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Article ; Online: Gastrointestinal symptoms, pathophysiology, and treatment in COVID-19.

Zhang, Jilei / Garrett, Shari / Sun, Jun

2020 Volume 8, Issue 4, Page(s) 385–400

Abstract: ... This article focuses on gastrointestinal symptoms and pathophysiology in COVID-19 disease. Evidence suggests ... COVID-19 disease, gastrointestinal symptoms and intestinal microbiota. The potential oral-fecal ... and control, as well as diagnosis and treatment of the COVID-19 disease. ...

Abstract	The novel coronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has emerged and is responsible for the Coronavirus Disease 2019 global pandemic. Coronaviruses, including SARS-CoV-2, are strongly associated with respiratory symptoms during infection, but gastrointestinal symptoms, such as diarrhea, vomiting, nausea, and abdominal pain, have been identified in subsets of COVID-19 patients. This article focuses on gastrointestinal symptoms and pathophysiology in COVID-19 disease. Evidence suggests that the gastrointestinal tract could be a viral target for SARS-CoV-2 infection. Not only is the SARS-CoV-2 receptor ACE2 highly expressed in the GI tract and is associated with digestive symptoms, but bleeding and inflammation are observed in the intestine of COVID-19 patients. We further systemically summarize the correlation between COVID-19 disease, gastrointestinal symptoms and intestinal microbiota. The potential oral-fecal transmission of COVID-19 was supported by viral RNA and live virus detection in the feces of COVID-19 patients. Additionally, the viral balance in the GI tract could be disordered during SARS-CoV-2 infection which could further impact the homeostasis of the gut microbial flora. Finally, we discuss the clinical and ongoing trials of treatments/therapies, including antiviral drugs, plasma transfusion and immunoglobulins, and diet supplementations for COVID-19. By reviewing the pathogenesis of SARS-CoV-2 virus, and understanding the correlation among COVID-19, inflammation, intestinal microbiota, and lung microbiota, we provide perspective in prevention and control, as well as diagnosis and treatment of the COVID-19 disease.
Language	English
Publishing date	2020-09-05
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2821806-1
ISSN	2352-3042 ; 2352-3042
ISSN (online)	2352-3042
ISSN	2352-3042
DOI	10.1016/j.gendis.2020.08.013
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Gastrointestinal symptoms, pathophysiology, and treatment in COVID-19

Jilei Zhang / Shari Garrett / Jun Sun

Genes and Diseases, Vol 8, Iss 4, Pp 385-

2021 Volume 400

Abstract	The novel coronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has emerged and is responsible for the Coronavirus Disease 2019 global pandemic. Coronaviruses, including SARS-CoV-2, are strongly associated with respiratory symptoms during infection, but gastrointestinal symptoms, such as diarrhea, vomiting, nausea, and abdominal pain, have been identified in subsets of COVID-19 patients. This article focuses on gastrointestinal symptoms and pathophysiology in COVID-19 disease. Evidence suggests that the gastrointestinal tract could be a viral target for SARS-CoV-2 infection. Not only is the SARS-CoV-2 receptor ACE2 highly expressed in the GI tract and is associated with digestive symptoms, but bleeding and inflammation are observed in the intestine of COVID-19 patients. We further systemically summarize the correlation between COVID-19 disease, gastrointestinal symptoms and intestinal microbiota. The potential oral-fecal transmission of COVID-19 was supported by viral RNA and live virus detection in the feces of COVID-19 patients. Additionally, the viral balance in the GI tract could be disordered during SARS-CoV-2 infection which could further impact the homeostasis of the gut microbial flora. Finally, we discuss the clinical and ongoing trials of treatments/therapies, including antiviral drugs, plasma transfusion and immunoglobulins, and diet supplementations for COVID-19. By reviewing the pathogenesis of SARS-CoV-2 virus, and understanding the correlation among COVID-19, inflammation, intestinal microbiota, and lung microbiota, we provide perspective in prevention and control, as well as diagnosis and treatment of the COVID-19 disease.
Keywords	ACE-2 ; COVID-19 ; Cytokine ; GI symptoms ; Inflammation ; Microbiota ; Medicine (General) ; R5-920 ; Genetics ; QH426-470
Subject code	610
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Gastrointestinal symptoms, pathophysiology, and treatment in COVID-19

Zhang, Jilei / Garrett, Shari / Sun, Jun

Genes & Diseases ; ISSN 2352-3042

2020

Keywords	covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
DOI	10.1016/j.gendis.2020.08.013
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Gastrointestinal Symptoms, Pathophysiology, and Treatment in COVID-19

Zhang, Jilei / Garrett, Shari / Sun, Jun

Genes & Diseases

Abstract: ... This article focuses on gastrointestinal symptoms and pathophysiology in COVID-19 disease Evidence suggests ... COVID-19 disease, gastrointestinal symptoms and intestinal microbiota The potential oral-fecal ... control, as well as diagnosis and treatment of the COVID-19 disease ...

