Pathology of the digestive tract and liver with COVID-19
https://doi.org/10.31146/1682-8658-ecg-176-4-19-23
Abstract
The damage of gastrointestinal tract and liver is detected in more than half of patients with COVID-19. The disease can begin with gastroenterological manifestations, to which respiratory symptoms subsequently join. The presence of gastrointestinal and liver lesions in patients with COVID-19 worsens the disease prognosis and increases the risk of mortality. There are multiple mechanisms of digestive system damages: the direct cytolytic eff ect of the virus on the target cells with SARSCoV-2 receptors on their surface, the action of components of systemic infl ammation, immunological and drug damages. The research of the use of rebamipide and ursodeoxycholic acid is a promising area in the treatment of COVID-19 patients with gastroenterological and liver lesions.
About the Authors
E. P. Yakovenko
Pirogov Russian National Research Medical University
Russian Federation
professor Department of Gastroenterology and nutrition, doctor of medical sciences
Moscow
Russian Federation
professor Department of Gastroenterology and nutrition, doctor of medical sciences
Moscow
A. V. Yakovenko
Pirogov Russian National Research Medical University
Russian Federation
associate professor department of gastroenterology and nutrition, candidate of medical sciences
Moscow
Russian Federation
associate professor department of gastroenterology and nutrition, candidate of medical sciences
Moscow
A. N. Ivanov
Pirogov Russian National Research Medical University
Russian Federation
associate professor department of gastroenterology and nutrition, candidate of medical sciences
Moscow
Russian Federation
associate professor department of gastroenterology and nutrition, candidate of medical sciences
Moscow
N. A. Agafonova
Pirogov Russian National Research Medical University
Russian Federation
associate professor department of gastroenterology and nutrition, candidate of medical sciences
Moscow
Russian Federation
associate professor department of gastroenterology and nutrition, candidate of medical sciences
Moscow
References
1. Phelan AL, Katz R, Gostin LO. The Novel Coronavirus Originating in Wuhan, China: Challenges for Global Health Governance. JAMA. 2020;323(8):709–710.
2. Wu Y, Ho W, Huang Y, et al. SARS-CoV-2 is an appropriate name for the new coronavirus. Lancet. 2020; Mar 21;395(10228):949–950.
3. Markus Hoffmann et al.SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and is Blocked by a Clinically Proven Protease Inhibitor. Cell 2020; 181, 1–10.
4. Hao Xu1, Liang Zhong1, Jiaxin Denget al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. International Journal of Oral Science. 2020; 12:8.
5. Wang К, Chen W., Zhou Y-S.et al. SARS-CoV-2 invades host cells via a novel route: CD147-spike protein. doi: https://doi.org/10.1101/2020.03.14.988345.
6. Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020; Mar;579(7798):270–273.
7. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507–13.
8. Guan W-J, Ni Z-Y, Hu Y, et al. Clinical characteristics of 2019 novel coronavirus infection in China. https://www.naturalnews.com/fi les/Clinical-characteristics-of-2019-novel-coronavirus-infection-in-China.pdf.
9. Wang F-S, Zhang C. What to do next to control the 2019-nCoV epidemic? Lancet 2020; 395: 391–93.
10. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506.
11. Holshue ML, DeBolt C, Lindquist S, et al. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med. 2020; Mar 5;382(10):929–936.
12. To KK, Tsang OT, Chik-Yan Yip C, et al. Consistent detection of 2019 novel coronavirus in saliva [published on February 12, 2020]. Clin Infect Dis. 2020 Feb 12: ciaa149.
13. Han, C., Duan С., Zhang S. Digestive Symptoms in COVID-19 Patients with Mild Disease Severity: Clinical Presentation, Stool Viral RNA Testing, and Outcomes. https://journals.lww.com/ajg/Documents/COVID19_Han_et_al_AJG_Preproof.pdf.
14. Gu J, Han B, Wang J. COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission, Gastroenterology (2020), doi: https://doi.org/10.1053/j.gastro.2020.02.054.
15. Chai X, Hu L, Zhang Y et al. Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection. BioRxiv 2020 February 4. doi: 10.1101/2020.02.03.931766.
16. Cai Q, Huang D, Yu H. et al. Characteristics of liver tests in COVID-19 patients, Journal of Hepatology (2020), doi: https://doi.org/10.1016/j.jhep.2020.04.006.
