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The mechanism and treatment of gastrointestinal symptoms in patients with COVID-19.
Am J Physiol Gastrointest Liver Physiol. 2020 08 01; 319(2):G245-G252.AJ

Abstract

In addition to the typical respiratory response, new coronavirus disease 2019 (COVID-19) is also associated with very common gastrointestinal symptoms. Cases with gastrointestinal symptoms are more likely to be complicated by liver injury and acute respiratory distress syndrome (ARDS). If not treated in time, coma and circulatory failure may ensue. As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects the human body through the combination of angiotensin-converting enzyme 2 (ACE2) in the gastrointestinal tract, the mechanism underlying the gastrointestinal symptoms may involve damage to the intestinal mucosal barrier and promotion of the production of inflammatory factors. Indeed, after cells in the lungs become infected by SARS-CoV-2, effector CD4+ T cells reach the small intestine through the gut-lung axis, causing intestinal immune damage and diarrhea; early extensive use of antibacterial and antiviral drugs can also lead to diarrhea in patients. Thus, treatment options for COVID-19 patients should be promptly adjusted when they have gastrointestinal symptoms. As SARS-CoV-2 has been detected in the feces of COVID-19 patients, future prevention and control efforts must consider the possibility of fecal-oral transmission of the virus.

Authors+Show Affiliations

National Clinical Research Center for Child Health, National Children's Regional Medical Center, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.National Clinical Research Center for Child Health, National Children's Regional Medical Center, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China. College of Medical Technology, Zhejiang Chinese Medical University. Hangzhou, China.College of Medical Technology, Zhejiang Chinese Medical University. Hangzhou, China.College of Medical Technology, Zhejiang Chinese Medical University. Hangzhou, China.National Clinical Research Center for Child Health, National Children's Regional Medical Center, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32639848

Citation

Ye, Qing, et al. "The Mechanism and Treatment of Gastrointestinal Symptoms in Patients With COVID-19." American Journal of Physiology. Gastrointestinal and Liver Physiology, vol. 319, no. 2, 2020, pp. G245-G252.
Ye Q, Wang B, Zhang T, et al. The mechanism and treatment of gastrointestinal symptoms in patients with COVID-19. Am J Physiol Gastrointest Liver Physiol. 2020;319(2):G245-G252.
Ye, Q., Wang, B., Zhang, T., Xu, J., & Shang, S. (2020). The mechanism and treatment of gastrointestinal symptoms in patients with COVID-19. American Journal of Physiology. Gastrointestinal and Liver Physiology, 319(2), G245-G252. https://doi.org/10.1152/ajpgi.00148.2020
Ye Q, et al. The Mechanism and Treatment of Gastrointestinal Symptoms in Patients With COVID-19. Am J Physiol Gastrointest Liver Physiol. 2020 08 1;319(2):G245-G252. PubMed PMID: 32639848.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The mechanism and treatment of gastrointestinal symptoms in patients with COVID-19. AU - Ye,Qing, AU - Wang,Bili, AU - Zhang,Ting, AU - Xu,Jian, AU - Shang,Shiqiang, Y1 - 2020/07/08/ PY - 2020/7/9/pubmed PY - 2020/8/25/medline PY - 2020/7/9/entrez KW - COVID-19 KW - SARS-CoV-2 KW - gastrointestinal symptoms SP - G245 EP - G252 JF - American journal of physiology. Gastrointestinal and liver physiology JO - Am J Physiol Gastrointest Liver Physiol VL - 319 IS - 2 N2 - In addition to the typical respiratory response, new coronavirus disease 2019 (COVID-19) is also associated with very common gastrointestinal symptoms. Cases with gastrointestinal symptoms are more likely to be complicated by liver injury and acute respiratory distress syndrome (ARDS). If not treated in time, coma and circulatory failure may ensue. As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects the human body through the combination of angiotensin-converting enzyme 2 (ACE2) in the gastrointestinal tract, the mechanism underlying the gastrointestinal symptoms may involve damage to the intestinal mucosal barrier and promotion of the production of inflammatory factors. Indeed, after cells in the lungs become infected by SARS-CoV-2, effector CD4+ T cells reach the small intestine through the gut-lung axis, causing intestinal immune damage and diarrhea; early extensive use of antibacterial and antiviral drugs can also lead to diarrhea in patients. Thus, treatment options for COVID-19 patients should be promptly adjusted when they have gastrointestinal symptoms. As SARS-CoV-2 has been detected in the feces of COVID-19 patients, future prevention and control efforts must consider the possibility of fecal-oral transmission of the virus. SN - 1522-1547 UR - https://www.unboundmedicine.com/medline/citation/32639848/The_mechanism_and_treatment_of_gastrointestinal_symptoms_in_patients_with_COVID_19_ L2 - https://journals.physiology.org/doi/10.1152/ajpgi.00148.2020?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -