Diarrhea in COVID-19 KTR has been proposed to result from direct infection of SARS-CoV-2 in the intestinal epithelium cells via angiotensin-converting enzyme 2 (ACE2) receptors, resulting in cytokine storm through direct cytopathic effects of SARS-CoV-2 contributing to gut dysbiosis and aberrant immune response resulting in increased intestinal permeability, which further exacerbates existing symptoms and worsen prognosis [34, 35]. Here, ACE2 is linked to infection.