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COVID-19 and gut immunomodulation.

Koushik Roy1, Sidra Agarwal2, Rajib Banerjee3

  • 1Microbiology and Immunology, Department of Pathology, School of Medicine, University of Utah, Salt Lake City, UT 84112, United States.

World Journal of Gastroenterology
|January 20, 2022
PubMed
Summary

Gastrointestinal symptoms are common in COVID-19 due to SARS-CoV-2 infection of the gut. This review explores gut immune responses, disease severity links, and potential treatments for these COVID-19 GI issues.

Keywords:
Adaptive immune responseCOVID-19DysbiosisGastrointestinal symptomsGut microbiotaInnate immune responsePathogenesisPre-existing diseasesProbioticTherapeutics

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Area of Science:

  • Gastroenterology
  • Virology
  • Immunology

Background:

  • Coronavirus disease 2019 (COVID-19) presents with diverse symptoms, including significant gastrointestinal (GI) manifestations.
  • The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may directly infect the GI tract, contributing to symptoms.

Purpose of the Study:

  • To review the immunomodulation of the GI tract by SARS-CoV-2.
  • To summarize the causes of GI symptoms in COVID-19 patients.
  • To explore the association between GI symptoms, disease severity, and potential therapies.

Main Methods:

  • Review of emerging reports and scientific literature on COVID-19 and GI symptoms.
  • Analysis of viral RNA detection in fecal samples and GI tissues.
  • Examination of immune responses within the GI tract of COVID-19 patients.

Main Results:

  • The intestinal epithelium expresses ACE2 and TMPRSS2, facilitating SARS-CoV-2 entry.
  • Viral RNA is detected in feces and GI tracts of many severe COVID-19 cases.
  • GI symptoms can arise from direct viral infection, immune responses, dysbiosis, and systemic factors.

Conclusions:

  • SARS-CoV-2 actively modulates the GI immune system, leading to symptoms.
  • GI involvement may correlate with COVID-19 severity.
  • Understanding GI immunomodulation is crucial for developing targeted therapeutic strategies.