The novel coronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has emerged and is responsible for the Coronavirus Disease 2019 global pandemic. Coronaviruses, including SARS-CoV-2, are strongly associated with respiratory symptoms during infection, but gastrointestinal symptoms, such as diarrhea, vomiting, nausea, and abdominal pain, have been identified in subsets of COVID-19 patients. This article focuses on gastrointestinal symptoms and pathophysiology in COVID-19 disease. Evidence suggests that the gastrointestinal tract could be a viral target for SARS-CoV-2 infection. Not only is the SARS-CoV-2 receptor ACE2 highly expressed in the GI tract and is associated with digestive symptoms, but bleeding and inflammation are observed in the intestine of COVID-19 patients. We further systemically summarize the correlation between COVID-19 disease, gastrointestinal symptoms and intestinal microbiota. The potential oral-fecal transmission of COVID-19 was supported by viral RNA and live virus detection in the feces of COVID-19 patients. Additionally, the viral balance in the GI tract could be disordered during SARS-CoV-2 infection which could further impact the homeostasis of the gut microbial flora. Finally, we discuss the clinical and ongoing trials of treatments/therapies, including antiviral drugs, plasma transfusion and immunoglobulins, and diet supplementations for COVID-19. By reviewing the pathogenesis of SARS-CoV-2 virus, and understanding the correlation among COVID-19, inflammation, intestinal microbiota, and lung microbiota, we provide perspective in prevention and control, as well as diagnosis and treatment of the COVID-19 disease.

新型冠状病毒严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 已经出现，并导致 2019 年冠状病毒病全球大流行。包括 SARS-CoV-2 在内的冠状病毒与感染期间的呼吸道症状密切相关，但在部分 COVID-19 患者中发现了胃肠道症状，如腹泻、呕吐、恶心和腹痛。本文重点介绍 COVID-19 疾病的胃肠道症状和病理生理学。有证据表明，胃肠道可能是 SARS-CoV-2 感染的病毒靶点。SARS-CoV-2受体ACE2不仅在胃肠道中高表达并与消化道症状相关，而且在COVID-19患者的肠道中观察到出血和炎症。我们进一步系统总结了COVID-19疾病、胃肠道症状和肠道菌群之间的相关性。COVID-19 患者粪便中的病毒 RNA 和活病毒检测支持了 COVID-19 潜在的口腔粪便传播。此外，在 SARS-CoV-2 感染期间，胃肠道中的病毒平衡可能会被扰乱，这可能会进一步影响肠道微生物菌群的稳态。最后，我们讨论了针对 COVID-19 的治疗/疗法的临床和正在进行的试验，包括抗病毒药物、血浆输注和免疫球蛋白以及饮食补充剂。通过回顾 SARS-CoV-2 病毒的发病机制，了解 COVID-19、炎症、肠道微生物群和肺部微生物群之间的相关性，我们为 COVID-19 疾病的预防和控制以及诊断和治疗提供视角。