CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2020; 11(01): 13-18
DOI: 10.1055/s-0040-1712077
Review Article

2019 Novel Coronavirus Infection: Gastrointestinal Manifestations

Jayanta Samanta
1   Department of Gastroenterology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
,
Jahnvi Dhar
1   Department of Gastroenterology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
,
Abdul Khaliq
2   Department of Gastroenterology, Umdaa Health Care, Hyderabad, Telangana, India
,
Rakesh Kochhar
1   Department of Gastroenterology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
› Institutsangaben

Abstract

The world is witnessing a major public health crisis in the wake of the third coronavirus strain pandemic, a novel coronavirus (severe acute respiratory syndrome coronavirus 2). Although initially thought to be a pure respiratory pathogen, recent reports have highlighted not only the extrapulmonary effects of the virus but also, importantly, the gastrointestinal tract (GIT) effects. Various studies have looked into the effects of this novel coronavirus infection (coronavirus-19 disease [COVID-19]) on GIT involvement with reports of more frequent involvement than previously expected. With feco-oral transmission, debate being conclusively proven with fecal samples testing positive for COVID-19 and longer shedding time, it only underlines the importance of GIT involvement. Moreover, the presence of other GI diseases, such as inflammatory bowel disease, with COVID-19 infection might wreak havoc leading to poor patient outcomes.



