GI-COVID: Are There COVID-19 Patients with Primary Gastrointestinal SARS-CoV-2 Infection and Symptoms?

Ong, John; Dan, Yock Young

doi:10.1007/s10620-020-06767-5

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…We therefore described the outcomes and features of patients hospitalized with COVID‐19 with liver dysfunction as manifested by jaundice. We found that 8.9% of the hospitalized patients with COVID‐19 in our cohort had hepatic jaundice, consistent with previous studies reporting jaundice in 6.0–16.7% patients 12 . Our analysis then specifically looked at mortality associated with hepatic jaundice and found it to be 40.8%, a case fatality rate similar to what has been reported for patients with COVID‐19 requiring invasive mechanical ventilation 13,14 .…”

Section: Discussionsupporting

confidence: 89%

“…We found that 8.9% of the hospitalized patients with COVID‐19 in our cohort had hepatic jaundice, consistent with previous studies reporting jaundice in 6.0–16.7% patients. 12 Our analysis then specifically looked at mortality associated with hepatic jaundice and found it to be 40.8%, a case fatality rate similar to what has been reported for patients with COVID‐19 requiring invasive mechanical ventilation. 13 , 14 We also found that the ICU admission rate was approximately 2.5 times higher for patients with hepatic jaundice.…”

Section: Discussionsupporting

confidence: 57%

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Jaundice in patients with COVID‐19

Bender

Worman

2021

JGH Open

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Background and Aim While many studies have reported on liver injury in patients with coronavirus disease 2019 (COVID‐19), none have specifically addressed the significance of hepatic jaundice. We aimed to determine the clinical consequences and etiologies of jaundice in patients with COVID‐19. Methods We retrospectively analyzed clinical features, laboratory abnormalities, and rates of survival and intensive care unit admission in 551 patients with COVID‐19, hospitalized between 1 March 2020, and 31 May 2020 at a tertiary care academic medical center. Hepatic jaundice was defined as a serum total bilirubin concentration >2.5 mg/dL and a direct bilirubin concentration >0.3 mg/dL that was >25% of the total. Liver injury was characterized as cholestatic, mixed, or hepatocellular at the time of peak serum total bilirubin concentration by calculating the R factor. Results Hepatic jaundice was present in 49 (8.9%) patients and associated with a mortality rate of 40.8% and intensive care unit admission rate of 69.4%, both significantly higher than for patients without jaundice. Jaundiced patients had an increased frequency of fever, leukopenia, leukocytosis, thrombocytopenia, hypotension, hypoxemia, elevated serum creatinine concentration, elevated serum procalcitonin concentration, and sepsis. Nine jaundiced patients had isolated hyperbilirubinemia. Of the 40 patients with abnormally elevated serum alanine aminotransferase or alkaline phosphatase activities, 62.5% had a cholestatic, 20.0% mixed, and 17.5% hepatocellular pattern of liver injury. Conclusion Hepatic jaundice in patients with COVID‐19 is associated with high mortality. The main etiologies of liver dysfunction leading to jaundice appear to be sepsis, severe systemic inflammation, and hypoxic/ischemic hepatitis.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 57%

Jaundice in patients with COVID‐19

Bender

Worman

2021

JGH Open

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“…Although the typical manifestations of COVID‐19 have been described at the pulmonary and vascular level, many patients infected with SARS‐CoV‐2 develop gastrointestinal symptoms, such as nausea, vomiting, and diarrhea (Ong & Dan, 2021).…”

Section: Discussionmentioning

confidence: 99%

Cannabidiol inhibits SARS‐Cov‐2 spike (S) protein‐induced cytotoxicity and inflammation through a PPARγ‐dependent TLR4/NLRP3/Caspase‐1 signaling suppression in Caco‐2 cell line

Corpetti

Seguella

et al. 2021

Phytotherapy Research

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Given the abundancy of angiotensin converting enzyme 2 (ACE-2) receptors density, beyond the lung, the intestine is considered as an alternative site of infection and replication for severe acute respiratory syndrome by coronavirus type 2 (SARS-CoV-2).Cannabidiol (CBD) has recently been proposed in the management of coronavirus disease 2019 (COVID-19) respiratory symptoms because of its anti-inflammatory and immunomodulatory activity exerted in the lung. In this study, we demonstrated the in vitro PPAR-γ-dependent efficacy of CBD (10 À9 -10 À7 M) in preventing epithelial damage and hyperinflammatory response triggered by SARS-CoV-2 spike protein (SP) in a Caco-2 cells. Immunoblot analysis revealed that CBD was able to reduce all the analyzed proinflammatory markers triggered by SP incubation, such as tool-like receptor 4 (TLR-4), ACE-2, family members of Ras homologues A-GTPase (RhoA-GTPase), inflammasome complex (NLRP3), and Caspase-1. CBD caused a parallel inhibition of interleukin 1 beta (IL-1β), IL-6, tumor necrosis factor alpha (TNF-α), and IL-18 by enzyme-linked immunosorbent assay (ELISA) assay. By immunofluorescence analysis, we observed increased expression of tight-junction proteins and restoration of transepithelial electrical resistance (TEER) following CBD treatment, as well as the rescue of fluorescein isothiocyanate (FITC)-dextran permeability induced by SP. Our data indicate, in conclusion, that CBD is a powerful inhibitor of SP protein enterotoxicity in vitro.

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“…Recent systematic reviews and meta-analyses have shown that the most common GI symptoms reported among COVID-19 patients include anorexia (15.8-26.8%), diarrhea (7.7-12.5%), nausea and vomiting (6-10.2%), and abdominal pain (3-9.2%). It is worth noting that these prevalence rates were reported in observational studies, which mainly include hospitalized COVID-19 patients and did not include all infected patients 56 , 57 .…”

Section: Serotoninmentioning

confidence: 99%