Coronavirus Can Invade Our Intestines As Well As Our Lungs, Study Finds

The coronavirus that causes COVID-19 can infect and replicate in human intestine cells, according to a study.

This may explain why some COVID-19 patients have gastrointestinal symptoms, Dutch researchers suggested in a paper published in the journal Science.

The coronavirus can invade and multiply in the human gut because the enzyme it uses to enter our cells is found in this part of the body, the team said. The enzyme, called Angiotensin-converting enzyme 2 (ACE2), is also present in the respiratory system.

To reach their conclusion, the team took SARS-CoV-2 (the coronavirus which causes COVID-19) and cells from the human intestine and watched how they interacted in a lab.

After 24 hours, the virus had invaded some of the cells. After 60 hours "the number of infected cells had dramatically increased," the authors wrote.

Next, they examined which genes were at work in the intestinal cells using a technique called RNA sequencing. This revealed genes that fight off viral infections were active in the gut cells.

The project saw the team culture gut cells so they would have different levels of ACE2, to see if this would change their chances of being infected. They found cells were vulnerable whether or not they had high or low levels of ACE2.

Study co-author Bart Haagmans, a virologist at Erasmus MC University Medical Center Rotterdam, commented in a statement: "The observations made in this study provide definite proof that SARS-CoV-2 can multiply in cells of the gastrointestinal tract.

"However, we don't yet know whether SARS-CoV-2, present in the intestines of COVID-19 patients, plays a significant role in transmission. Our findings indicate that we should look into this possibility more closely."

The team aren't the first to explore whether the coronavirus not only affects the respiratory system, causing common symptoms such as a dry cough and breathing difficulties, but other parts of the body too.

Last month, a study published in The American Journal of Gastroenterology involving 206 people in China showed diarrhea may be the first or only symptom some COVID-19 patients experience.

An article published in the journal the BMJ involving 96 people with COVID-19 in China found the coronavirus appeared to linger longer in some patients' stools than their respiratory system.

Brennan Spiegel, professor of medicine and public health at Cedars-Sinai and co-author of The American Journal of Gastroenterology study, told Newsweek in April: "I think the main message is COVID-19 is not just cough.

He said: "We're starting to learn from our colleagues in China and around the world now that there's a large group of people who may not ever report for care, or at home with digestive symptoms—diarrhea, nausea, vomiting, less so abdominal pain but that too, low appetite—who are struggling to determine if they have COVID-19 or not."

Since the COVID-19 pandemic is thought to have started in late 2019, more than 3.6 million people around the world have been diagnosed with the disease, according to Johns Hopkins University. 257,301 have died, and over 1.1 million are known to have survived. The U.S. is the country with the most cases, as the Statista graph below shows.

Statista COVID-19 cases May 5 2020
The number of confirmed COVID-19 cases as of 01:30 a.m. EDT on Tuesday. Statista

Centers for Disease Control and Prevention Advice on Using Face Coverings to Slow Spread of COVID-19

  • CDC recommends wearing a cloth face covering in public where social distancing measures are difficult to maintain.
  • A simple cloth face covering can help slow the spread of the virus by those infected and by those who do not exhibit symptoms.
  • Cloth face coverings can be fashioned from household items. Guides are offered by the CDC. (
  • Cloth face coverings should be washed regularly. A washing machine will suffice.
  • Practice safe removal of face coverings by not touching eyes, nose, and mouth, and wash hands immediately after removing the covering.

World Health Organization advice for avoiding spread of coronavirus disease (COVID-19)

Hygiene advice

  • Clean hands frequently with soap and water, or alcohol-based hand rub.
  • Wash hands after coughing or sneezing; when caring for the sick; before, during and after food preparation; before eating; after using the toilet; when hands are visibly dirty; and after handling animals or waste.
  • Maintain at least 1 meter (3 feet) distance from anyone who is coughing or sneezing.
  • Avoid touching your hands, nose and mouth. Do not spit in public.
  • Cover your mouth and nose with a tissue or bent elbow when coughing or sneezing. Discard the tissue immediately and clean your hands.

Medical advice

  • Avoid close contact with others if you have any symptoms.
  • Stay at home if you feel unwell, even with mild symptoms such as headache and runny nose, to avoid potential spread of the disease to medical facilities and other people.
  • If you develop serious symptoms (fever, cough, difficulty breathing) seek medical care early and contact local health authorities in advance.
  • Note any recent contact with others and travel details to provide to authorities who can trace and prevent spread of the disease.
  • Stay up to date on COVID-19 developments issued by health authorities and follow their guidance.

Mask and glove usage

  • Healthy individuals only need to wear a mask if taking care of a sick person.
  • Wear a mask if you are coughing or sneezing.
  • Masks are effective when used in combination with frequent hand cleaning.
  • Do not touch the mask while wearing it. Clean hands if you touch the mask.
  • Learn how to properly put on, remove and dispose of masks. Clean hands after disposing of the mask.
  • Do not reuse single-use masks.
  • Regularly washing bare hands is more effective against catching COVID-19 than wearing rubber gloves.
  • The COVID-19 virus can still be picked up on rubber gloves and transmitted by touching your face.