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SARS-CoV-2 causes gastric damage: structural and ultrastructural evaluation
Erva Sevic Yilmaz1, Engin Alp Onen2, Hasan Serdar Mutlu3
1Department of Histology and Embryology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. erva.sevic@gmail.com.
Journal of Molecular Histology
|June 21, 2025
Summary
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) damages stomach cells via inflammation and cell death, impairing gastric protection. This may increase susceptibility to secondary infections and cause digestive symptoms.
Area of Science:
- Gastroenterology
- Virology
- Cell Biology
Background:
- Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection targets the gastrointestinal tract, with ACE2 receptors present in the gastric mucosa.
- The specific impact of SARS-CoV-2 on gastric tissue, including cellular mechanisms and protective responses, remains largely uncharacterized.
Purpose of the Study:
- To investigate the effects of SARS-CoV-2 on distinct gastric cell types and identify underlying mechanisms of damage and host defense.
- To analyze the role of apoptosis, pyroptosis, necroptosis, and Galectin-3 in SARS-CoV-2-induced gastric pathology.
Main Methods:
- Utilized K18-hACE2 transgenic mice, infected with SARS-CoV-2, and analyzed gastric tissues at day 8 post-infection.
- Assessed histological damage, mucin content, cell death pathways (apoptosis, pyroptosis, necroptosis), and Galectin-3 expression.
- Employed transmission electron microscopy for ultrastructural analysis of viral particles and cellular changes.
Main Results:
- SARS-CoV-2 infection led to significant epithelial damage, desquamation, hemorrhage, and reduced mucin content in gastric tissues.
- Elevated levels of apoptosis and pyroptosis were observed, alongside decreased Galectin-3 expression, indicating impaired gastric protection.
- Parietal cells showed severe damage and high viral load, while enteroendocrine cells exhibited increased activity; virus-like particles were detected.
Conclusions:
- SARS-CoV-2 causes substantial damage to gastric epithelial and parietal cells through inflammatory and cell death pathways.
- Reduced Galectin-3 expression exacerbates gastric damage and impairs protective mechanisms, potentially increasing susceptibility to secondary infections like H. pylori.
- The observed gastric pathology may contribute to clinical symptoms such as nausea, dyspepsia, and unexplained gastrointestinal complaints in COVID-19 patients.
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