Background: SARS-CoV-2 is highly infectious and has been a significant public health threat. Despite typical manifestations of illness are dominated by respiratory symptom, some patients have concurrent gastrointestinal manifestations, including nausea, diarrhea MESHD diarrhea HP, and vomiting MESHD vomiting HP. Massive gastrointestinal bleeding, however, has rarely been reported. Case presentation: We herein describe a case of severe SARS-CoV-2 infected patient with several risk factors for poor prognosis, including male TRANS, hypertension MESHD hypertension HP, old age TRANS, mixed bacterial infection MESHD and multilobular infiltration on radiological imaging. After improvement of respiratory status, the onset of gastrointestinal bleeding occurred, probably resulting from direct viral invasion as evidenced by the positive findings for SARS-CoV-2 in the repeat stool specimens. Although aggressive resuscitation was administered, hematochezia HP was uncontrolled. The patient rapidly deteriorated, suffered cardiac arrest HP, and expired. Conclusions: Digestive symptoms could be severe in SARS-CoV-2 infected patients, especially for the high-risk individuals with predisposing conditions. A more thorough protocol for preventing cross-infection MESHD through faecal-oral transmission TRANS should be implemented in the process of patient care and infection MESHD control.