Abstract	The novel coronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has emerged and is responsible for the Coronavirus Disease 20191 global pandemic Coronaviruses, including SARS-CoV-2, are strongly associated with respiratory symptoms during infection, but gastrointestinal symptoms, such as diarrhea, vomiting, nausea, and abdominal pain, have been identified in subsets of COVID-19 patients This article focuses on gastrointestinal symptoms and pathophysiology in COVID-19 disease Evidence suggests that the gastrointestinal tract could be a viral target for SARS-CoV-2 infection Not only is the SARS-CoV-2 receptor ACE2 highly expressed in the GI tract and is associated with digestive symptoms, but bleeding and inflammation are observed in the intestine of COVID-19 patients We further systemically summarized the correlation between COVID-19 disease, gastrointestinal symptoms and intestinal microbiota The potential oral-fecal transmission of COVID-19 was supported by viral RNA and live virus detection in the feces of COVID-19 patients Additionally, the viral balance in the GI tract could be disordered during SARS-CoV-2 infection which could further impact the homeostasis of the gut microbial flora Finally, we discuss the clinical and ongoing trials of treatments/therapies, including antiviral drugs, plasma transfusion and immunoglobulins, and diet supplementations for COVID-19 By reviewing the pathogenesis of SARS-CoV-2 virus, and understanding the correlation between COVID-19, GI health and the intestinal microbiota, we provide perspective in prevention and control, as well as diagnosis and treatment of the COVID-19 disease
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #743975
Database	COVID19

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Article ; Online: Gastrointestinal manifestations in COVID-19.

Kariyawasam, Jayani C / Jayarajah, Umesh / Riza, Rishdha / Abeysuriya, Visula / Seneviratne, Suranjith L

Transactions of the Royal Society of Tropical Medicine and Hygiene

2021 Volume 115, Issue 12, Page(s) 1362–1388

Abstract: ... of COVID-19-associated GI symptoms are mild and self-limiting and include anorexia, diarrhoea, nausea ... the gastrointestinal (GI) system. In this review we outline the important GI manifestations of COVID-19 and discuss ... reported in 11.4-61.1% of individuals with COVID-19, with variable onset and severity. The majority ...

Abstract	Coronavirus disease 2019 (COVID-19), a respiratory viral infection, has affected more than 78 million individuals worldwide as of the end of December 2020. Previous studies reported that severe acute respiratory syndrome coronavirus 1 and Middle East respiratory syndrome-related coronavirus infections may affect the gastrointestinal (GI) system. In this review we outline the important GI manifestations of COVID-19 and discuss the possible underlying pathophysiological mechanisms and their diagnosis and management. GI manifestations are reported in 11.4-61.1% of individuals with COVID-19, with variable onset and severity. The majority of COVID-19-associated GI symptoms are mild and self-limiting and include anorexia, diarrhoea, nausea, vomiting and abdominal pain/discomfort. A minority of patients present with an acute abdomen with aetiologies such as acute pancreatitis, acute appendicitis, intestinal obstruction, bowel ischaemia, haemoperitoneum or abdominal compartment syndrome. Severe acute respiratory syndrome coronavirus 2 RNA has been found in biopsies from all parts of the alimentary canal. Involvement of the GI tract may be due to direct viral injury and/or an inflammatory immune response and may lead to malabsorption, an imbalance in intestinal secretions and gut mucosal integrity and activation of the enteric nervous system. Supportive and symptomatic care is the mainstay of therapy. However, a minority may require surgical or endoscopic treatment for acute abdomen and GI bleeding.
MeSH term(s)	Acute Disease ; COVID-19 ; Gastrointestinal Tract ; Humans ; Pancreatitis ; SARS-CoV-2
Language	English
Publishing date	2021-03-03
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	441375-1
ISSN	1878-3503 ; 0035-9203
ISSN (online)	1878-3503
ISSN	0035-9203
DOI	10.1093/trstmh/trab042
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Article ; Online: Gastrointestinal bleeding in patients with COVID-19: an integrative review.

Costa, Ana Clara Freitas Galvão Soares DA / Fonseca Neto, Olival Cirilo Lucena DA

Revista do Colegio Brasileiro de Cirurgioes

2024 Volume 51, Page(s) e20243600

Abstract: ... Early recognition of symptoms and suspicion of gastrointestinal involvement allows better management of patients and ... manifestations, but there is involvement of the gastrointestinal tract, causing symptoms ranging from mild ... of gastrointestinal bleeding.: Conclusion: The presence of gastrointestinal bleeding in patients with COVID-19 is ...

