SARS-CoV-2-associated gastrointestinal and liver diseases: what is known and what is needed to explore

被引:5
作者
Sweed, Dina [1 ]
Abdelsameea, Eman [2 ]
Khalifa, Esraa A. [3 ]
Abdallah, Heba [4 ]
Moaz, Heba [5 ]
Moaz, Inas [6 ]
Abdelsattar, Shimaa [7 ]
Abdel-Rahman, Nadine [8 ]
Mosbeh, Asmaa [1 ]
Elmahdy, Hussein A. [9 ]
Sweed, Eman [10 ]
机构
[1] Menoufia Univ, Natl Liver Inst, Dept Pathol, Shibin Al Kawm 32511, Egypt
[2] Menoufia Univ, Natl Liver Inst, Dept Gastroenterol & Hepatol, Shibin Al Kawm, Egypt
[3] Menoufia Univ, Dept Radiol, Fac Med, Shibin Al Kawm, Egypt
[4] Menoufia Univ, Natl Liver Inst, Dept Clin Pathol, Shibin Al Kawm, Egypt
[5] Menoufia Univ, Dept Microbiol, Fac Med, Shibin Al Kawm, Egypt
[6] Menoufia Univ, Epidemiol & Prevent Med Dept, Shibin Al Kawm, Egypt
[7] Menoufia Univ, Natl Liver Inst, Clin Biochem & Mol Diagnost Dept, Shibin Al Kawm, Egypt
[8] Ohio State Coll Med, Columbus, OH USA
[9] Cairo Univ, Dept Biochem, Fac Sci, Giza, Egypt
[10] Menoufia Univ, Dept Clin Pharmacol, Fac Med, Shibin Al Kawm, Egypt
关键词
COVID-19; Gastrointestinal; Liver; Pathophysiology; SARS-CoV-2; SARS-COV-2; INFECTION; HEPATIC MANIFESTATIONS; COVID-19; CORONAVIRUS; RISK;
D O I
10.1186/s43066-021-00123-6
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BackgroundThe pandemic of COVID19 which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first described in China as an unexplained pneumonia transmitted by respiratory droplets. Gastrointestinal (GI) and liver injury associated with SARS-CoV-2 infection were reported as an early or sole disease manifestation, mainly outside China. The exact mechanism and incidence of GI and liver involvement are not well elucidated.Main bodyWe conducted a PubMed search for all articles written in the English language about SARS-CoV-2 affecting the GI and liver. Following data extraction, 590 articles were selected. In addition to respiratory droplets, SARS-CoV-2 may reach the GI system through the fecal-oral route, saliva, and swallowing of nasopharyngeal fluids, while breastmilk and blood transmission were not implicated. Moreover, GI infection may act as a septic focus for viral persistence and transmission to the liver, appendix, and brain. In addition to the direct viral cytopathic effect, the mechanism of injury is multifactorial and is related to genetic and demographic variations. The most frequently reported GI symptoms are diarrhea, nausea, vomiting, abdominal pain, and bleeding. However, liver infection is generally discovered during laboratory testing or a post-mortem. Radiological imaging is the gold standard in diagnosing COVID-19 patients and contributes to understanding the mechanism of extra-thoracic involvement. Medications should be prescribed with caution, especially in chronic GI and liver patients.ConclusionGI manifestations are common in COVID-19 patients. Special care should be paid for high-risk patients, older males, and those with background liver disease.
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页数:15
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