Gastrointestinal symptoms associated with COVID-19: impact on the gut microbiome

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the greatest worldwide pandemic since the 1918 flu. The consequences of the coronavirus disease 2019 (COVID-19) are devastating and represent the current major public health issue across the globe. At the onset, SARS-CoV-2 primarily attacks the respiratory system as it represents the main point of entry in the host, but it also can affect multiple organs. Although most of the patients do not present symptoms or are mildly symptomatic, some people infected with SARS-CoV-2 that experience more severe multiorgan dysfunction. The severity of COVID-19 is typically combined with a set of comorbidities such as hypertension, diabetes, obesity, and/or advanced age that seriously exacerbates the consequences of the infection. Also, SARS-CoV-2 can cause gastrointestinal symptoms, such as vomiting, diarrhea, or abdominal pain during the early phases of the disease. Intestinal dysfunction induces changes in intestinal microbes, and an increase in inflammatory cytokines. Thus, diagnosing gastrointestinal symptoms that precede respiratory problems during COVID-19 may be necessary for improved early detection and treatment. Uncovering the composition of the microbiota and its metabolic products in the context of COVID-19 can help determine novel biomarkers of the disease and help identify new therapeutic targets. Elucidating changes to the microbiome as reliable biomarkers in the context of COVID-19 represent an overlooked piece of the disease puzzle and requires further investigation. (Translational Research 2020; 226:57À69) Abbreviations: ARDS = acute respiratory distress syndrome; ACE2 = Angiotensin-Converting Enzyme II; CNS = central nervous system; COVID-19 = coronavirus disease 2019; CPR = C-reactive protein; H1N1 = influenza A virus; IL = Interleukin; MERS = Middle East respiratory syndrome; PRS = proteomic risk score; SARS = severe acute respiratory syndrome; SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2; SCFA = short-chain fatty acids; RAS = renin-angiotensin system; ROS = Reactive oxygen species; RT-PCR = reverse transcription-polymerase chain reaction; TMPRSS2 = transmembrane serine protease 2; TNFa = tumor necrosis factor alpha;

SARS-CoV-2 Infection and Oral Health: Therapeutic Opportunities and Challenges

“…Nitric oxide-mediated S-nitro-sylation of viral cysteine proteases and host serine protease, TMPRSS2, which are both critical in viral cellular entry, appear to be nitric oxide sensitive [ 60 , 63 , 64 ]. COVID-19 patients often experience periodontal disease [ 65 , 66 ], and vascular [ 67 , 68 ] and gastrointestinal (GI) [ 69 , 70 ] complications, perhaps because ACE2 receptors are widely expressed among these tissues [ 71 , 72 ]. A hyposalivation symptom is exhibited highly in COVID-19 patients [ 73 , 74 ].…”

Probiotics in Treatment of Viral Respiratory Infections and Neuroinflammatory Disorders

“…Patients with COVID-19 have higher serum concentrations of cytokines, including TNF-α, IFN-γ, IL-2, IL-4, IL-6, and IL-10 [74]. A high level of proinflammatory cytokines is associated with severe complications such as ARDS or septic shock in these patients [75]. Therefore, effective treatment to reduce inflammation-related lung damage and severe complications of COVID-19 is critical.…”

Nanomedicine & Nanotoxicology Future Could Be Reshaped Post-COVID-19 Pandemic

“…While SARS-CoV-2 has proven to be a savage virus through its associated complications causing coagulation disorders for COVID-19 patients (Al-Samkari et al, 2020;Kander, 2020) and other extrapulmonary ramifications (Gupta et al, 2020) such those on the heart (Samidurai and Das, 2020), brain (Lu et al, 2020), kidney (Fanelli et al, 2020) and gastrointestinal tract (Ng and Tilg, 2020;Villapol, 2020), there are still limited studies on the effects of synthetic NPs on these organs following different routes of administration. Perhaps the slight exception is with CNTs as there are more studies about their pseudoinhalation consequences due to some resemblance to asbestos fibers.…”