Abstract	Introduction: In 2020, the world suffered a major impact from the COVID-19 pandemic, especially due to the high transmissibility of the virus. It is a disease that predominates with respiratory manifestations, but there is involvement of the gastrointestinal tract, causing symptoms ranging from mild to more severe. Highlighting gastrointestinal bleeding, it is a symptom resulting from the involvement of the SARS-CoV-2 virus described by several reports and case series. Methods: through an integrative literature review, of a qualitative nature, works that corresponded to the eligibility criteria were selected, totaling 16 articles included in this review. Results: of the patients who manifested gastrointestinal symptoms associated with the disease, common comorbidities and clinical manifestations were identified, in addition to therapies used to treat the infection, which were predisposing factors for the development of gastrointestinal bleeding. Conclusion: The presence of gastrointestinal bleeding in patients with COVID-19 is established in the literature, since the pathophysiological mechanisms of the disease directly affect the GIT. Early recognition of symptoms and suspicion of gastrointestinal involvement allows better management of patients and complications.
MeSH term(s)	Humans ; COVID-19/complications ; Gastrointestinal Hemorrhage/etiology ; SARS-CoV-2 ; Risk Factors
Language	Portuguese
Publishing date	2024-05-06
Publishing country	Brazil
Document type	Journal Article ; Review
ZDB-ID	2223714-8
ISSN	1809-4546 ; 1809-4546
ISSN (online)	1809-4546
ISSN	1809-4546
DOI	10.1590/0100-6991e-20243600-en
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Article ; Online: Gastrointestinal implications in COVID-19.

Dahiya, Dushyant Singh / Kichloo, Asim / Albosta, Michael / Pagad, Sukrut / Wani, Farah

Journal of investigative medicine : the official publication of the American Federation for Clinical Research

2020 Volume 68, Issue 8, Page(s) 1397–1401

Abstract: ... in China, the COVID-19 has had an unprecedented and catastrophic impact on humanity, with the WHO declaring ... organ-specific viral loads to compare and contrast with other organ systems. We briefly detail specific treatment ... it a global pandemic. Although the first case of COVID-19 was reported in December 2019, the primary source ...

Abstract	Believed to have originated from a local Huanan Seafood Wholesale Market in Wuhan, Hubei Province in China, the COVID-19 has had an unprecedented and catastrophic impact on humanity, with the WHO declaring it a global pandemic. Although the first case of COVID-19 was reported in December 2019, the primary source and intermediate host have not been confirmed, but human-to-human transmission has been universally accepted. The main mode of transmission of the virus is through respiratory droplets along with prominent respiratory system involvement. However, fecal-oral transmission due to the shedding of the virus in the gastrointestinal (GI) tract may continue for up to 10 weeks after respiratory clearance and is fast becoming important. SARS-CoV-2 shows a high affinity to ACE2 receptors, making sites of high ACE2 receptor expression, such as lungs, GI tract, brain, kidneys, heart, liver and immune system, a prime target for infection. Through this literature review, we aim to summarize the current knowledge of immunological pathways that contribute to the disease with a focus specifically on the GI tract involvement. We direct attention to the pathophysiological mechanism of involvement of the GI tract leading to symptomatic manifestations, track GI organ-specific viral loads to compare and contrast with other organ systems. We briefly detail specific treatment strategies from a GI disease standpoint and mention special considerations when there is involvement of the GI tract.
MeSH term(s)	COVID-19/complications ; Gastrointestinal Diseases/complications ; Gastrointestinal Diseases/physiopathology ; Humans ; Practice Guidelines as Topic ; SARS-CoV-2/physiology ; Viral Load ; Virus Internalization
Keywords	covid19
Language	English
Publishing date	2020-09-14
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1217870-6
ISSN	1708-8267 ; 0009-9279 ; 1081-5589
ISSN (online)	1708-8267
ISSN	0009-9279 ; 1081-5589
DOI	10.1136/jim-2020-001559
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Article ; Online: Gastrointestinal implications in COVID-19

Dahiya, Dushyant Singh / Kichloo, Asim / Albosta, Michael / Pagad, Sukrut / Wani, Farah

