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World J Gastroenterol. Dec 28, 2022; 28(48): 6811-6826
Published online Dec 28, 2022. doi: 10.3748/wjg.v28.i48.6811
Mechanism and potential treatments for gastrointestinal dysfunction in patients with COVID-19
Yang Yao, Zhu-Jun Liu, Yu-Kun Zhang, Hui-Jun Sun
Yang Yao, Zhu-Jun Liu, Yu-Kun Zhang, Hui-Jun Sun, Chongqing Key Laboratory of Development and Utilization of Genuine Medicinal Materials in Three Gorges Reservoir Area, College of Basic Medical, Chongqing 404120, China
Yang Yao, Department of Clinical Pharmacology, College of Pharmacy, Dalian 116044, Liaoning Province, China
Yang Yao, Ministry of Public Infrastructure, Chongqing Three Gorges Medical College, Chongqing 404120, China
Zhu-Jun Liu, Department of Basic Medicine, Chongqing Three Gorges Medical College, Chongqing 404120, China
Zhu-Jun Liu, Department of Business Administration, Metropolitan College of Science and Technology, Chongqing 404120, China
Yu-Kun Zhang, State Key Laboratory of Natural and Biomimetic Drugs, Department of Pharmacology, Peking University, Beijing 100191, China
Hui-Jun Sun, Department of Clinical Pharmacology, College of Pharmacy, Dalian Medical University, Dalian 116044, Liaoning Province, China
Author contributions: Yao Y designed this article and wrote the introduction; Yao Y and Liu ZJ wrote the main gastrointestinal symptoms of coronavirus disease 2019; Zhang YK analyzed and visualized the data of the article; Sun HJ designed and revised the manuscript.
Supported by the Commission, No. KJZD-K202002701; General Project of Chongqing Natural Science Foundation, No. cstc2019jcyj msxmX0299; Key Project of Chongqing Three Gorges Medical College, No. XJ2021000101; Chongqing Natural Drug Anti-Tumor Innovation Research Group, No. CXQT20030; Special Fund for Key Laboratory of Development and Utilization of Genuine Medicinal Materials in Three Gorges Reservoir Area, No. Sys20210002; and the Open Project in 2022 of Chongqing Key Laboratory for the Development and Utilization of Authentic Medicinal Materials in the Three Gorges Reservoir Area, No. KFKT2022004.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui-Jun Sun, MMed, PhD, Professor, Researcher, Department of Clinical Pharmacology, College of Pharmacy, Dalian Medical University, No. 9, West Section of Lushun South Road, Lvshunkou District, Dalian 116044, Liaoning Province, China. sunhuijun@dmu.edu.cn
Received: September 9, 2022
Peer-review started: September 9, 2022
First decision: October 19, 2022
Revised: November 1, 2022
Accepted: December 6, 2022
Article in press: December 6, 2022
Published online: December 28, 2022
Processing time: 108 Days and 18.1 Hours
Abstract

The global coronavirus disease 2019 (COVID-19) has become one of the biggest threats to the world since 2019. The respiratory and gastrointestinal tracts are the main targets for severe acute respiratory syndrome coronavirus 2 infection for they highly express angiotensin-converting enzyme-2 and transmembrane protease serine 2. In patients suffering from COVID-19, gastrointestinal symptoms have ranged from 12% to 61%. Anorexia, nausea and/or vomiting, diarrhea, and abdominal pain are considered to be the main gastrointestinal symptoms of COVID-19. It has been reported that the direct damage of intestinal mucosal epithelial cells, malnutrition, and intestinal flora disorders are involved in COVID-19. However, the underlying mechanisms remain unclear. Thus, in this study, we reviewed and discussed the correlated mechanisms that cause gastrointestinal symptoms in order to help to develop the treatment strategy and build an appropriate guideline for medical workers.

Keywords: COVID-19; Angiotensin-converting enzyme-2; Transmembrane protease serine 2; Gastrointestinal symptom; Mechanism; Intestinal barrier permeability

Core Tip: Gastrointestinal symptoms in coronavirus disease 2019 patients have ranged from 12% to 61%, which include anorexia, nausea and/or vomiting, diarrhea, abdominal pain, and so on. However, the underlying mechanisms remain unclear. This study reviewed and discussed the correlated mechanisms that cause gastrointestinal symptoms in order to help to develop the treatment strategy and build an appropriate guideline for medical workers.