17. Fan Z, Chen L, Li J, et al. Clinical features of COVID-19 related liver damage. MedRxiv 2020 February 28. doi: 10.1101/2020.02.26.20026971. [Epub ahead of print].
18. Xu L, Liu J, Lu M, et al. Liver injury during highly pathogenic human coronavirus infections. Liver Int 2020 March 14. doi: 10.1111/liv.14435. [Epub ahead of print].
19. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28;395(10229):1054–1062.
20. Boettler T., Newsome P. N., Mondelli M. U. Care of patients with liver disease during the COVID-19 pandemic: EASL-ESCMID Position Paper. https://doi.org/10.1016/j.jhepr.2020.100113
21. Xiao F, Tang M, Zheng X et al. Evidence for gastrointestinal infection of SARS-CoV-2, Gastroenterology (2020), https://doi.org/10.1053/j.gastro.2020.02.055.
22. Zhang H, Kang ZJ, Gong HY, et al. The digestive system is a potential route of 2019-n Cov infection: a bioinformatics analysis based on single-cell transcriptomes. Preprint. Posted. online January 30, 2020. bioRxiv 927806. doi: 10.1101/2020.01.30.927806.
23. Budden KF, Gellatly SL, Wood DL, et al. Emerging pathogenic links between microbiota and the gut-lung axis. Nat Rev Microbiol. 2017;15:55–63.
24. He Y, Wen Q, Yao F, Xu D, Huang Y, Wang J. Gut-lung axis: The microbial contributions and clinical implications. Crit Rev Microbiol. 2017;43:81–95.
25. Li M, Wang B, Zhang M, et al. Symbiotic gut microbes modulate human metabolic phenotypes. Proc Natl Acad Sci U S A. 2008;105:2117–22.
26. Zhang C, Shi L, Wang FS. Liver injury in COVID-19: management and challenges. Lancet Gastroenterol Hepatol 2020; published online March 4. https://www.researchgate.net/publication/339783197_Liver_injury_in_COVID-19_management_and_challenges.
27. Liu Q, Wang R, Qu G et al. Macroscopic autopsy findings in a patient with COVID-19. J Forensic Med 2020; 36: 1–3 (in Chinese).
28. Arakawa T, Higuchi K, Fujiwara Y et al. 15th Anniversary of Rebamipide: Looking Ahead to the New Mechanisms and New Applications. Dig Dis Sci. 2005; 50(1): S3-S11. doi:10.1007/s10620–005–2800–9.
29. Genta R. M. Review article: the role of rebamipide in the management of infl ammatory disease of the gastrointestinal tract Aliment Pharmacol Ther 2003; 18 (Suppl. 1): 8–13.
30. Urita, Yoshihisa & Watanabe, et al. Rebamipide Improves Salivary Gland Function and Saliva Transit to the Distal Esophagus: 48. American Journal of Gastroenterology. 2007. 102. S135. doi:10.14309/00000434–200709002–00048.
31. Lee SY et al. The inhibitory effects of rebamipide on cigarette smoke-induced airway mucin production. Respir Med. 2006 Mar;100(3):503–11.
32. Gohil P et al. Preliminary studies on the effect of rebamipide against the trypsin and egg-albumin induced experimental model of asthma. Acta Pharm. 2011 Dec;61(4):427–33.
33. Ling Xu Jia Liu Mengji Lu et al. Liver injury during highly pathogenic human coronavirus infections Liver International. 2020;00:1–7. doi.org/10.1111/liv.14435.
34. Fangfang Niu et al. Ursodeoxycholic Acid Stimulates Alveolar Fluid Clearance in LPS-induced Pulmonary Edema via ALX/cAMP/PI3K Pathway J Cell Physiol. 2019 Nov;234(11):20057–20065.
35. Willart MA van Nimwegen M, Gref horst A, et al. Ursodeoxycholic acid suppresses eosinophilic airway infl ammation by inhibiting the function of dendritic cells through the nuclear farnesoid X receptor. Allergy. 2012 Dec;67(12):1501–10. doi: 10.1111/all.12019. Epub 2012 Sep 25.
Review
For citations:
Yakovenko E.P., Yakovenko A.V., Ivanov A.N., Agafonova N.A. Pathology of the digestive tract and liver with COVID-19. Experimental and Clinical Gastroenterology. 2020;174(4):19-23. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-176-4-19-23
Views:
1060
Email this article 