KORONAVİRÜS HASTALIĞI 2019 (COVID-19)’DA GASTROİNTESTİNAL BELİRTİLERİN ÖNEMİ VE OLASI MEKANİZMALARI

Zinnet Şevval Aksoyalp; Nergiz Hacer Turgut; Kemal Buharalıoğlu

doi:10.34108/eujhs.987842

Derleme

IMPORTANCE AND POTENTIAL MECHANISMS OF GASTROINTESTINAL SYMPTOMS IN CORONAVIRUS DISEASE 2019 (COVID-19)

Yıl 2022, Cilt: 31 Sayı: 2, 263 - 267, 11.08.2022

Zinnet Şevval Aksoyalp Nergiz Hacer Turgut Kemal Buharalıoğlu

https://doi.org/10.34108/eujhs.987842

Öz

Severe acute respiratory syndrome coronavirus-2 (SARS‐CoV‐2), the Coronavirus Disease 2019 (COVID-19) agent, poses a serious threat to human health worldwide. The virus is transmitted by droplets and contact and often occurs with fever, cough, and shortness of breath. SARS-CoV-2 not only affects the respiratory system but also causes gastrointestinal system disorders such as diarrhea, nausea, and vomiting. SARS-CoV-2 has been detected in fecal samples of COVID-19 patients. Besides, diarrhea may be an early symptom for COVID-19 was suggested. Nausea, vomiting, and diarrhea are treated symptomatically in COVID-19. Consistent with these gastrointestinal symptoms, the gut microbiota balance was disturbed in COVID-19 patients, and opportunistic pathogens were increased while beneficial commensal bacteria were decreased. The gut microbiota may be a new therapeutic target for COVID-19, and these patients may benefit from probiotic treatment. Consequently, gastrointestinal symptoms should be taken into account in COVID-19 patients. In this way, the isolation of patients diagnosed at an early stage may help control the epidemic.

