*4.2. Atypical Symptoms in SOT Patients with COVID-19*

A remarkable observation is that SOT patients frequently have gastrointestinal symptoms as part of COVID-19. These symptoms have been described in immunocompetent COVID-19 patients, but they appear to be rare (3−5%) [51,52]. Gastrointestinal symptoms from COVID-19 in SOT patients cannot be explained as yet, but may be related to the immunosuppressive treatment, or to the co-medication possibly altering the intestinal microbiome and thus modifying the intestinal reactivity to the viral infection. Again, the number of observations of COVID-19 patients with these manifestations is too small for firm conclusions.
