Dr Kaniz Fathema, Resident, Department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; Email:
Mymensingh Med J. 2021 Apr;30(2):570-579.
The most devastating pandemic of this era coronavirus disease-2019 (COVID-19) is caused by a novel virus named severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Although it is primarily a respiratory pathogen, it can also result in several extra-pulmonary manifestations includes gastrointestinal symptoms, hepatocellular injury. Angiotensin-converting enzyme-2 (ACE-2) receptor and transmembrane serine protease 2 (TMPRSS2), the entry receptor for the causative coronavirus SARS-CoV-2 is co-express in the gastrointestinal tract, hepatocyte, and cholangiocytes similar to the respiratory mucosa. The presence of these receptors facilitates the entry into the tissue and causes direct viral tissue damage, which is a proposed mechanism of injury. Diarrhoea, nausea, vomiting, abdominal discomfort are common gastrointestinal manifestations, whereas derangement of liver function tests is the most hepatic manifestation in COVID-19. In this article, we reviewed on SARS-CoV-2 disease COVID-19 regarding gastrointestinal, hepatic, and pancreatic manifestation, the mechanisms by which the virus may inflict damage, and their management perspective.
本次疫情由新型冠状病毒(SARS-CoV-2)引起,引发了这一时代最具破坏性的大流行病——2019 年冠状病毒病(COVID-19)。虽然它主要是一种呼吸道病原体,但它也可能导致多种肺外表现,包括胃肠道症状、肝细胞损伤。血管紧张素转换酶 2(ACE-2)受体和跨膜丝氨酸蛋白酶 2(TMPRSS2)是 SARS-CoV-2 的致病冠状病毒的进入受体,在胃肠道、肝细胞和胆管细胞中与呼吸道黏膜相似表达。这些受体的存在有利于进入组织并导致直接的病毒组织损伤,这是一种损伤的拟议机制。腹泻、恶心、呕吐、腹部不适是常见的胃肠道表现,而 COVID-19 中肝功能检查异常是最常见的肝脏表现。本文综述了 SARS-CoV-2 病 COVID-19 的胃肠道、肝脏和胰腺表现、病毒可能造成损害的机制及其治疗观点。