The gastrointestinal tract and COVID-19. Observations after the year of the pandemic. Part 1. Patients with diseases of the upper gastrointestinal tract Review article
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Published:
Sep 30, 2021
Keywords:
COVID-19, SARS-CoV-2, gastrointestinal symptoms
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Abstract
The most common clinical manifestations of coronavirus SARS-CoV-2 (COVID-19) include fever, cough, dyspnea, sore throat, muscle or bone aches, chills, and headache. Nevertheless, gastrointestinal infections have been reported, with symptoms such as diarrhea, nausea, vomiting, abdominal pain, and lack of appetite. Although is not clear the mechanisms responsible for the development of diarrhea in COVID-19, the current hypothesis is that the direct viral infection on the intestinal tissue and local immune response to the virus may be involved. Additionally, after gastrointestinal SARS-CoV-2 infection some patients may develop alterations in the gastrointestinal microbiota. In this review we outlined the important GI manifestations of COVID-19 and discussed the possible mechanisms and aspects relating to their diagnosis and management.
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Gąsiorowska , A. (2021). The gastrointestinal tract and COVID-19. Observations after the year of the pandemic. Part 1. Patients with diseases of the upper gastrointestinal tract. Medycyna Faktow (J EBM), 14(3(52), 225-231. https://doi.org/10.24292/01.MF.0321.2
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References
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45. Kountouras J, Chatzopoulos D, Zavos C et al. Efficacy of trimebutine therapy in patients with gastroesophageal reflux disease and irritablebowel syndrome. Hepatogastroenterology. 2002; 49(43): 193-7.
2. Kariyawasam JC, Jayarajah U, Riza R et al. Gastrointestinal manifestations in COVID-19. Trans R Soc Trop Med Hyg. 2021; 0: 1-27.
3. Yeo C, Kaushal S, Yeo D. Enteric involvement of coronaviruses: is faecal-oral transmission of SARS-CoV-2 possible? Lancet Gastroenterol Hepatol. 2020; 5(4): 335-7.
4. Hui DS, Wong PC, Wang C. SARS: clinical features and diagnosis. Respirology. 2003; 8(suppl 1): S20-4.
5. Kim MN, Kim EC. Considering revision the criteria for patients under investigations for MERS-CoV infections: diarrhea or not. J Korean Med Sci. 2018; 33(53): e344.
6. Troisi J, Venutolo G, Tanyà MP et al. COVID-19 and the gastrointestinal tract: Source of infection or merely a target of the inflammatory process following SARS-CoV-2 infection? World J Gastroenterol. 2021; 27(14): 1406-18.
7. Neurath MF, Überla K, Ng SC. Gut as viral reservoir: lessons from gut viromes, HIV and COVID-19. Gut. 2021.
8. Lamers MM, Beumer J, van der Vaart J et al. SARS-CoV-2 productively infects human gut enterocytes. Science. 2020; 369(6499): 50-4.
9. Hashimoto T, Perlot T, Rehman A et al. ACE2 links amino acid malnutrition to microbial ecology and intestinal inflammation. Nature. 2012; 487(7408): 477-81.
10. Yang T, Chakraborty S, Saha P et al. Gnotobiotic rats reveal that gut microbiota regulates colonic mRNA of Ace2, the receptor for SARS-CoV-2 infectivity. Hypertension. 2020; 76(1): e1-e3.
11. Zuo T, Zhang F, Lui GCY et al. Alterations in gut microbiota of patients with COVID-19 during Time of Hospitalization. Gastroenterology. 2020; 159(3): 944-55.
12. Hufnagl K, Pali-Schöll I, Roth-Walter F et al. Dysbiosis of the gut and lung microbiome has a role in asthma. Semin Immunopathol. 2020; 42(1): 75-93.
13. Budden KF, Gellatly SL, Wood DL et al. Emerging pathogenic links between microbiota and the gut-lung axis. Nat Rev Microbiol. 2017; 15(1): 55-63.
14. Joynt GM, Wu WK. Understanding COVID-19: what does viral RNA load really mean? Lancet Infect Dis. 2020; 20(6): 635-6.
15. Xiao F, Tang M, Zheng X et al. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology. 2020; 158(6): 1831-3.e3.
16. Deshmukh V, Motwani R, Kumar A et al. Histopathological observations in COVID-19: a systematic review. J Clin Pathol. 2021; 74(2): 76-83.
17. Han C, Duan C, Zhang S et al. Digestive symptoms in COVID-19 patients with mild disease severity: clinical presentation, stool viral RNA testing, and outcomes. Am J Gastroenterol. 2020; 115(6): 916-23.
18. Seeliger B, Philouze G, Benotmane I et al. Is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) present intraperitoneally in patients with coronavirus disease 2019 (COVID-19) infection undergoing emergency operations? Surgery. 2020; 168(2): 220-1.
19. D’Amico F, Baumgart DC, Danese S et al. Diarrhea during COVID-19 infection: pathogenesis, epidemiology, prevention, and management. Clin Gastroenterol Hepatol. 2020; 18(8): 1663-72.
20. Carvalho A, Alqusairi R, Adams A et al. SARS-CoV-2 Gastrointestinal Infection Causing Hemorrhagic Colitis: Implications for Detection and Transmission of COVID-19 Disease. Am J Gastroenterol. 2020; 115(6): 942-6.
