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新型冠状病毒肺炎:胃肠道和肝胆系统表现。

COVID-19: gastrointestinal and hepatobiliary manifestations.

机构信息

Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.

Department of Pathology, Yale New Haven Hospital, Yale University, New Haven, CT, 06510, USA.

出版信息

Hum Pathol. 2023 Feb;132:39-55. doi: 10.1016/j.humpath.2022.07.006. Epub 2022 Jul 16.


DOI:10.1016/j.humpath.2022.07.006
PMID:35843340
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9288242/
Abstract

SARS-CoV-2 is the viral agent of COVID-19, a pandemic that surfaced in 2019. Although predominantly a respiratory ailment, patients with COVID-19 can have gastrointestinal (GI) and hepatobiliary manifestations. These manifestations are often mild and transient, but they can be severe and consequential. In the GI tract, ischemic enterocolitis is the most common and significant consequence of COVID-19. In the liver, the reported pathologic findings may often be related to consequences of severe systemic viral infection, but reports of hepatitis presumed to be due to SARS-CoV-2 suggest that direct viral infection of the liver may be a rare complication of COVID-19. In both the GI tract and liver, lingering symptoms of GI or hepatic injury after resolution of pulmonary infection may be part of the evolving spectrum of long COVID.

摘要

SARS-CoV-2 是 COVID-19 的病毒病原体,这是一种 2019 年出现的大流行疾病。尽管 COVID-19 主要是一种呼吸道疾病,但 COVID-19 患者可能会出现胃肠道(GI)和肝胆系统表现。这些表现通常较轻且短暂,但也可能严重并产生后果。在胃肠道中,缺血性肠炎是 COVID-19 最常见和最重要的后果。在肝脏中,报告的病理发现可能通常与严重全身性病毒感染的后果有关,但由于 SARS-CoV-2 而推测的肝炎报告表明,肝脏的直接病毒感染可能是 COVID-19 的罕见并发症。在胃肠道和肝脏中,肺部感染消退后胃肠道或肝损伤的持续症状可能是长 COVID 不断发展的表现谱的一部分。

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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df53/9288242/ebe2c5caab28/gr12_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df53/9288242/88c14a6d950b/gr13_lrg.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df53/9288242/400124ee9a35/gr15_lrg.jpg
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本文引用的文献

[1]
Cytomegalovirus Hepatitis in Allograft Livers May Show Histologic Features of Acute Cellular Rejection.

Arch Pathol Lab Med. 2023-6-1

[2]
Persistent Cholestatic Injury and Secondary Sclerosing Cholangitis in COVID-19 Patients.

Arch Pathol Lab Med. 2022-10-1

[3]
Gastrointestinal manifestations in patients with coronavirus disease-2019 (COVID-19): Impact on clinical outcomes.

J Res Med Sci. 2022-4-15

[4]
Mechanistic insight of SARS-CoV-2 infection using human hepatobiliary organoids.

Gut. 2023-1

[5]
Gastrointestinal symptoms and the severity of COVID-19: Disorders of gut-brain interaction are an outcome.

Neurogastroenterol Motil. 2022-9

[6]
Human liver organoid derived intra-hepatic bile duct cells support SARS-CoV-2 infection and replication.

Sci Rep. 2022-3-30

[7]
Extensive mucosal sloughing of the small intestine and colon in a patient with severe COVID-19.

DEN Open. 2022-4

[8]
Vascular thrombosis and vasculitis in the gastrointestinal tract are associated with poor prognosis in patients with COVID-19.

Int J Clin Exp Pathol. 2021-11-15

[9]
Bowel Ischemia in COVID-19 Infection: One-Year Surgical Experience.

Am Surg. 2021-12

[10]
Autoimmune hepatitis after COVID-19 vaccine - more than a coincidence.

J Autoimmun. 2021-12

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