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Mechanism and potential treatments for gastrointestinal dysfunction in patients with COVID-19

Yang Yao1,2,3, Zhu-Jun Liu1,4,5, Yu-Kun Zhang1,6

  • 1Chongqing Key Laboratory of Development and Utilization of Genuine Medicinal Materials in Three Gorges Reservoir Area, College of Basic Medical, Chongqing 404120, China.

World Journal of Gastroenterology
|January 12, 2023
PubMed

Insights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes gastrointestinal symptoms through mechanisms like direct cell damage and gut dysbiosis. Understanding these pathways is crucial for effective COVID-19 patient management and treatment guidelines.

Area of Science:

  • Gastroenterology
  • Virology
  • Infectious Diseases

Background:

  • The COVID-19 pandemic, caused by SARS-CoV-2, presents significant global health challenges.
  • Gastrointestinal (GI) symptoms are prevalent in COVID-19 patients, affecting 12-61% and including anorexia, nausea, vomiting, diarrhea, and abdominal pain.
  • ACE2 and TMPRSS2 expression in the respiratory and GI tracts facilitates SARS-CoV-2 infection.

Purpose of the Study:

  • To review and discuss the underlying mechanisms contributing to GI symptoms in COVID-19.
  • To provide insights for developing targeted treatment strategies for GI manifestations of COVID-19.
  • To aid in establishing appropriate clinical guidelines for healthcare professionals managing COVID-19 patients with GI issues.

Main Methods:

  • Literature review and synthesis of existing research on COVID-19 and gastrointestinal pathology.
  • Analysis of proposed mechanisms linking SARS-CoV-2 infection to gastrointestinal dysfunction.
  • Discussion of the roles of direct viral damage, malnutrition, and gut microbiota alterations.

Main Results:

  • SARS-CoV-2 infection can directly damage intestinal mucosal epithelial cells.
  • Malnutrition and dysbiosis of the gut microbiota are implicated in the development of GI symptoms during COVID-19.
  • The precise mechanisms underlying these GI manifestations require further elucidation.

Conclusions:

  • Understanding the mechanisms of COVID-19-induced GI symptoms is essential for clinical practice.
  • This review aims to inform the development of effective treatment strategies and clinical guidelines for managing GI symptoms in COVID-19 patients.
  • Further research is needed to fully clarify the complex interplay between SARS-CoV-2 and the gastrointestinal system.
Keywords:
Angiotensin-converting enzyme-2COVID-19Gastrointestinal symptomIntestinal barrier permeabilityMechanismTransmembrane protease serine 2

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