Nabil Ahmed, Elshemy Mohamed M, Uto Koichiro, Soliman Reham, Hassan Ayman A, Shiha Gamal, Ebara Mitsuhiro
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.
EXCLI J. 2021 Feb 16;20:366-385. doi: 10.17179/excli2021-3417. eCollection 2021.
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.
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。