Anahtar Kelimeler

COVID-19, SARS-CoV-2, diarrhea, microbiota, probiotics

Kaynakça

1. John Hopkins Coronavirus Resource Center, 2022. https://coronavirus.jhu.edu/map.html; Erişim tarihi: 01.02.2022
2. Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med 2020; 382:1199-1207.
3. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020; 323:1061-1069.
4. Danzi GB, Loffi M, Galeazzi G, et al. Acute pulmonary embolism and COVID-19 pneumonia: a random association? Eur Heart J 2020; 41:1858.
5. Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 2020; 395:1033-1034.
6. Mizumoto K, Kagaya K, Zarebski A, et al. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill 2020; 25:2000180.
7. Pan L, Mu M, Yang P, et al. Clinical Characteristics of COVID-19 Patients With Digestive Symptoms in Hubei, China: A Descriptive, Cross-Sectional, Multicenter Study. Am J Gastroenterol 2020; 115:766-773.
8. Lee IC, Huo TI, Huang YH. Gastrointestinal and liver manifestations in patients with COVID-19. J Chin Med Assoc 2020; 83:521-523.
9. Cholankeril G, Podboy A, Aivaliotis VI, et al. High Prevalence of Concurrent Gastrointestinal Manifestations in Patients With Severe Acute Respiratory Syndrome Coronavirus 2: Early Experience From California. Gastroenterology 2020; 159:775-777.
10. Arjmand B, Ghorbani F, Koushki M, et al. Gastrointestinal symptoms in patients with mild and severe COVID-19: a scoping review and meta-analysis. Gastroenterol Hepatol Bed Bench 2020; 13:321-330.
11. Silva FAFd, Brito BBd, Santos MLC, et al. COVID-19 gastrointestinal manifestations: a systematic review. Rev Soc Bras Med Trop 2020; 53:e20200714.
12. Jin X, Lian JS, Hu JH, et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut 2020; 69:1002-1009.
13. Song Y, Liu P, Shi XL, et al. SARS-CoV-2 induced diarrhoea as onset symptom in patient with COVID-19. Gut 2020; 69:1143-1144.
14. Gu J, Han B, Wang J. COVID-19: Gastrointestinal Manifestations and Potential Fecal-Oral Transmission. Gastroenterology 2020; 158:1518-1519.
15. Wolfel R, Corman VM, Guggemos W, et al. Virological assessment of hospitalized patients with COVID-2019. Nature 2020; 581:465-469.
16. Xu Y, Li X, Zhu B, et al. Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nat Med 2020; 26:502-505.
17. Xiao F, Tang M, Zheng X, et al. Evidence for Gastrointestinal Infection of SARS-CoV-2. Gastroenterology 2020; 158:1831-1833.
18. Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell 2020; 181:271-280.
19. Verdecchia P, Cavallini C, Spanevello A, et al. The pivotal link between ACE2 deficiency and SARS-CoV-2 infection. Eur J Intern Med 2020; 76:14-20.
20. Hamming I, Timens W, Bulthuis ML, et al. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol 2004; 203:631-7.
21. Zhang H, Kang Z, Gong H, et al. Digestive system is a potential route of COVID-19: an analysis of single-cell coexpression pattern of key proteins in viral entry process. Gut 2020; 69:1010-1018.
22. Gheblawi M, Wang K, Viveiros A, et al. Angiotensin-Converting Enzyme 2: SARS-CoV-2 Receptor and Regulator of the Renin-Angiotensin System: Celebrating the 20th Anniversary of the Discovery of ACE2. Circ Res 2020; 126:1456-1474.
23. Hoel H, Heggelund L, Reikvam DH, et al. Elevated markers of gut leakage and inflammasome activation in COVID-19 patients with cardiac involvement. J Intern Med 2021; 289:523-531.
24. Trottein F, Sokol HJCr. Potential causes and consequences of gastrointestinal disorders during a SARS-CoV-2 infection. Cell Rep 2020; 32:107915.
25. Hashimoto T, Perlot T, Rehman A, et al. ACE2 links amino acid malnutrition to microbial ecology and intestinal inflammation. Nature 2012; 487:477-81.
26. Perlot T, Penninger JM. ACE2- from the renin-angiotensin system to gut microbiota and malnutrition. Microbes Infect 2013; 15:866-73.
27. Gu S, Chen Y, Wu Z, et al. Alterations of the Gut Microbiota in Patients with COVID-19 or H1N1 Influenza. Clin Infect Dis 2020; 71:2669-2678.
28. Yeoh YK, Zuo T, Lui GC, et al. Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19. Gut 2021; 70:698-706.
29. Zuo T, Zhang F, Lui GC, et al. Alterations in Gut Microbiota of patients with COVID-19 during time of hospitalization. Gastroenterology 2020; 159:944-955.
30. Kotfis K, Skonieczna-Zydecka K. COVID-19: gastrointestinal symptoms and potential sources of SARS-CoV-2 transmission. Anaesthesiol Intensive Ther 2020; 52:171-172.
31. Gao QY, Chen YX, Fang JY. 2019 Novel coronavirus infection and gastrointestinal tract. J Dig Dis 2020; 21:125-126.
32. Guillemard E, Tanguy J, Flavigny A, et al. Effects of consumption of a fermented dairy product containing the probiotic Lactobacillus casei DN-114 001 on common respiratory and gastrointestinal infections in shift workers in a randomized controlled trial. J Am Coll Nutr 2010; 29:455-68.
33. Guo Q, Goldenberg JZ, Humphrey C, et al. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev 2019; 4:CD004827.
34. Goldenberg JZ, Yap C, Lytvyn L, et al. Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database Syst Rev 2017; 12:CD006095.
35. Liu F, Ye S, Zhu X, et al. Gastrointestinal disturbance and effect of fecal microbiota transplantation in discharged COVID-19 patients. J Med Case Rep 2021; 15:60.