Journal of Investigative Medicine

2020 , Page(s) jim–2020–001559

Abstract	Believed to have originated from a local Huanan Seafood Wholesale Market in Wuhan, Hubei Province in China, the COVID-19 has had an unprecedented and catastrophic impact on humanity, with the WHO declaring it a global pandemic. Although the first case of COVID-19 was reported in December 2019, the primary source and intermediate host have not been confirmed, but human-to-human transmission has been universally accepted. The main mode of transmission of the virus is through respiratory droplets along with prominent respiratory system involvement. However, fecal-oral transmission due to the shedding of the virus in the gastrointestinal (GI) tract may continue for up to 10 weeks after respiratory clearance and is fast becoming important. SARS-CoV-2 shows a high affinity to ACE2 receptors, making sites of high ACE2 receptor expression, such as lungs, GI tract, brain, kidneys, heart, liver and immune system, a prime target for infection. Through this literature review, we aim to summarize the current knowledge of immunological pathways that contribute to the disease with a focus specifically on the GI tract involvement. We direct attention to the pathophysiological mechanism of involvement of the GI tract leading to symptomatic manifestations, track GI organ-specific viral loads to compare and contrast with other organ systems. We briefly detail specific treatment strategies from a GI disease standpoint and mention special considerations when there is involvement of the GI tract.
Keywords	General Biochemistry, Genetics and Molecular Biology ; General Medicine ; covid19
Language	English
Publisher	BMJ
Publishing country	uk
Document type	Article ; Online
ISSN	1081-5589
DOI	10.1136/jim-2020-001559
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Gastrointestinal implications in COVID-19

Dahiya, Dushyant Singh / Kichloo, Asim / Albosta, Michael / Pagad, Sukrut / Wani, Farah

J. invest. med

Abstract	Believed to have originated from a local Huanan Seafood Wholesale Market in Wuhan, Hubei Province in China, the COVID-19 has had an unprecedented and catastrophic impact on humanity, with the WHO declaring it a global pandemic. Although the first case of COVID-19 was reported in December 2019, the primary source and intermediate host have not been confirmed, but human-to-human transmission has been universally accepted. The main mode of transmission of the virus is through respiratory droplets along with prominent respiratory system involvement. However, fecal-oral transmission due to the shedding of the virus in the gastrointestinal (GI) tract may continue for up to 10 weeks after respiratory clearance and is fast becoming important. SARS-CoV-2 shows a high affinity to ACE2 receptors, making sites of high ACE2 receptor expression, such as lungs, GI tract, brain, kidneys, heart, liver and immune system, a prime target for infection. Through this literature review, we aim to summarize the current knowledge of immunological pathways that contribute to the disease with a focus specifically on the GI tract involvement. We direct attention to the pathophysiological mechanism of involvement of the GI tract leading to symptomatic manifestations, track GI organ-specific viral loads to compare and contrast with other organ systems. We briefly detail specific treatment strategies from a GI disease standpoint and mention special considerations when there is involvement of the GI tract.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #768005
Database	COVID19

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Article ; Online: Symptomatology and microbiology of the gastrointestinal tract in post-COVID conditions.

Norouzi Masir, Mohamad / Shirvaliloo, Milad

JGH open : an open access journal of gastroenterology and hepatology

2022

Abstract: ... the prevalence of gastrointestinal symptoms and pathophysiology underlying possible infection of the gut ... in COVID-19 might have major implications for disease pathogenesis and treatment. This review discussed ... to the persistence of symptoms in COVID-19 long-haulers. Various manifestations of post-COVID conditions are general ...

Abstract	Post-COVID conditions, also known as post-acute sequelae of SARS-CoV-2 (PASC), refer to the persistence of symptoms in COVID-19 long-haulers. Various manifestations of post-COVID conditions are general symptoms and/or manifestations of damage in multiple organs. Besides, SARS-CoV-2 can involve the gastrointestinal tract, resulting in sequelae such as diarrhea, abdominal pain, nausea, anorexia, vomiting, constipation, abdominal distension, acid reflux, and/or gastrointestinal bleeding. Previous investigations point to SARS-CoV-2 entry into enterocytes enhances by the angiotensin-converting enzyme 2 (ACE2) receptors. Interestingly, ACE2 receptors are abundantly expressed in the gut, implying infection with SARS-CoV-2 might occur through this route as well as in the respiratory tract. According to mounting evidence, SARS-CoV-2 RNA has been identified in fecal specimens of patients with COVID-19 during and beyond the acute phase. In addition, studies have shown gut microbiome composition is altered in patients with PASC, hence, another putative mechanism linked to gastrointestinal symptoms is gut dysbiosis. The presence of the gut-lung axis in COVID-19 might have major implications for disease pathogenesis and treatment. This review discussed the prevalence of gastrointestinal symptoms and pathophysiology underlying possible infection of the gut in patients with PASC. Also, SARS-COV-2 induced NLRP3 inflammasome-dependent inflammatory pathways are briefly addressed.
Language	English
Publishing date	2022-08-25
Publishing country	Australia
Document type	Journal Article ; Review
ISSN	2397-9070
ISSN (online)	2397-9070
DOI	10.1002/jgh3.12811
Database	MEDical Literature Analysis and Retrieval System OnLINE

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