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新冠病毒感染后(post-acute)急性冠状病毒疾病(COVID-19)综合征的胃肠道累及。

Gastrointestinal involvement in post-acute Coronavirus disease (COVID)-19 syndrome.

机构信息

Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow.

Department of Microbiology, All India Institute of Medical Science, Kalyani, West Bengal, India.

出版信息

Curr Opin Infect Dis. 2023 Oct 1;36(5):366-370. doi: 10.1097/QCO.0000000000000959. Epub 2023 Aug 22.

DOI:10.1097/QCO.0000000000000959
PMID:37606895
Abstract

PURPOSE OF REVIEW

Ten percentage of patients with coronavirus disease (COVID)-19 report having gastrointestinal (GI) symptoms as severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) not only infects the pulmonary but also the GI tract. GI infections including that due to viral infection is known to cause postinfection disorders of gut-brain interaction (DGBI); hence, we wish to review the long-term GI consequences following COVID-19, particularly post-COVID-19 DGBI.

RECENT FINDINGS

At least 12 cohort studies, four of which also included controls documented the occurrence of post-COVID-19 DGBI, particularly IBS following COVID-19. The risk factors for post-COVID-19 DGBI included female gender, symptomatic COVID-19, particularly GI symptoms, the severity of COVID-19, the occurrence of anosmia and ageusia, use of antibiotics and hospitalization during the acute illness, persistent GI symptoms beyond 1 month after recovery, presence of mental health factors, The putative mechanisms for post-COVID-19 DGBI include altered gut motility, visceral hypersensitivity, gut microbiota dysbiosis, GI inflammation, and immune activation, changes in intestinal permeability, and alterations in the enteroendocrine system and serotonin metabolism.

SUMMARY

Long-term sequelae of SARS-CoV2 infection may persist even after recovery from COVID-19. Patients with COVID-19 are more likely to develop post-COVID-19 IBS than healthy controls. Post-COVID-19 IBS may pose a substantial healthcare burden to society.

摘要

目的综述

有 10%的新型冠状病毒病(COVID-19)患者报告有胃肠道(GI)症状,因为严重急性呼吸综合征冠状病毒-2(SARS-CoV-2)不仅感染肺部,还感染胃肠道。已知 GI 感染,包括病毒感染,会引起肠-脑相互作用的感染后障碍(DGBI);因此,我们希望综述 COVID-19 后的长期 GI 后果,特别是 COVID-19 后的 DGBI。

最近发现

至少有 12 项队列研究,其中 4 项还包括对照,记录了 COVID-19 后的 DGBI,特别是 COVID-19 后的肠易激综合征(IBS)的发生。COVID-19 后 DGBI 的危险因素包括女性、有症状的 COVID-19,特别是 GI 症状、COVID-19 的严重程度、嗅觉丧失和味觉丧失、使用抗生素和住院治疗急性疾病、在恢复后 1 个月以上持续存在的 GI 症状、存在心理健康因素。COVID-19 后 DGBI 的推测机制包括肠道运动改变、内脏高敏性、肠道微生物群失调、GI 炎症和免疫激活、肠通透性改变以及肠内分泌系统和 5-羟色胺代谢改变。

总结

SARS-CoV-2 感染的长期后遗症即使在 COVID-19 康复后也可能持续存在。COVID-19 患者比健康对照更有可能发生 COVID-19 后 IBS。COVID-19 后 IBS 可能会给社会带来巨大的医疗保健负担。

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