21. Schmulson M, Ghoshal UC, Giovanni B et al. Managing the inevitable surge of Post-COVID-19 functional gastrointestinal disorders. Am J Gastroenterol. 2021; 116(1): 4-7.
22. Gadiparthi C, Perisetti A, Sayana H et al. Gastrointestinal Bleeding in Patients with Severe SARS-CoV-2. Am J Gastroenterol. 2020; 115(8): 1283-5.
23. Martin TA, Wan DW, Hajifathalian K et al. Gastrointestinal Bleeding in Patients With Coronavirus Disease 2019: A Matched Case-Control Study. Am J Gastroenterol. 2020; 115(10): 1609-16.
24. Han C, Duan C, Zhang S et al. Digestive symptoms in COVID-19 patients with mild disease severity: clinical presentation, stool viral RNA testing, and outcomes. Am J Gastroenterol. 2020; 115(6): 916-23.
25. Deidda S, Tora L, Firinu D et al. Gastrointestinal coronavirus disease 2019: epidemiology, clinical features, pathogenesis, prevention, and management. Exp Rev Gastroenterol Hepatol. 2021; 15(1): 41-50.
26. Li J, Li C, Wang X et al. Considerations and perspectives on digestive diseases during the COVID-19 pandemic: a narrative review. Ann Palliat Med. 2021; 10(4): 4858-67.
27. Beigmohammadi MT, Jahanbin B, Safaei M et al. Pathological findings of postmortem biopsies from lung, heart, and liver of 7 deceased COVID-19 patients. Int J Surg Pathol. 2021; 29(2): 135-45.
28. Almario CV, Chey WD, Spiegel B. Increased risk of COVID-19 among users of proton pump inhibitors. Am J Gastroenterol. 2020; 115(10): 1707-15.
29. Lee SW, Ha EK, Yeniova AÖ et al. Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching. Gut. 2021; 70: 76-84.
30. Tastemur S, Ataseven H. Is it possible to use proton pump inhibitors in COVID-19 treatment and prophylaxis? Med Hypotheses. 2020; 143: 110018.
31. Spechler SJ. Proton pump inhibitors: What the internist needs to know. Med Clin N Am. 2019; 103(1): 1-14.
32. Hogan RB, Hogan RB, Cannon T et al. Dual-histamine receptor blockade with cetirizine – famotidine reduces pulmonary symptoms in COVID-19 patients. Pulm Pharmacol Ther. 2020; 63: 101942.
33. Dąbrowski A. Bezpieczeństwo stosowania inhibitorów pompy protonowej. Med Prakt. 2019; 7-8: 128-30.
34. Alberca GGF, Solis-Castro RS, Solis-Castro MR. Coronavirus disease-2019 and the intestinal tract: An overview. World J Gastroenterol. 2021; 27(13): 1255-66.
35. Barazzoni R, Bischoff SC, Breda J et al. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clin Nutr. 2020; 39(6): 1631-8.
36. Rishi P, Thakur K, Vij S et al. Diet, gut microbiota and COVID-19. Indian J Microbiol. 2020; 60(4): 1-10.
37. Wei PF. Diagnosis and treatment protocol for novel coronavirus pneumonia (trial version 7). Chin Med J (Engl). 2020; 133(9): 1087-95.
38. Segal JP, Mak JWY, Mullish BH et al. The gut microbiome: an under-recognised contributor to the COVID-19 pandemic? Therap Adv Gastroenterol. 2020; 13: 1756284820974914.
39. Marek T, Reguła J, Kamiński MF et al. Wytyczne Polskiego Towarzystwa Gastroenterologii i Konsultanta Krajowego w dziedzinie gastroenterologii dotyczące wykonywania endoskopii przewodu pokarmowego w związku z epidemią COVID-19 (z dnia 16.03.2020 roku). Gastroenterol Klin. 2020; 12(1): 1-6.
40. Fligor SC, Wang S, Allar BG et al. Gastrointestinal malignancies and the COVID-19 pandemic: evidence-based triage to surgery. J Gastrointest Surg. 2020; 24(10): 2357-73.
41. Glasbey JC, Nepogodiev D, Simoes JFF et al. Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: an international, multicenter, comparative cohort study. J Clin Oncol. 2021; 39(1): 66-78.
42. Greenhalgh T, Knight M, A’Court C et al. Management of post-acute covid-19 in primary care. BMJ. 2020; 370: m3026.
43. Shah W, Hillman T, Playford ED et al. Managing the long term effects of covid-19: summary of NICE, SIGN, and RCGP rapid guideline. BMJ. 2021; 372: n136.
44. Oshima T, Siah KTH, Yoshimoto T et al. Impacts of the COVID‐19 pandemic on functional dyspepsia and irritable bowel syndrome: A population- based survey. J Gastroenterol Hepatol. 2020. http://doi.org/10.1111/jgh.15346.
45. Kountouras J, Chatzopoulos D, Zavos C et al. Efficacy of trimebutine therapy in patients with gastroesophageal reflux disease and irritablebowel syndrome. Hepatogastroenterology. 2002; 49(43): 193-7.