New Coronavirus Infection (COVID-19) and Digestive System
V. T. Ivashkin,
A. A. Sheptulin,
O. Yu. Zolnikova,
A. V. Okhlobystin,
E. A. Poluektova,
A. S. Trukhmanov,
E. N. Shirokova,
M. I. Gonik,
N. I. Trofimivskaya https://doi.org/10.22416/1382-4376-2020-30-3-7
Abstract
Aim. The study reviews current evidence on digestive system lesions provoked by the new COVID-19 coronavirus infection.
Key points. Alongside the destructive impact on respiratory system, COVID-19 manifests itself in gastrointestinal symptoms (nausea, vomiting, diarrhoea) that may precede respiratory signs and prevail in the clinical picture of infection. Patients with chronic inflammatory bowel diseases receiving immunosuppressive therapy are at elevated risk of severe COVID-19 progression. The new coronavirus infection may induce liver damage with increased transaminase activity.
Conclusion. Association of digestive system lesions with COVID-19 remains understudied and requires further research.
About the Authors
V. T. Ivashkin
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Vladimir T. Ivashkin — Dr. Sci. (Med.), RAS Academician, Prof., Departament Head, Departament of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, building 1.
A. A. Sheptulin
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Arkady A. Sheptulin — Dr. Sci. (Med.), Prof., Departament of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, building 1.
O. Yu. Zolnikova
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Oxana Yu. Zolnikova — Cand. Sci. (Med.), Associate Prof., Departament of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, building 1.
A. V. Okhlobystin
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Alexey V. Okhlobystin — Cand. Sci. (Med.), Associate Prof., Departament of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, building 1.
E. A. Poluektova
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Elena A. Poluektova — Dr. Sci. (Med.), Prof., Departament of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, building 1.
A. S. Trukhmanov
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Alexander S. Trukhmanov — Dr. Sci. (Med.), Prof., Departament of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, building 1.
E. N. Shirokova
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Elena N. Shirokova — Dr. Sci. (Med.), Prof., Departament of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, building 1.
M. I. Gonik
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Maxim I. Gonik — Clinical Resident, Departament of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, building 1.
N. I. Trofimivskaya
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Natalia I. Trofimivskaya — Clinical Resident, Departament of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, building 1.
References
1. Interim methodological guidelines «Prevention, diagnosis and treatment of new coronavirus infection (COVID-19)» (In Russ.) URL: rosminzdrav.ru/ministry/med_covid19.
2. Gu J., Han, B., Wang J. COVID-19: gastrointestinal manifestations and potential fecal–oral transmission. Gastroenterology. 2020;158(6):1518–19. DOI: 10.1053/j.gastro.2020.02.054.
3. Holshue M.L., DeBolt C., Lindquist S., Lofy K.H., Wiesman J., Bruce, et al. First case of 2019 novel coronavirus in the United States. N Engl J Med. 2020 Mar 5;382(10):929–36. DOI: 10.1056/NEJMoa2001191
4. Xiao F., Tang M., Zheng X. Liu Y., Li X., Shan H. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology. 2020; 158(6):1831–33. DOI:10.1053/j.gastro.2020.02.055
5. Zhang W., Du R.H., Li B., Xu D., Wang J., Li Z., Lin J. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerg Microbes Infect 2020;9(1):386–9. DOI:10.1080/22221751.2020.1729071
6. Tang A., Tong Z.D., Wang H.L., Dai Y.X., Li K.F., Liu J.N., et al. Detection of novel coronavirus by RT-PCR in stool specimen from asymptomatic child, China. Emerg Infect Dis. 2020;26(6):1337–39. DOI: 10.3201/eid2606.200301.
