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.