Gordian Knot: Gastrointestinal lesions caused by three highly pathogenic coronaviruses from SARS-CoV and MERS-CoV to SARS-CoV-2

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pathogen of 2019 novel coronavirus disease (COVID-19), is currently spreading around the world. The WHO declared on January 31 that the outbreak of SARS-CoV-2 was a public health emergency. SARS-Cov-2 is a member of highly pathogenic coronavirus group that also consists of severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Although respiratory tract lesions were regarded as main manifestation of SARS-Cov-2 infection, gastrointestinal lesions were also reported. Similarly, patients with SARS-CoV and MERS-CoV were also observed. Common gastrointestinal symptoms of patients mainly included diarrhea, vomiting and abdominal pain. Gastrointestinal lesions could be used as basis for early diagnosis of patients, and at the same time, controlling gastrointestinal lesions better facilitated to cut off the route of fecal-oral transmission. Hence, this review summarizes the characteristics and mechanism of gastrointestinal lesions caused by three highly pathogenic human coronavirus infections including SARS-CoV, MERS-CoV, as well as SARS-CoV-2. Furthermore, it is expected to gain experience from gastrointestinal lesions caused by SARS-CoV and MERS-CoV infections in order to be able to better relieve SARS-CoV-2 epidemic. Targetin gut microbiota to regulate the process of SARS-CoV-2 infection should be a concern. Especially, the application of nanotechnology may provide help for further controlling COVID-19.

Reduction in SARS-CoV-2 Virus Infectivity in Human and Hamster Feces

“…The combination of high concentrations of viral RNA [10], the detection of subgenomic RNA [11] and viral antigens [12] as well as prolonged detectability in fecal samples compared with respiratory samples [10,[13][14][15][16] supports an active replication of SARS-CoV-2 in the GI tract. Finally, viral lesions were observed in the GI tract of patients [17,18].…”

Defense of COVID-19 by Human Organoids

“…SARS­-CoV-­2 infected patients have clinical manifestations ranging from asymptomatic infection, mild influenza like symptoms to severe lung injury (Dai et al 2020 ; Gao et al 2020 ). Yet symptoms are noted in a wide range of other organs, such as heart, brain, lung, liver, kidney, intestine and coagulation system, accompanying symptoms like fever, cough, myalgia, fatigue, odynophagia, and dyspnea (Meng et al 2021 ; Norma and Raul 2020 ; Wang et al 2020a ; Xiong et al 2020 ; Yang et al 2020a ). This pandemic has caused over 157 million people infected and more than 3 million deaths worldwide as of 9 May 2021 (WHO 2021 ).…”