Publikationsverlauf

Artikel online veröffentlicht:
16. Mai 2020

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  • References

  • 1 WHO. Coronavirus disease 2019 (COVID-19) Situation Report – 90. May 1, 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200419-sitrep-90-covid-19.pdf?sfvrsn=551d47fd_2
  • 2 Holshue ML, DeBolt C, Lindquist S. et al. Washington State 2019-nCoV Case Investigation Team. First case of 2019 novel coronavirus in the United States. N Engl J Med 2020; 382 (10) 929-936
  • 3 Guan WJ, Ni ZY, Hu Y. et al. China Medical Treatment Expert Group for COVID-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; DOI: 10.1056/NEJMoa2002032.
  • 4 Zhu N, Zhang D, Wang W. et al. China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382 (08) 727-733
  • 5 Huang C, Wang Y, Li X. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395 (10223) 497-506
  • 6 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 (10223) 507-513
  • 7 Lin L, Jiang X, Zhang Z. et al. Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection. Gut 2020; gutjnl-2020-321013 DOI: 10.1136/gutjnl-2020-321013.
  • 8 Jin X, Lian JS, Hu JH. et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut 2020; gutjnl-2020-320926 DOI: 10.1136/gutjnl-2020-320926.
  • 9 Chan JF, Yuan S, Kok KH. et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020; 395 (10223) 514-523
  • 10 Phan LT, Nguyen TV, Luong QC. et al. Importation and human-to-human transmission of a novel coronavirus in Vietnam. N Engl J Med 2020; 382 (09) 872-874
  • 11 Yin Y, Wunderink RG. MERS, SARS and other coronaviruses as causes of pneumonia. Respirology 2018; 23 (02) 130-137
  • 12 Zhou P, Yang XL, Wang XG. et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020; 579 (7798) 270-273
  • 13 Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. [The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41 (02) 145-151
  • 14 Leung WK, To KF, Chan PK. et al. Enteric involvement of severe acute respiratory syndrome-associated coronavirus infection. Gastroenterology 2003; 125 (04) 1011-1017
  • 15 Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by the novel coronavirus from Wuhan: an analysis based on decade-long structural studies of SARS coronavirus. J Virol 2020; 94 (07) e00127-20
  • 16 Wan Y, Shang J, Sun S. et al. Molecular mechanism for antibody-dependent enhancement of coronavirus entry. J Virol 2020; 94 (05) e02015-19
  • 17 Hashimoto T, Perlot T, Rehman A. et al. ACE2 links amino acid malnutrition to microbial ecology and intestinal inflammation. Nature 2012; 487 (7408) 477-481
  • 18 Hoffmann M, Kleine-Weber H, Schroeder S. et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020; 181 (02) 271-280.e8
  • 19 Zhang H, Kang Z, Gong H. et al. Digestive system is a potential route of COVID-19: an analysis of single-cell coexpression pattern of key proteins in viral entry process. Gut 2020; DOI: 10.1136/gutjnl-2020-320953.
  • 20 Liang W, Feng Z, Rao S. et al. Diarrhoea may be underestimated: a missing link in 2019 novel coronavirus. Gut 2020; gutjnl-2020-320832 DOI: 10.1136/gutjnl-2020-320832.
  • 21 Xu Y, Li X, Zhu B. et al. Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nat Med 2020; 26 (04) 502-505
  • 22 Xie C, Jiang L, Huang G. et al. Comparison of different samples for 2019 novel coronavirus detection by nucleic acid amplification tests. Int J Infect Dis 2020; 93: 264-267
  • 23 Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology 2020; S0016-5085 (20) 30282-1 DOI: 10.1053/j.gastro.2020.02.055.
  • 24 Budden KF, Gellatly SL, Wood DL. et al. Emerging pathogenic links between microbiota and the gut-lung axis. Nat Rev Microbiol 2017; 15 (01) 55-63
  • 25 Fang D, Ma J, Guan J, Wang M, Song Y, Tian D. Manifestations of digestive system in hospitalized patients with novel coronavirus pneumonia in Wuhan, China: a single-center, descriptive study. Chin J Dig 2020; 40
  • 26 An P, Chen H, Jiang X, Su J, Xiao Y, Ding Y, et al. Clinical features of 2019 novel coronavirus pneumonia presented gastrointestinal symptoms but without fever onset. 2020
  • 27 Wang D, Hu B, Hu C. et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; DOI: 10.1001/jama.2020.1585.
  • 28 Henry BM, de Oliveira MHS, Benoit J, Lippi G. Gastrointestinal symptoms associated with severity of coronavirus disease 2019 (COVID-19): a pooled analysis. Intern Emerg Med 2020; DOI: 10.1007/s11739-020-02329-9.
  • 29 Liu W, Zhang Q, Chen J. et al. Detection of covid-19 in children in early January 2020 in Wuhan, China. N Engl J Med 2020; 382 (14) 1370-1371
