Abstract
As a new infectious disease, COVID-19 is spread through the respiratory tract in most cases. Its source and pathological mechanism are not clear. The most common clinical feature is pulmonary infection. Also, a lot patients have gastrointestinal symptoms. Angiotensin-converting enzyme 2 (ACE2) is a functional cellular receptor for SARS-CoV-2, which is like SARS-CoV, a coronavirus associated with severe acute respiratory syndrome (SARS) outbreak in 2003. The tissues and cells expressing ACE2 are potential targets for SARS-CoV-2 infection, and the high expression of ACE2 in intestinal epithelial cells marks that SARS-CoV-2 may directly infect intestinal epithelial cells. Recent studies also suggest that SARS-CoV-2 existed and replicated in intestinal environment for a long time. The interaction between SARS-CoV-2 and RAS system leads to the decrease of local anti-inflammatory ability. The virus cycle leads to excessive imbalance of immune response and cytokine release. The downregulation of ACE2 after viral infection leads to gastrointestinal dysfunction. The above are the causes of gastrointestinal symptoms. Here, we reviewed the possible causes and mechanisms of gastrointestinal symptoms caused by COVID-19. Additionally, we discussed the influence of gastrointestinal symptoms on the prognosis of patients.
Highlights
Since the end of 2019, COVID-19 has begun to spread rapidly around the world [1]
that gastrointestinal tissues are susceptible to SARS-CoV-2
It is very necessary for gastroenterologists to understand
Summary
Since the end of 2019, COVID-19 has begun to spread rapidly around the world [1]. Recent studies showed the persistent positive rate of SARS-CoV-2 in stool specimens of patients with COVID-19 [2]. The inflammation caused by viral infection was severe, the intestinal damage was aggravated, and the incidence of acute gastrointestinal injury was as high as 86.7% [130], and it often indicated a higher mortality rate [130,131,132,133,134]. This suggested a vicious cycle between the intestinal damage caused by SARSCoV-2 and the inflammatory response caused by it. Patients with symptoms should take timely and effective preventive measures to prevent the hidden spread of the virus in the population
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