COVID-19 and gastroenterological pathology. Review

Abstract

SARS‑CoV‑2 has led to numerous cases of coronavirus disease (COVID‑19) around the world. In addition to fever and respiratory symptoms, some COVID‑19 patients also have manifestations from digestive system. On the other hand, patients with chronic diseases of the gastrointestinal tract (GIT) also suffer from coronavirus disease.
 Objective — to provide an understanding of the characteristics, possible mechanisms and consequences of gastrointestinal damage caused by SARS‑CoV‑2 infection, in particular in patients with gastrointestinal tract pathology.
 Literature search was carried out using such databases as Scopus, Web of Science. Clinical studies of patients with COVID‑19 have shown that gastrointestinal (GI) symptoms such as anorexia, nausea, vomiting, abdominal pain and diarrhea precede or follow respiratory syndromes with a frequency of about 10 to 60%. Literary sources were studied regarding the relationship of COVID‑19 and such gastroenterological pathologies as gastrointestinal bleeding, hepatitis, pancreatitis and inflammatory bowel diseases. Lesions of the digestive system both in patients without chronic pathology and with existing diseases, apparently, are associated with a high concentration of angiotensin converting enzyme 2 (ACE2) throughout the entire GIT, including the intestine, liver, and pancreas. Some studies have shown that the spike (S) SARS‑CoV‑2 protein has a high affinity for human ACE2, while SARS‑CoV‑2 mainly enters cells through the ACE2 receptor. In addition, endothelial injury and thrombus inflammation and dysregulated immune responses may contribute to extrapulmonary manifestations of COVID 19. This requires an appropriate correction of the diagnostic search and therapy.