Gastrointestinal (GI) symptoms are observed in patients with COVID-19, but the link between GI immune responses and disease outcomes is unclear. This preprint shows that COVID-19 severity and mortality, and levels of circulating inflammatory cytokines, are reduced in patients with GI symptoms. The SARS-CoV-2 receptor ACE2 was highly expressed in small intestinal enterocytes and viral particles were detected in these cells in patients with COVID-19. GI inflammation was absent in patients with COVID-19, as shown by a reduction of cellular inflammatory subsets and downregulation of inflammatory pathways. This study provides a basis for exploring the mechanisms involved in attenuation of SARS-CoV-2-associated GI inflammation to aid a comprehensive understanding of organ-specific immune responses in COVID-19.