Considerations and perspectives on digestive diseases during the COVID-19 pandemic: a narrative review
Juan Li1, Chunmei Li2, Xiaojun Wang3
1Department of Gastroenterology, the First Hospital of Lanzhou University, Lanzhou, China; Key Laboratory for Gastrointestinal Diseases, Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China; Department of Gastroenterology, Gansu Provincial Hospital, Lanzhou, China.
Insights
The gut-lung axis influences digestive symptoms in COVID-19 patients, complicating diagnosis. Understanding this connection offers new targets for preventing and treating digestive issues, reducing disease severity.
Area of Science:
- Gastroenterology and Infectious Diseases
- Microbiome Research
- Respiratory Medicine
Background:
- Coronavirus disease 2019 (COVID-19) pandemic presents diagnostic challenges, with increasing asymptomatic cases showing digestive symptoms.
- Digestive symptoms are common in COVID-19 patients, highlighting a bidirectional relationship between the respiratory and digestive systems.
- The "gut-lung" axis is implicated in COVID-19 pathogenesis, affecting clinical presentation and treatment strategies.
Purpose of the Study:
- To review the relationship between the digestive and respiratory systems in COVID-19 patients via the "gut-lung" axis.
- To explore the pathogenesis of digestive symptoms associated with COVID-19.
- To identify potential novel therapeutic targets for COVID-19-related digestive complications.
Main Methods:
- Literature review of extant studies on COVID-19, digestive symptoms, and the "gut-lung" axis.
- Analysis of clinical data and research findings on the interplay between respiratory and gastrointestinal manifestations.
- Synthesis of information regarding the pathogenesis of digestive system involvement in COVID-19.
Main Results:
- COVID-19 significantly impacts the gastrointestinal tract, often presenting with non-respiratory symptoms.
- The "gut-lung" axis plays a crucial role in the manifestation and progression of digestive symptoms in COVID-19.
- Understanding the pathogenesis of these digestive symptoms is key to effective clinical management.
Conclusions:
- Investigating the pathogenesis of digestive system diseases in COVID-19 can reveal novel prevention and treatment targets.
- Targeting the "gut-lung" axis may reduce COVID-19 virulence and the overall socio-sanitary burden.
- This review facilitates differential diagnosis and treatment strategies for COVID-19 patients with digestive complaints.
Abstract:
Coronavirus disease 2019 (COVID-19) was initially reported in December 2019, and since then it has become a pandemic with newly confirmed cases and deaths increasing continuously. The COVID-19 pandemic has dramatically impacted the organization and execution of activities in the clinical sector. Asymptomatic infections are increasingly being identified when patients seek medical advice for non-respiratory system illnesses, particularly digestive system symptoms. This has posed a significant challenge for clinical diagnosis and treatment. Based on the clinical symptoms of patients with COVID-19 reported to date, patients with typical clinical symptoms of COVID-19 may also present with symptoms associated with the digestive system. Digestive illness symptoms in patients with COVID-19 are underscored by a bidirectional relationship between respiratory and digestive systems. Because the clinical diagnosis and treatment of digestive illnesses caused by COVID-19 have been challenging so far, we hypothesized that investigating the pathogenesis of digestive system diseases in patients with COVID-19 will provide potential novel targets for its prevention and treatment, and concurrently reduce COVID-19 virulence and socio-sanitary burden. This review summarizes the relationship between the digestive and respiratory systems in patients with COVID-19 from the perspective of the "gut-lung" axis. We discuss extant literature on the pathogenesis of COVID-19-related digestive symptoms, which may facilitate differential diagnosis and treatment of this condition.
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