  • 30 Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID-19 infection: different points from adults. Pediatr Pulmonol 2020; 55 (05) 1169-1174
  • 31 Chen Y, Chen L, Deng Q. et al. The presence of SARS-CoV-2 RNA in feces of COVID-19 patients. J Med Virol 2020; DOI: 10.1002/jmv.25825.
  • 32 Zhang J, Wang S, Xue Y. Fecal specimen diagnosis 2019 novel coronavirus-infected pneumonia. J Med Virol 2020; DOI: 10.1002/jmv.25742.
  • 33 Ling Y, Xu SB, Lin YX. et al. Persistence and clearance of viral RNA in 2019 novel coronavirus disease rehabilitation patients. Chin Med J (Engl) 2020; DOI: 10.1097/CM9.0000000000000774.
  • 34 Wu Y, Guo C, Tang L. et al. Prolonged presence of SARS-CoV-2 viral RNA in faecal samples. Lancet Gastroenterol Hepatol 2020; 5 (05) 434-435
  • 35 Ong J, Young BE, Ong S. COVID-19 in gastroenterology: a clinical perspective. Gut 2020; gutjnl-2020-321051 DOI: 10.1136/gutjnl-2020-321051.
  • 36 van Doremalen N, Bushmaker T, Morris DH. et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med 2020; 382 (16) 1564-1567
  • 37 Ong SWX, Tan YK, Chia PY. et al. Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA 2020; DOI: 10.1001/jama.2020.3227.
  • 38 Yu IT, Li Y, Wong TW. et al. Evidence of airborne transmission of the severe acute respiratory syndrome virus. N Engl J Med 2004; 350 (17) 1731-1739
  • 39 Garg M, Royce SG, Tikellis C. et al. Imbalance of the renin-angiotensin system may contribute to inflammation and fibrosis in IBD: a novel therapeutic target?. Gut 2020; 69 (05) 841-851
  • 40 Jablaoui A, Kriaa A, Mkaouar H. et al. Fecal serine protease profiling in inflammatory bowel diseases. Front Cell Infect Microbiol 2020; 10: 21
  • 41 Wisniewski A, Kirchgesner J, Seksik P. et al. Saint-Antoine IBD network. Increased incidence of systemic serious viral infections in patients with inflammatory bowel disease associates with active disease and use of thiopurines. United European Gastroenterol J 2019; DOI: 10.1177/2050640619889763.
  • 42 IOIBD. IOIBD Update on COVID19 for Patients with Crohn’s Disease and Ulcerative Colitis. April 13, 2020. Available at: https://www.ioibd.org/ioibd-update-on-covid19-for-patients-with-crohns-disease-and-ulcerative-colitis
  • 43 Bai X, Yang H, Qian J. COVID-19 outbreak and inflammatory bowel disease management: a questionnaire survey from realistic practice. J Crohn’s Colitis 2020; jjaa064 DOI: 10.1093/ecco-jcc/jjaa064.
  • 44 Danese S, Cecconi M, Spinelli A. Management of IBD during the COVID-19 outbreak: resetting clinical priorities. Nat Rev Gastroenterol Hepatol 2020; DOI: 10.1038/s41575-020-0294-8.
  • 45 Boyapati RK, Torres J, Palmela C. et al. Withdrawal of immunosuppressant or biologic therapy for patients with quiescent Crohn’s disease. Cochrane Database Syst Rev 2018; 5: CD012540
  • 46 Rosenbaum L. Facing COVID-19 in Italy - ethics, logistics, and therapeutics on the epidemic’s front line. N Engl J Med 2020; DOI: 10.1056/NEJMp2005492.
  • 47 SECURE-IBD. Surveillance Epidemiology of Coronavirus (COVID-19) Under Research Exclusion in Inflammatory Bowel Disease (SECURE-IBD). April 17, 2020. Available at: https://covidibd.org/current-data
  • 48 Higgins PDR, Ng S, Danese S, Rao K. The risk of SARS-CoV-2 in immunosuppressed IBD patients. Crohn’s Colitis 360 2020; 2 (02) DOI: 10.1093/crocol/otaa026.
  • 49 Rubin DT, Feuerstein JD, Wang AY, Cohen RD. AGA clinical practice update on management of inflammatory bowel disease during the COVID-19 Pandemic: expert commentary. Gastroenterology 2020; S0016-5085(20)30482-0 DOI: 10.1053/j.gastro.2020.04.012.
  • 50 ECCO. 1st Interview COVID-19 ECCO Taskforce. April 13, 2020. Available at: https://www.ecco-ibd.eu/images/6_Publication/6_8_Surveys/1st_interview_COVID-19%20ECCOTaskforce_published.pdf
  • 51 BSG. BSG expanded consensus advice for the management of IBD during the COVID-19 pandemic. April 6, 2020. Available at: https://www.bsg.org.uk/covid-19-advice/bsg-advice-for-management-of-inflammatory-bowel-diseases-during-the-covid-19-pandemic
  • 52 Foundation Csa C. Resources for IBD Healthcare Professionals 2019 Novel Coronavirus (COVID-19). April 6, 2020. Available at: https://www.crohnscolitisfoundation.org/coronavirus/professional-resources
  • 53 Turner D, Huang Y, Martín-de-Carpi J, et al; Paediatric IBD Porto group of ESPGHAN. COVID-19 and paediatric inflammatory bowel diseases: global experience and provisional guidance (March 2020) from the Paediatric IBD Porto group of ESPGHAN. J Pediatr Gastroenterol Nutr 2020
  • 54 Wang F, Wang H, Fan J, Zhang Y, Wang H, Zhao Q. Pancreatic injury patterns in patients with COVID-19 pneumonia. Gastroenterology 2020; S0016-5085(20)30409-1 DOI: 10.1053/j.gastro.2020.03.055.