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胃肠病学中的冠状病毒(SARS-CoV-2)及其当前流行病学情况:截至2021年1月的最新综述

Coronavirus (SARS-CoV-2) in gastroenterology and its current epidemiological situation: An updated review until January 2021.

作者信息

Nabil Ahmed, Elshemy Mohamed M, Uto Koichiro, Soliman Reham, Hassan Ayman A, Shiha Gamal, Ebara Mitsuhiro

机构信息

Research Center for Functional Materials, National Institute for Materials Science (NIMS), 1-1Namiki, Tsukuba, Ibaraki 305-0044, Japan.

Biotechnology and Life Sciences Department, Faculty of Postgraduate Studies for Advanced Sciences (PSAS), Beni-Suef University, Beni-Suef, Egypt.

出版信息

EXCLI J. 2021 Feb 16;20:366-385. doi: 10.17179/excli2021-3417. eCollection 2021.

Abstract

Coronaviruses are positive-sense single-strand RNA viruses that infect amphibians, birds, and mammals. Coronavirus Disease 2019 (COVID-19) has become a major health problem caused by one of the coronaviruses called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has spread fast throughout the globe since its first identification in Wuhan, China, in December 2019. Although COVID-19 is principally defined by its respiratory symptoms, it is now clear that the virus can also affect the digestive system causing gastrointestinal (GI) symptoms like diarrhea, loss of appetite, nausea/vomiting, and abdominal pain as a major complaint. GI symptoms could be the initial signs of preceding respiratory signs, carrying a potential for slowed investigation and raised disease transmission opportunities. Various studies recognized the COVID-19 RNA in stool specimens of infected patients, and its viral receptor angiotensin-converting enzyme-2 (ACE-2) is highly expressed in GI epithelial cells. Many cases were reported negative using nasopharyngeal/oropharyngeal swabs and finally, SARS-CoV-2 RNA was detected in their anal/rectal swabs and stool specimens. These suggest that COVID-19 can actively infect and replicate in the GI tract. In this review, we elaborate on the close relationship between SARS-CoV-2 and the digestive system, focusing on the current status in the field of COVID-19 in gastroenterology, liver injury, endoscopy, inflammatory bowel disease, imaging, and the potential underlying mechanisms with illustrating the current epidemiological status regarding this pandemic.

摘要

冠状病毒是感染两栖动物、鸟类和哺乳动物的正链单股RNA病毒。2019冠状病毒病(COVID-19)已成为由一种名为严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的冠状病毒引起的主要健康问题。自2019年12月在中国武汉首次发现以来,它已在全球迅速传播。尽管COVID-19主要以呼吸道症状为特征,但现在很清楚,该病毒也可影响消化系统,导致腹泻、食欲不振、恶心/呕吐和腹痛等胃肠道(GI)症状成为主要主诉。胃肠道症状可能是先前呼吸道症状的初始迹象,有可能导致调查延迟并增加疾病传播机会。多项研究在感染患者的粪便标本中检测到了COVID-19 RNA,并且其病毒受体血管紧张素转换酶2(ACE-2)在胃肠道上皮细胞中高度表达。许多病例使用鼻咽/口咽拭子检测呈阴性,但最终在其肛门/直肠拭子和粪便标本中检测到了SARS-CoV-2 RNA。这些表明COVID-19可在胃肠道中主动感染并复制。在这篇综述中,我们阐述了SARS-CoV-2与消化系统之间的密切关系,重点关注COVID-19在胃肠病学、肝损伤、内镜检查、炎症性肠病、影像学等领域的现状以及潜在的潜在机制,并说明了关于这一流行病的当前流行病学状况。

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