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Temporal Correlation Between Neurological and Gastrointestinal Symptoms of SARS-CoV-2.
Inflamm Bowel Dis. 2020 07 17; 26(8):e89-e91.IB

Abstract

Severe Acute Respiratory Syndrome Coronavirus-2 (SAR-CoV-2) has been shown to invade brain tissue. Based on the evolutionary similarity with SARS-CoV, researchers propose that SARS-CoV-2 can invade the olfactory bulb and gastrointestinal (GI) system through angiotensin-converting enzyme 2. However, how SARS-CoV-2 causes neurological or GI symptoms is not clear. Many suggested intestinal and neural inflammations, caused by viral invasion, as the most likely reason for the GI and neurological symptoms; however, the patients with coronavirus disease 2019 (COVID-19) without neurological or GI symptoms indicate that this is not the case. The gut-brain axis could explain the reason for why some with COVID-19 do not have these symptoms. COVID-19 patients mostly show respiratory distress first, then diarrhea, anorexia, stroke, or loss of consciousness comes into view. Obviously, GI invasion is a mechanical process that begins with oral invasion and, therefore, most probably exists before the brain invasion, as indicated in case reports. However, when the GI tract is invaded, the virus may enter the central nervous system through vascular and lymphatic systems or the vagal nerve. SARS-CoV-2 can infect leukocytes and migrate with them into the brain, or the viral particles can be directly transported across the blood-brain barrier to the brain. Also, more recent research has revealed that SARS-CoV-2 can invade the peripheral lymphatic vessels connecting with the glymphatic system of the brain. The temporal correlation between neurological and gastrointestinal symptoms suggests the lymph vessels around the GI tract, the vascular system, or the gut-brain axis (enteric nervous system) as the most likely entry route for SARS-CoV-2 to the brain.

Authors+Show Affiliations

Elysium Health Center, Gaziantep, Turkey.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32440692

Citation

Bostancıklıoğlu, Mehmet. "Temporal Correlation Between Neurological and Gastrointestinal Symptoms of SARS-CoV-2." Inflammatory Bowel Diseases, vol. 26, no. 8, 2020, pp. e89-e91.
Bostancıklıoğlu M. Temporal Correlation Between Neurological and Gastrointestinal Symptoms of SARS-CoV-2. Inflamm Bowel Dis. 2020;26(8):e89-e91.
Bostancıklıoğlu, M. (2020). Temporal Correlation Between Neurological and Gastrointestinal Symptoms of SARS-CoV-2. Inflammatory Bowel Diseases, 26(8), e89-e91. https://doi.org/10.1093/ibd/izaa131
Bostancıklıoğlu M. Temporal Correlation Between Neurological and Gastrointestinal Symptoms of SARS-CoV-2. Inflamm Bowel Dis. 2020 07 17;26(8):e89-e91. PubMed PMID: 32440692.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Temporal Correlation Between Neurological and Gastrointestinal Symptoms of SARS-CoV-2. A1 - Bostancıklıoğlu,Mehmet, PY - 2020/5/23/pubmed PY - 2020/7/28/medline PY - 2020/5/23/entrez KW - COVID-19 KW - SARS-CoV-2 KW - anorexia KW - gastrointestinal symptoms KW - gut-brain axis KW - neurological symptoms SP - e89 EP - e91 JF - Inflammatory bowel diseases JO - Inflamm Bowel Dis VL - 26 IS - 8 N2 - Severe Acute Respiratory Syndrome Coronavirus-2 (SAR-CoV-2) has been shown to invade brain tissue. Based on the evolutionary similarity with SARS-CoV, researchers propose that SARS-CoV-2 can invade the olfactory bulb and gastrointestinal (GI) system through angiotensin-converting enzyme 2. However, how SARS-CoV-2 causes neurological or GI symptoms is not clear. Many suggested intestinal and neural inflammations, caused by viral invasion, as the most likely reason for the GI and neurological symptoms; however, the patients with coronavirus disease 2019 (COVID-19) without neurological or GI symptoms indicate that this is not the case. The gut-brain axis could explain the reason for why some with COVID-19 do not have these symptoms. COVID-19 patients mostly show respiratory distress first, then diarrhea, anorexia, stroke, or loss of consciousness comes into view. Obviously, GI invasion is a mechanical process that begins with oral invasion and, therefore, most probably exists before the brain invasion, as indicated in case reports. However, when the GI tract is invaded, the virus may enter the central nervous system through vascular and lymphatic systems or the vagal nerve. SARS-CoV-2 can infect leukocytes and migrate with them into the brain, or the viral particles can be directly transported across the blood-brain barrier to the brain. Also, more recent research has revealed that SARS-CoV-2 can invade the peripheral lymphatic vessels connecting with the glymphatic system of the brain. The temporal correlation between neurological and gastrointestinal symptoms suggests the lymph vessels around the GI tract, the vascular system, or the gut-brain axis (enteric nervous system) as the most likely entry route for SARS-CoV-2 to the brain. SN - 1536-4844 UR - https://www.unboundmedicine.com/medline/citation/32440692/Temporal_Correlation_Between_Neurological_and_Gastrointestinal_Symptoms_of_SARS_CoV_2_ L2 - https://academic.oup.com/ibdjournal/article-lookup/doi/10.1093/ibd/izaa131 DB - PRIME DP - Unbound Medicine ER -