Why Does SARS-CoV-2 Invade the Gastrointestinal Epithelium?

Uno, Yoshiharu

doi:10.1053/j.gastro.2020.04.006

Cited by 29 publications

(29 citation statements)

References 8 publications

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“…There is a furan cleavage site at the boundary between S1 and S2 subunits, which is mutated during virus invasion, thus distinguishing SARS-CoV-2 from SARS-CoV [16]. Veesler et al showed that SARS-CoV-2 entered cells using S protein by utilizing the angiotensin-converting enzyme 2 (ACE2) receptor on the surface of host cells, which is widely present in human respiratory and intestinal mucosal epithelial cells, enabling SARS-CoV-2 to infect humans and cause transmission in humans, which is similar to the transmission mechanism of SARS-CoV [16,19]. In addition, studies have shown that the expression level of ACE2 gene in the lungs of smokers is significantly higher than that of non-smokers, and smokers are more likely to be infected with SARS-CoV-2 [20].…”

Section: Virologymentioning

confidence: 99%

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): a review

et al. 2020

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In recent years, the prevalence and spread of coronavirus has had a huge impact on global public health. Due to the incomplete understanding of the pathogenic mechanism of the virus, it is difficult for humans to fight against the virus quickly and effectively once the outbreak occurs. In early 2020, a novel coronavirus was discovered in Wuhan, China. Soon after, similar cases were found in other countries around the world, and the number of infected people increased rapidly. So far, the global cumulative number of infected people has exceeded 3 million, and more than 200,000 people have died, which has had a huge impact on global human health and economic development. Every outbreak of disease makes a deep impression on mankind. Herein, we summarize the virology, epidemiology, clinical manifestations, diagnosis, treatment and prevention of SARS-CoV-2, and hope that countries can control the outbreak as soon as possible to minimize the loss.

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Section: Virologymentioning

confidence: 99%

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): a review

et al. 2020

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“…Although gastric acid can significantly reduce virus viability, SARS-CoV-2 is not inactivated in the stomach at gastric pH higher than 3.0 at room temperature [ 39 , 40 ]. This suggests the possibility that the virus travels to the intestine by passing through the gastric acid barrier, at least under conditions of chronic gastritis or Helicobacter pylori infection, the use of gastric acid inhibitors, or previous gastrectomy [ 41 ]. However, to date, several studies exploring the association between the use of proton pump inhibitors and increased disease severity/susceptibility to COVID-19 are controversial [ 42 , 43 , 44 ], making it difficult to determine whether there is indeed an increased risk for SARS-CoV-2 infection and COVID-19-related death for users of proton pump inhibitors.…”

Section: Clinical Gi Featuresmentioning

confidence: 99%

Clinical Features and Pathogenic Mechanisms of Gastrointestinal Injury in COVID-19

Mitsuyama

Tsuruta

Takedatsu

et al. 2020

JCM

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the global coronavirus disease 2019 (COVID-19) outbreak. Along with the respiratory tract, the gastrointestinal (GI) tract is one of the main extra-pulmonary targets of SARS-CoV-2 with respect to symptom occurrence and is a potential route for virus transmission, most likely due to the presence of angiotensin-converting enzyme 2. Therefore, understanding the mechanisms of GI injury is crucial for a harmonized therapeutic strategy against COVID-19. This review summarizes the current evidence for the clinical features of and possible pathogenic mechanisms leading to GI injury in COVID-19.

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“…Since SARS-CoV is completely inactivated by gastric pH ( 20 ), it is plausible that the replication of SARS-CoV-2 in the GIT may have become resistent to an increase in the gastric pH due to atrophic gastritis, gastric intestinal metaplasia, Helicobacter pylori infection, or the prolonged use of proton pump inhibitors ( 5 , 21 ). The presence of the coronavirus in the feces cannot be justified only by the swallowing saliva containing the virus because fecal swabs often remain positive even when pharyngeal swabs are negative ( 21 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

ACE2 Expression in the Cat and the Tiger Gastrointestinal Tracts

et al. 2020

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Angiotensin-converting enzyme 2 (ACE2) has been identified as the functional receptor for Severe Acute Respiratory Syndrome-Coronavirus−2 (SARS-CoV-2). It has been identified in the human gastrointestinal tract (GIT), and SARS-CoV-2 has been isolated in human and animal fecal samples. The aim of the present study was to investigate the expression of ACE2 in the gastrointestinal tract of domestic (cat) and wild (tiger) felines. Samples of the pylorus, duodenum, and distal colon were collected from six cats and one tiger. The tissues were processed for immunofluorescence assay with an anti-human ACE2 antibody. Angiotensin-converting enzyme 2 was widely expressed in the gastrointestinal mucosa of the cats and the tiger. In both the species, ACE2-immunoreactivity (ACE2-IR) was expressed by the mucosal epithelial cells of the GIT and by the enteric neurons. In the cats, ACE2-IR was also expressed by the smooth muscle cells of the blood vessels and the tunica muscularis. The expression of the ACE2 receptor in enteric neurons may support the potential neurotropic properties of SARS-CoV-2. Although the evidence of ACE2-IR in the feline GIT does not necessarily indicate the possibility of viral replication and SARS-CoV-2 spread with stool, the findings in the present study could serve as an anatomical basis for additional studies considering the risk of the SARS-CoV-2 fecal-oral transmission between cats/felids, and between cats/felids and humans.

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Why Does SARS-CoV-2 Invade the Gastrointestinal Epithelium?

Cited by 29 publications

References 8 publications

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): a review

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): a review

Clinical Features and Pathogenic Mechanisms of Gastrointestinal Injury in COVID-19

ACE2 Expression in the Cat and the Tiger Gastrointestinal Tracts

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