS-CoV-2 or indirect systemic inflammatory and immune-mediated cellular responses leading to organ damage or secondary enzymatic abnormalities. Gastrointestinal symptoms can occur earlier than other COVID-19 symptoms, and early testing can facilitate diagnosis and treatment before the disease becomes severe.