Stasi Cristina, Bellini Massimo
Department of Life Science, Health and Health Professions, Link Campus University, 00165 Rome, Italy.
Gastrointestinal Unit and Regional Center for Functional and Motility Digestive Disorders, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy.
Pathogens. 2025 Jun 3;14(6):555. doi: 10.3390/pathogens14060555.
Post-COVID-19 is a chronic infection-related syndrome, including exacerbations of pre-existing or newly diagnosed conditions that have been established after the acute phase of COVID-19 and have demonstrated a wide range of systemic effects beyond the lungs. SARS-CoV-2 attaches to its receptor, angiotensin-converting enzyme 2 (ACE-2). Transmembrane serine protease 2 (TMPRSS2) facilitates viral entry and spread. ACE-2 receptors are detectable in several tissues, including the respiratory mucosa, digestive tract, heart, kidney, and brain. Several investigations have demonstrated an increase in digestive manifestations post-acute COVID-19, likely related to an alteration in the intestinal microbiota following infection. These changes can lead to a loss of species diversity, resulting in an overgrowth of opportunistic pathogens and deprivation of commensal bacteria. In this context, post-infection irritable bowel syndrome shows an increased incidence compared to controls. Growing evidence also suggests the enduring presence of SARS-CoV-2 in the gut tissue. Studies are ongoing to investigate antiviral agents that counteract prolonged COVID-19 symptoms. Therefore, the objectives of this review were to summarize the digestive manifestations, focusing on irritable bowel syndrome and therapeutic strategies. This review gives an overview of studies published in English in the last two years on the PubMed database.
新冠后综合征是一种与慢性感染相关的综合征，包括在新冠急性期后出现或新诊断的疾病的加重，这些疾病已表现出超出肺部的广泛全身影响。严重急性呼吸综合征冠状病毒2（SARS-CoV-2）附着于其受体血管紧张素转换酶2（ACE-2）。跨膜丝氨酸蛋白酶2（TMPRSS2）促进病毒进入和传播。ACE-2受体在包括呼吸道黏膜、消化道、心脏、肾脏和大脑在内的多个组织中均可检测到。多项研究表明，新冠急性感染后消化系统表现有所增加，这可能与感染后肠道微生物群的改变有关。这些变化可导致物种多样性丧失，从而导致机会性病原体过度生长和共生细菌缺失。在此背景下，与对照组相比，感染后肠易激综合征的发病率有所增加。越来越多的证据还表明SARS-CoV-2在肠道组织中持续存在。正在进行研究以调查对抗新冠长期症状的抗病毒药物。因此，本综述的目的是总结消化系统表现，重点关注肠易激综合征和治疗策略。本综述概述了过去两年在PubMed数据库上以英文发表的研究。
