Gastrointestinal implications in COVID-19.
Dushyant Singh DahiyaAsim KichlooMichael Stanley AlbostaSukrut PagadFarah WaniPublished in: Journal of investigative medicine : the official publication of the American Federation for Clinical Research (2020)
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.
Keyphrases
- sars cov
- coronavirus disease
- respiratory syndrome coronavirus
- endothelial cells
- healthcare
- heart failure
- magnetic resonance
- angiotensin ii
- south africa
- induced pluripotent stem cells
- case report
- atrial fibrillation
- working memory
- computed tomography
- brain injury
- resting state
- blood brain barrier
- gestational age
- cerebral ischemia