Liver Diseases Research Lab, Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
J Dig Dis. 2020 Dec;21(12):687-695. doi: 10.1111/1751-2980.12951.
Patients affected by coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, manifest various gastrointestinal and hepatic abnormalities alongside respiratory disorders. The identification of this virus in the feces of more than 50% of infected individuals indicates the possibility of viral shedding and fecal-to-oral transmission. Preliminary reports have also identified alterations in the intestinal microbiota profile in infected individuals. Moreover, COVID-19 patients manifest various degrees of liver injury characterized by alterations in liver enzymes. Digestive symptoms and liver abnormalities correlate with disease severity, the incidence of critical outcomes and patient's recovery. However, the pathogenic mechanisms behind COVID-19-induced abnormalities in the gut-liver axis seem to be multifactorial in origin. This review compiles current knowledge sourced from preclinical and clinical research and summarizes gastrointestinal and hepatic dysfunctions observed following SARS-CoV-2 infection, and also explores the possible mechanisms generating abnormalities in the gut-liver axis. Furthermore, this review sheds light on possible therapeutic targets against these disorders.
感染由严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起的 2019 年冠状病毒病（COVID-19）的患者除了呼吸系统疾病外，还表现出各种胃肠道和肝脏异常。在超过 50%的感染个体的粪便中发现这种病毒表明存在病毒脱落和粪口传播的可能性。初步报告还发现感染个体的肠道微生物群谱发生改变。此外，COVID-19 患者表现出不同程度的肝损伤，其特征是肝酶的改变。消化道症状和肝脏异常与疾病严重程度、严重不良结局的发生率和患者的恢复相关。然而，COVID-19 引起的肠-肝轴异常的发病机制似乎是多因素的。这篇综述汇集了来自临床前和临床研究的最新知识，总结了 SARS-CoV-2 感染后观察到的胃肠道和肝脏功能障碍，并探讨了产生肠-肝轴异常的可能机制。此外，这篇综述还阐明了针对这些疾病的可能治疗靶点。
