Tags

Type your tag names separated by a space and hit enter

COVID-19 pandemic: Pathophysiology and manifestations from the gastrointestinal tract.
World J Gastroenterol. 2020 Aug 21; 26(31):4579-4588.WJ

Abstract

The pandemic of coronavirus disease 2019 (COVID-19), caused by a newly identified β-coronavirus (SARS-CoV-2) has emerged as a dire health problem, causing a massive crisis for global health. Primary method of transmission was firstly thought to be animal to human transmission. However, it has been observed that the virus is transmitted from human to human via respiratory droplets. Interestingly, SARS-CoV-2 ribonucleic acid (RNA) has been isolated from patient stools, suggesting a possible gastrointestinal (GI) involvement. Most commonly reported clinical manifestations are fever, fatigue and dry cough. Interestingly, a small percentage of patients experience GI symptoms with the most common being anorexia, diarrhea, nausea and vomiting. The presence of viral RNA in stools is also common and fecal tests can be positive even after negative respiratory samples. The exact incidence of digestive symptoms is a matter of debate. The distribution of Angiotensin converting enzyme type 2 receptors in multiple organs in the body provides a possible explanation for the digestive symptoms' mechanism. Cases with solely GI symptoms have been reported in both adults and children. Viral RNA has also been detected in stool and blood samples, indicating the possibility of liver damage, which has been reported in COVID-19 patients. The presence of chronic liver disease appears to be a risk factor for severe complications and a poorer prognosis, however data from these cases is lacking. The aim of this review is firstly, to briefly update what is known about the origin and the transmission of SARS-CoV-2, but mainly to focus on the manifestations of the GI tract and their pathophysiological background, so that physicians on the one hand, not to underestimate or disregard digestive symptoms due to the small number of patients exhibiting exclusively this symptomatology and on the other, to have SARS-CoV-2 on their mind when the "gastroenteritis" type symptoms predominate.

Authors+Show Affiliations

Department of Gastroenterology, 401 General Military Hospital of Athens, Athens 11525, Attiki, Greece.Department of Gastroenterology, Evangelismos, Ophthalmiatreion Athinon and Polyclinic Hospitals, Athens 10676, Attiki, Greece.Medical Office of Hellenic Army General Staff, 401 General Military Hospital of Athens, Athens 11525, Attiki, Greece.Medical Office of Hellenic Army General Staff, 401 General Military Hospital of Athens, Athens 11525, Attiki, Greece.Department of Gastroenterology, Evangelismos, Ophthalmiatreion Athinon and Polyclinic Hospitals, Athens 10676, Attiki, Greece.Department of Oncology, 401 General Military Hospital of Athens, Athens 11525, Attiki, Greece.Department of Gastroenterology, Evangelismos, Ophthalmiatreion Athinon and Polyclinic Hospitals, Athens 10676, Attiki, Greece.Department of Gastroenterology, 401 General Military Hospital of Athens, Athens 11525, Attiki, Greece.Department of Gastroenterology, Evangelismos, Ophthalmiatreion Athinon and Polyclinic Hospitals, Athens 10676, Attiki, Greece. galanopoulosdr@gmail.com.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32884218

Citation

Galanopoulos, Michail, et al. "COVID-19 Pandemic: Pathophysiology and Manifestations From the Gastrointestinal Tract." World Journal of Gastroenterology, vol. 26, no. 31, 2020, pp. 4579-4588.
Galanopoulos M, Gkeros F, Doukatas A, et al. COVID-19 pandemic: Pathophysiology and manifestations from the gastrointestinal tract. World J Gastroenterol. 2020;26(31):4579-4588.
Galanopoulos, M., Gkeros, F., Doukatas, A., Karianakis, G., Pontas, C., Tsoukalas, N., Viazis, N., Liatsos, C., & Mantzaris, G. J. (2020). COVID-19 pandemic: Pathophysiology and manifestations from the gastrointestinal tract. World Journal of Gastroenterology, 26(31), 4579-4588. https://doi.org/10.3748/wjg.v26.i31.4579
Galanopoulos M, et al. COVID-19 Pandemic: Pathophysiology and Manifestations From the Gastrointestinal Tract. World J Gastroenterol. 2020 Aug 21;26(31):4579-4588. PubMed PMID: 32884218.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - COVID-19 pandemic: Pathophysiology and manifestations from the gastrointestinal tract. AU - Galanopoulos,Michail, AU - Gkeros,Filippos, AU - Doukatas,Aris, AU - Karianakis,Grigorios, AU - Pontas,Christos, AU - Tsoukalas,Nikolaos, AU - Viazis,Nikos, AU - Liatsos,Christos, AU - Mantzaris,Gerassimos J, PY - 2020/05/06/received PY - 2020/06/02/revised PY - 2020/08/12/accepted PY - 2020/9/5/entrez PY - 2020/9/5/pubmed PY - 2020/9/10/medline KW - ACE2 receptors and COVID-19 KW - COVID-19 KW - COVID-19 and gastrointestinal pathophysiology KW - COVID-19 gastrointestinal manifestations KW - COVID-19 on chronic liver diseases KW - Gastrointestinal tract KW - SARS-CoV-2 SP - 4579 EP - 4588 JF - World journal of gastroenterology JO - World J Gastroenterol VL - 26 IS - 31 N2 - The pandemic of coronavirus disease 2019 (COVID-19), caused by a newly identified β-coronavirus (SARS-CoV-2) has emerged as a dire health problem, causing a massive crisis for global health. Primary method of transmission was firstly thought to be animal to human transmission. However, it has been observed that the virus is transmitted from human to human via respiratory droplets. Interestingly, SARS-CoV-2 ribonucleic acid (RNA) has been isolated from patient stools, suggesting a possible gastrointestinal (GI) involvement. Most commonly reported clinical manifestations are fever, fatigue and dry cough. Interestingly, a small percentage of patients experience GI symptoms with the most common being anorexia, diarrhea, nausea and vomiting. The presence of viral RNA in stools is also common and fecal tests can be positive even after negative respiratory samples. The exact incidence of digestive symptoms is a matter of debate. The distribution of Angiotensin converting enzyme type 2 receptors in multiple organs in the body provides a possible explanation for the digestive symptoms' mechanism. Cases with solely GI symptoms have been reported in both adults and children. Viral RNA has also been detected in stool and blood samples, indicating the possibility of liver damage, which has been reported in COVID-19 patients. The presence of chronic liver disease appears to be a risk factor for severe complications and a poorer prognosis, however data from these cases is lacking. The aim of this review is firstly, to briefly update what is known about the origin and the transmission of SARS-CoV-2, but mainly to focus on the manifestations of the GI tract and their pathophysiological background, so that physicians on the one hand, not to underestimate or disregard digestive symptoms due to the small number of patients exhibiting exclusively this symptomatology and on the other, to have SARS-CoV-2 on their mind when the "gastroenteritis" type symptoms predominate. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/32884218/COVID_19_pandemic:_Pathophysiology_and_manifestations_from_the_gastrointestinal_tract_ L2 - https://www.wjgnet.com/1007-9327/full/v26/i31/4579.htm DB - PRIME DP - Unbound Medicine ER -