Gastrointestinal Disease and COVID-19: A Review of Current Evidence
Fei Chen1, Zhiqing Dai1, Chaofan Huang1
1Department of Physiology, Jining Medical University, Jining, China.
Insights
The coronavirus disease 2019 (COVID-19) pandemic impacts the gastrointestinal (GI) system, causing symptoms like diarrhea and nausea. COVID-19 drugs can worsen these GI issues, necessitating careful patient management.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pharmacology
Background:
- The COVID-19 pandemic presents significant global health challenges.
- Many COVID-19 patients experience gastrointestinal (GI) symptoms, including diarrhea, nausea, and vomiting, beyond respiratory issues.
Purpose of the Study:
- To review the impact of COVID-19 and its treatments on the GI system.
- To discuss the pathogenesis of GI manifestations in COVID-19.
- To provide guidance on managing inflammatory bowel disease (IBD) and GI cancer patients during the pandemic.
Main Methods:
- Comprehensive literature review of recent scientific knowledge.
- Analysis of molecular pathways and mechanisms involved in COVID-19's GI effects.
- Discussion of therapeutic drug interactions with GI function.
Main Results:
- SARS-CoV-2 (the virus causing COVID-19) affects the digestive system by binding to ACE2 receptors, leading to gut microbiome dysbiosis.
- COVID-19 treatments can interfere with GI function, potentially exacerbating symptoms like nausea, vomiting, gastroparesis, and gastric ulcers.
Conclusions:
- Close monitoring of GI symptoms in COVID-19 patients is crucial.
- Minimizing corticosteroid and immunosuppressive agent use (especially thiopurines) is recommended for IBD patients during vaccination or COVID-19 infection.
- Timely vaccination for IBD patients and measures to reduce SARS-CoV-2 incidence in GI cancer patients are advised.
Background:
The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented and catastrophic impact on humanity and continues to progress. In addition to typical respiratory symptoms such as fever, cough, and dyspnea, a large percentage of COVID-19 patients experience gastrointestinal (GI) complaints, with the most common symptoms being diarrhea, nausea, vomiting, and abdominal discomfort.
Summary:
We comprehensively summarize the latest knowledge of the adverse effects of COVID-19 and therapeutic drugs on the GI system, as well as related disease pathogenesis, and then provide a discussion focusing on the management and vaccination of patients who have inflammatory bowel disease (IBD) and GI cancer. The virus can affect the digestive system via binding to ACE2 receptors and subsequent gut microbiome dysbiosis. Through a variety of molecular pathways and mechanisms, numerous drugs for the treatment of COVID-19 could interfere with GI function and lead to multiple clinical manifestations, which may further intensify the risk and severity of GI symptoms of COVID-19 infection, such as nausea, vomiting, gastroparesis, and gastric ulcers.
Key Messages:
We should monitor GI manifestations closely while managing COVID-19 patients and take timely measures to reduce the incidence of SARS-CoV-2 infections in GI cancer patients. IBD patients should receive vaccination timely, but corticosteroid use should be minimized when they are vaccinated. Simultaneously, for persons with IBD who have known or suspected COVID-19, immunosuppressive agents, especially thiopurines, should be avoided/minimized if possible.
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