tetano
Editor, Senior Moderator
Expert Rev Gastroenterol Hepatol
. 2020 Sep 21.
doi: 10.1080/17474124.2020.1821653. Online ahead of print.
Gastrointestinal Coronavirus disease 2019: epidemiology, clinical features, pathogenesis, prevention and management
Deidda Simona[SUP] 1 [/SUP], Tora Lorena[SUP] 2 [/SUP], Firinu Davide[SUP] 3 [/SUP], Del Giacco Stefano[SUP] 3 [/SUP], Campagna Marcello[SUP] 4 [/SUP], Meloni Federico[SUP] 4 [/SUP], Orr? Germano[SUP] 5 [/SUP], Chessa Luchino[SUP] 6 [/SUP], Carta Mauro Giovanni[SUP] 7 [/SUP], Alessandra Melis[SUP] 1 [/SUP], Spolverato Gaya[SUP] 8 [/SUP], Zorcolo Luigi[SUP] 1 [/SUP], Restivo Angelo[SUP] 1 [/SUP]
Affiliations
Abstract
The new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the etiologic agent of coronavirus disease 2019. Some authors reported evidences that patients with SARS-CoV-2 infection could have a direct involvement of the gastrointestinal tract, and in symptomatic cases, gastrointestinal symptoms (diarrhea, nausea/vomiting, abdominal pain) could be very common. Area covered: In this article, we reviewed current published data of the gastrointestinal aspects involved in SARS-CoV-2 infection, including prevalence and incidence of specific symptoms, presumptive biological mechanism of GI infection, prognosis, clinical management and public health related concerns on the possible risk of oral-fecal transmission. Expert opinion: Different clues point to a direct virus infection and replication in mucosal cells of the gastrointestinal tract. In vitro studies showed that SARS-CoV-2 could enters into the gastrointestinal epithelial cells by the Angiotensin-Converting enzyme 2 membrane receptor. These findings, coupled with identification of viral RNA found in stools of patients, clearly suggest that a direct involvement of gastrointestinal tract is very likely. This can justify most of the gastrointestinal symptoms but also suggest a risk for an oral fecal route for transmission, additionally or alternatively to the main respiratory route.
Keywords: COVID-19; Coronavirus; fecal-oral transmission; gastrointestinal involvement; management.
. 2020 Sep 21.
doi: 10.1080/17474124.2020.1821653. Online ahead of print.
Gastrointestinal Coronavirus disease 2019: epidemiology, clinical features, pathogenesis, prevention and management
Deidda Simona[SUP] 1 [/SUP], Tora Lorena[SUP] 2 [/SUP], Firinu Davide[SUP] 3 [/SUP], Del Giacco Stefano[SUP] 3 [/SUP], Campagna Marcello[SUP] 4 [/SUP], Meloni Federico[SUP] 4 [/SUP], Orr? Germano[SUP] 5 [/SUP], Chessa Luchino[SUP] 6 [/SUP], Carta Mauro Giovanni[SUP] 7 [/SUP], Alessandra Melis[SUP] 1 [/SUP], Spolverato Gaya[SUP] 8 [/SUP], Zorcolo Luigi[SUP] 1 [/SUP], Restivo Angelo[SUP] 1 [/SUP]
Affiliations
- PMID: 32955375
- DOI: 10.1080/17474124.2020.1821653
Abstract
The new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the etiologic agent of coronavirus disease 2019. Some authors reported evidences that patients with SARS-CoV-2 infection could have a direct involvement of the gastrointestinal tract, and in symptomatic cases, gastrointestinal symptoms (diarrhea, nausea/vomiting, abdominal pain) could be very common. Area covered: In this article, we reviewed current published data of the gastrointestinal aspects involved in SARS-CoV-2 infection, including prevalence and incidence of specific symptoms, presumptive biological mechanism of GI infection, prognosis, clinical management and public health related concerns on the possible risk of oral-fecal transmission. Expert opinion: Different clues point to a direct virus infection and replication in mucosal cells of the gastrointestinal tract. In vitro studies showed that SARS-CoV-2 could enters into the gastrointestinal epithelial cells by the Angiotensin-Converting enzyme 2 membrane receptor. These findings, coupled with identification of viral RNA found in stools of patients, clearly suggest that a direct involvement of gastrointestinal tract is very likely. This can justify most of the gastrointestinal symptoms but also suggest a risk for an oral fecal route for transmission, additionally or alternatively to the main respiratory route.
Keywords: COVID-19; Coronavirus; fecal-oral transmission; gastrointestinal involvement; management.