Evidence map›Paper›PMID 32278065›Full record

SynthesisClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2020

Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiology, Prevention, and Management.

Ferdinando D'Amico, Daniel C Baumgart, Silvio Danese, Laurent Peyrin-Biroulet

Registry-linked trialOpen access · bronzeAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04554979 (Corona Virus), which is not on this map. Cited by 290 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
290citing papers in PubMed, 10 pooled it
13.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04554979 completednot on this map

Corona Virus (COVID-19) Disease Duration and Gastrointestinal Tract (GIT) Manifestations; Can be New Disease Severity Classification. A Pilot Egyptian Single National Center Experience

TypeobservationalSponsorCairo UniversityRan2020 to 2020Enrolled199ConditionsCovid19, DiarrheaArmsHydroxychloroquine Pill
3 · Its place in the literature

Who cites it

290 citing papers in PubMed, 10 syntheses or guidelines pooled it, 615 citations in OpenAlex.

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  12. Review
  13. Current status and future perspectives of fecal immunological markers in the differential diagnosis of Clostridioides difficile infection in children.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026
    Review
  14. Article
  15. Has the COVID-19 pandemic affected the incidence ofTurkish journal of surgery · 2025
    Article
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230 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 3 countries.

Ferdinando D'AmicoDepartment of Biomedical Sciences, Humanitas University, Milan, Italy; Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France.
Daniel C BaumgartDivision of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada.
Silvio DaneseDepartment of Biomedical Sciences, Humanitas University, Milan, Italy; IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Center, IRCCS, Milan, Italy.
Laurent Peyrin-BirouletDepartment of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France. Electronic address: peyrinbiroulet@gmail.com.
Humanitas University · ITInserm · FRUniversity of Alberta · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) pandemic is a worldwide emergency. An increasing number of diarrhea cases is reported. Here we investigate the epidemiology, clinical presentation, molecular mechanisms, management, and prevention of SARS-CoV-2 associated diarrhea. We searched on PubMed, EMBASE, and Web of Science up to March 2020 to identify studies documenting diarrhea and mechanism of intestinal inflammation in patients with confirmed diagnosis of SARS-CoV-2 infection. Clinical studies show an incidence rate of diarrhea ranging from 2% to 50% of cases. It may precede or trail respiratory symptoms. A pooled analysis revealed an overall percentage of diarrhea onset of 10.4%. SARS-CoV uses the angiotensin-converting enzyme 2 (ACE2) and the serine protease TMPRSS2 for S protein priming. ACE2 and TMPRSS2 are not only expressed in lung, but also in the small intestinal epithelia. ACE2 is expressed furthermore in the upper esophagus, liver, and colon. SARS-CoV-2 binding affinity to ACE2 is significantly higher (10-20 times) compared with SARS-CoV. Several reports indicate viral RNA shedding in stool detectable longer time period than in nasopharyngeal swabs. Current treatment is supportive, but several options appear promising and are the subject of investigation. Diarrhea is a frequent presenting symptom in patients infected with SARS-CoV-2. Increasing evidence indicates possible fecal oral transmission, indicating the need for a rapid and effective modification of the screening and diagnostic algorithms. The optimal methods to prevent, manage, and treat diarrhea in COVID-19 infected patients are subjects of intensive research.

Indexed as

Disease ManagementAngiotensin-Converting Enzyme 2BetacoronavirusChildCoronavirus InfectionsCOVID-19DiarrheaDisease Transmission, InfectiousFecesHumansIncidenceInfection ControlPandemicsPeptidyl-Dipeptidase APneumonia, ViralSARS-CoV-2ACE2 protein, humanAngiotensin-Converting Enzyme 2Peptidyl-Dipeptidase ASerine EndopeptidasesSpike Glycoprotein, CoronavirusTMPRSS2 protein, humanACE2Angiotensin-Converting Enzyme 2COVID-19DiarrheaEpidemiologySARS-CoV-2TMPRSS2

Identifiers

PMID32278065
PMCPMC7141637
OpenAlexW3016005141

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.