TABLE 2.

Non‐invasive commonly used biomarkers for gastrointestinal, liver and pancreatic COVID‐19 involvement evaluation

Sample	Parameter	Variation	Meaning
Sputum	SARS‐CoV‐2 RNA	+	COVID‐19 diagnosis Positive rate higher than throat swabs (from 28.6% 146 to 72% 147 )
Blood	Blood count and coagulation
	Neutrophils	↑	Associated with diarrhea and deaths 148
	Lymphocyte	↑	Associated with diarrhea and deaths 148
	Hemoglobin	↓	GI bleeding 149
	D‐dimer	↑	Associated with ischemic colitis 85
	Inflammatory markers
	C‐reactive protein	↑	Associated with GI symptoms 150
	Interleukin‐6	↑	Associated with diarrhea and death 148 Correlation with fecal calprotectin 47
	Interleukin‐10	↑	Associated with diarrhea and death 148
	Tumor necrosis factor‐α	↑	Associated with diarrhea and death 148
	Ferritin	↑	Associated with severe clinical course and thrombotic complications 151
	Interferon‐γ	↑	Stimulate the production of inflammatory cytokines. Enhance hyper‐inflammation and exacerbates the severity of the disease. 152
	Hepato‐biliopancreatic tests
	Alanine aminotransferase Aspartate aminotransferase	↑	In 19% of patients, associated with severe clinical course 100
	Gamma‐glutamyltransferase Alkaline Phosphatase	↑	In 32.7% 153 of patients. Associated with liver injury, longer hospital stay, 153 and intensive care unit admission 154
	Lactate dehydrogenase	↑	Associated with GI symptoms 150 and severe/critical clinical course 155
	Bilirubin	↑	Associated with severe clinical course 156
	Albumin	↓	Associated with GI symptoms 155
	Lipase	↑	In 12.1% of patients, no association with poor outcomes or symptoms 157 Case reports on acute pancreatitis 115 , 158
	Glucose	↑	Associated with severe/critical clinical course 155
	Intestinal cells integrity tests
	Citrulline	↓	Associated with systemic inflammation and GI symptoms 40 Associated with ↑ C reactive protein and Ferritin and ↓ Albumin 40
Feces	SARS‐CoV‐2 RNA	+	From 29% 147 to 58.1% 159 of patients; pooled results: 43.7% 160
	Fecal calprotectin	↑	Associated with diarrhea 47
	Fecal occult blood	+	In 38% of patients with GI symptoms 161

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