7. Young B.E., Ong S.W.X., Kalimuddin S., Low J.G., Tan S.J., Loh J., et al. Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. JAMA. 2020;323(15):1488–94. DOI:10.1001/jama.2020.3204
8. Chan K.H., Poon L.L., Cheng V.C., Guan Y., Hung I.F., Kong J., et al. Detection of SARS coronavirus in patients with suspected SARS. Emerg Infect Dis. 2004;10(2):294–9. DOI:10.3201/eid1002.030610
9. Wu Y., Guo C., Tang L., Hong Z., Zhou J., Dong X., et al. Prolonged presence of SARS-CoV-2 viral RNA in faecal samples. Lancet Gastroenterol Hepatol 2020;5(5):434–35. DOI: 10.1016/S2468-1253(20)30083-2
10. To K.K.W., Tsang O.T.Y., Yip C.C.Y., Chan K.H., Wu T.C., Chan J.V.C., et al. Consistent detection of 2019 novel coronavirus in saliva. Clin Infect Dis. 2020; 12:149. DOI: 10.1093/cid/ciaa149
11. Lu R., Zhao X., Li J., Niu P., Yang B., Wu H., et al. Genomic characterization and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020; 395(10224):565–74. DOI: 1016/S0140-6736(20)30251-8
12. Zhou P., Yang X.L., Wang X.G., Hu B., Zhang L., Zhang W., et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020; 579(7798):270–273. DOI: 10.1038/s41586-020-2012-7
13. Liang W., Feng Z., Rao S., Xiao O., Xue X., Lin Z., et al. Diarrhoea may be underestimated: a missing link in 2019 novel coronavirus. Gut. 2020;69(6):1141–43. DOI: 10.1136/gutjnl-2020-320832
14. Guan W.-J., Ni Z.-Y., Hu Y., Liang W.H., Ou C.Q., He J.X., et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708–20. DOI:10.1056/NEJMoa2002032
15. Pan L., Mu M., Ren H. G., Yang P., Sun Y. Wang R., et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study. Am J Gastroenterol, 2020;115(5):766–73. DOI: 10.14309/ajg.0000000000000620
16. Wang D., Hu B., Hu C., Zhu F., Liu X., Zhang J., et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–69. DOI:10.1001/jama.2020.1585
17. Lin L., Jiang X., Zhang Z., Huang S., Zhang Z., Fang Z., et al. Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection. Gut. 2020; 69(6):997–1001 DOI: 10.1136/gutjnl-2020-321013
18. Song Y., Liu P., Shi X.L., Chu J.L., Zhang J., Xia J., et al. SARS-CoV-2 induced diarrhea as onset symptom in patient with COVID-19. Gut. 2020;69(6):1143–44. DOI: 10.1136/gutjnl-2020-320891
19. Liu K., Fang Y.-Y., Deng Y., Liu W., Wang M.-F., Ma J.-P.,et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J 2020;133(9):1025–31. DOI: 10.1097/CM9.0000000000000744
20. Ungaro R.C., Sullivan T., Colombel J.-F., Patel G. What should gastroenterologists and patients know about COVID-19? Clin Gastroenterol Hepatol. 2020;18(7):1409–11. DOI: 10.1016/j.cgh2020.03.02
21. Jin X., Lian J.-S., Hu J.-H., Gao J., Zheng L., Zhang Y.-M., et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut. 2020;69(6):1002–09. DOI:10.1136/gutjnl-2020-320926
22. Hormati A, Shahhamzeh A, Afifian M, Khodadust F, Ahmadpour S. Can COVID-19 present unusual GI symptoms? J Microbiol Immunol Infect. 2020. DOI:10.1016/j.jmii.2020.03.020
23. Mazza S., Sorce A., Peyvandy F., Vecchi M., Caprioli F. A fatal case of COVID-19 pneumonia occurring in a patient with severe acute ulcerative colitis. Gut. 2020;69(6):1148–49. DOI: 10.1136/gutjnl-2020-321183
24. Mao, R., Liang, J., Shen J., Ghosh S., Zhu L.-R., Yang H., et al. Implications of COVID-19 for patients with pre-existing digestive diseases. Lancet Gastroenterol Hepatol. 2020;5(5):425–27. DOI: 10.1016/S2468-1253(20)30076-5
