Role of gastrointestinal system on transmission and pathogenesis of SARS-CoV-2

Abstract

Coronavirus disease 2019 (COVID-19) continues to pose a significant threat to global health. Primary prevention remains as a major strategy against the pandemic. Current evidence proves that aerosol and droplet-based routes are the main means of transmission of COVID-19 but other ways should be sought in order to prevent possible collateral transmission. The gastrointestinal system may be one such route. Angiotensin converting enzyme 2 is the target entry receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is abundantly expressed in the gastrointestinal tract. SARS-CoV-2 is able to infect human enterocytes similar to severe acute respiratory syndrome and Middle Eastern respiratory syndrome. Herein this review, we discuss the current knowledge regarding the role of gastrointestinal transmission in transmission and pathophysiology of COVID-19.

Intra-Host Evolution Analyses in an Immunosuppressed Patient Supports SARS-CoV-2 Viral Reservoir Hypothesis

“…Given that the sampling of viral sequences was performed in only one anatomical location, our study is, however, not able to determine which organ is the source of the reservoir. The gut has been proposed as one assumed location for viral reservoirs of SARS-CoV-2 [ 30 , 31 ]. Other studies have reported on the neuroinvasive capacity of SARS-CoV-2 [ 32 ], which is difficult to confirm in patients during an infection due to lack of technology to directly sample central nervous system tissues.…”

Solar desalination/purification (solar stills, humidification-dehumidification, solar disinfection) in high altitude during COVID19: Insights of gastrointestinal manifestations and systems’ mechanism

“…Previously, Kotifs et al [141] pointed out the gastrointestinal tract would be considered as an alternative path for infection of the person to person by the SARS-CoV-2. Simsek et al [142] in a meta-analysis on the findings of the all studies on gastrointestinal transmission concluded that the fecal-oral transmission should not be underestimated. Jiao et al [143] in a non-human model proved that the gastrointestinal tract can be considered as a transmission route of the SARS-CoV-2.…”

Type I Interferon and COVID-19

“…Through the transmembrane serine protease 2 (TMPRSS2) and the angiotensin-converting enzyme 2 (ACE-2) receptor, the virus enters the nasal mucosa, targeting the most receptive epithelial cells of the nasal mucosa [16]. A possible route of virus transmission has been identified through the alimentary system because SARS-CoV-2 receptors are widely expressed in the gastrointestinal tract [17]. As a consequence of viral infection and active viral replication, cytosolic viral sensors in the respiratory epithelium induce immunological responses in epithelial cells, primarily type III IFNs, and less commonly type I IFNs [18].…”