25. Rubin D.T., Abrey M.T., Rai V., Siegel C.A. International Organization for the Study of Inflammatory Bowel Disease. Management of Patients with Crohn’s Disease and Ulcerative Colitis During the COVID-19 Pandemic: Results of an International Meeting. Gastroenterology. 2020; S0016-5085(20)30465-0. DOI: 10.1053/j.gastro.2020.04.002
26. Chai X., Hu L., Zhang Y., Han W., Lu Z., Ke A., et al. Specific ACE2 Expression in cholangiocytes COVID-19 may cause liver damage after 2019-nCoV infection. bioRxiv. 2020; DOI:10.1101/2020.02.03.931766
27. Xu J., Helfand B. Genetic risk score linked with younger age diagnosis of prostate cancer. Oncology Times. 2020;42(6):8,36. DOI:10.1097/01.cot.0000658832.18056.12
28. Albillos A., Lario M., Álvarez-Mon M. Cirrhosis-associated immune dysfunction: Distinctive features and clinical relevance. J Нepatol. 2014;61(6):1385–96. DOI:10.1016/j.jhep.2014.08.010
29. Boettler T., Newsome P.N., Mondelli M.U., Matitic M., Cordeo E., Cornberg M., et al. Care of patients with liver disease during the COVID-19 pandemic: EASL-ESCMID position paper. JHEP Rep. 2020;2(3):100113. DOI:10.1016/j.jhepr.2020.100113
30. Fan Z., Chen L., Li J., Tian C., Zhang Y., Huang S., Liu Z., Cheng J. Clinical Features of COVID-19-Related Liver Damage. 2020. Available at SSRN 3546077. DOI:10.2139/ssrn.3546077
31. Chen N., Zhou M., DongX., Qu J., Gong F., Han Y., et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395(10223): 507–13. DOI:10.1016/S0140-6736(20)30211-7
32. Ong J., Young B.E., Ong S. COVID-19 in gastroenterology: a clinical perspective. Gut. 2020;69(6):1144–45. DOI: 10.1136/gutjnl-2020-321051.
33. Xu Z., Shi L., Wang Y., Zhang J., Huang L., Zhang C., et al. Patholigical findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020; 8(4):420–2. DOI: 10.1016/S2213-2600(20)30076-X
34. Li X., Geng M., Peng Y., Meng L., Lu S. Molecular immune pathogenesis and diagnosis of COVID-19. J Pharm Anal 2020;10(2):102–8. DOI: 10.1016/j.jpha.2020.03.001.
35. Mehta P., McAuley D.F., Brown M., Sanchez E., Tattersall R.S, Manson J.J. COVID-19: consider cytokine storm syndromes and immunosupression. Lancet. 2020;395(10229):1033–34. DOI:10.1016/S0140-6736(20)30628-0.
36. 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;395(10229):1054–62. DOI:10.1016/S0140-6736(20)30566-3.
37. https://www.foodnavigator-asia.com/Article/2020/03/17/Fight-COVID-19-with-dairy-China-industry-associations-issue-consumption-guidelines-to-build-immuneresistance?utm_source=copyright&utm_medium=OnSite&utm_campaign=copyright
38. WHO. Coronavirus disease (COVID-19) advice for the public: Myth busters [Internet]. WHO: WHO; 2020. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters
39. British Dietetic Association. COVID-19 / Coronavirus — Advice for the General Public: «Can I boost my immune system through my diet?» 16 Mar 2020 [updated April 14 2020]. BDA: BDA; Available from https://www.bda.uk.com/resource/covid-19-corona-virus-advice-for-the-general public.html
40. WHO. Food and nutrition tips during self-quarantine [Internet]. WHO: WHO; 2020. Available from: http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/novel-coronavirus-2019-ncov-technical-guidance/food-and-nutrition-tips-during-self-quarantine
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For citations:
Ivashkin V.T., Sheptulin A.A., Zolnikova O.Yu., Okhlobystin A.V., Poluektova E.A., Trukhmanov A.S., Shirokova E.N., Gonik M.I., Trofimivskaya N.I. New Coronavirus Infection (COVID-19) and Digestive System. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2020;30(3):7-13. (In Russ.) https://doi.org/10.22416/1382-4376-2020-30-3-7
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