KORONAVİRÜS HASTALIĞI 2019 (COVID-19)’DA GASTROİNTESTİNAL BELİRTİLERİN ÖNEMİ VE OLASI MEKANİZMALARI

Yıl 2022, Cilt: 31 Sayı: 2, 263 - 267, 11.08.2022

Zinnet Şevval Aksoyalp Nergiz Hacer Turgut Kemal Buharalıoğlu

https://doi.org/10.34108/eujhs.987842

Öz

Şiddetli akut solunum sendromu koronavirüsü-2 (SARS‐CoV‐2) etkeninin neden olduğu koronavirüs hastalığı 2019 (COVID-19) dünya çapında insan sağlığı için ciddi bir tehdit oluşturmaktadır. Virüs damlacık ve temas yolu ile bulaşmakta ve çoğunlukla ateş, öksürük ve nefes darlığı belirtileri ile ortaya çıkmaktadır. SARS-CoV-2 solunum sistemindeki etkilerinin yanı sıra diyare, bulantı-kusma gibi gastrointestinal sistem bozukluklarına da yol açmaktadır. COVID-19 hastalarının fekal örneklerinde SARS-CoV-2 saptanmıştır. Ayrıca diyarenin COVID-19 için erken bir belirti olabileceği öne sürülmektedir. Hastalarda gözlemlenen bulantı-kusma ve diyare semptomatik olarak tedavi edilmektedir. Gastrointestinal belirtilerle uyumlu olarak COVID-19 hastalarında bağırsak mikrobiyotası dengesinin bozulduğuna dair veriler elde edilmiştir ve fırsatçı patojenlerde artış ve yararlı kommensal bakterilerde azalma görülmüştür. Bağırsak mikrobiyotasının COVID-19 için yeni bir terapötik hedef olabileceği ve bu hastaların tedavisinde probiyotiklerin fayda sağlayabileceği öne sürülmüştür. Sonuç olarak COVID-19 hastalarında gastrointestinal belirtilerin dikkate alınması gerekmektedir. Bu sayede erken dönemde tanı konulan hastaların izolasyona alınması salgının kontrol altına alınabilmesine yarar sağlayabilir.

Anahtar Kelimeler

COVID-19, SARS-CoV-2, diyare, mikrobiyota, probiyotikler

Kaynakça

1. John Hopkins Coronavirus Resource Center, 2022. https://coronavirus.jhu.edu/map.html; Erişim tarihi: 01.02.2022
2. Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med 2020; 382:1199-1207.
3. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020; 323:1061-1069.
4. Danzi GB, Loffi M, Galeazzi G, et al. Acute pulmonary embolism and COVID-19 pneumonia: a random association? Eur Heart J 2020; 41:1858.
5. Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 2020; 395:1033-1034.
6. Mizumoto K, Kagaya K, Zarebski A, et al. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill 2020; 25:2000180.
7. Pan L, Mu M, Yang P, et al. Clinical Characteristics of COVID-19 Patients With Digestive Symptoms in Hubei, China: A Descriptive, Cross-Sectional, Multicenter Study. Am J Gastroenterol 2020; 115:766-773.
8. Lee IC, Huo TI, Huang YH. Gastrointestinal and liver manifestations in patients with COVID-19. J Chin Med Assoc 2020; 83:521-523.
9. Cholankeril G, Podboy A, Aivaliotis VI, et al. High Prevalence of Concurrent Gastrointestinal Manifestations in Patients With Severe Acute Respiratory Syndrome Coronavirus 2: Early Experience From California. Gastroenterology 2020; 159:775-777.
10. Arjmand B, Ghorbani F, Koushki M, et al. Gastrointestinal symptoms in patients with mild and severe COVID-19: a scoping review and meta-analysis. Gastroenterol Hepatol Bed Bench 2020; 13:321-330.
11. Silva FAFd, Brito BBd, Santos MLC, et al. COVID-19 gastrointestinal manifestations: a systematic review. Rev Soc Bras Med Trop 2020; 53:e20200714.
12. Jin X, Lian JS, Hu JH, et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut 2020; 69:1002-1009.
13. Song Y, Liu P, Shi XL, et al. SARS-CoV-2 induced diarrhoea as onset symptom in patient with COVID-19. Gut 2020; 69:1143-1144.
14. Gu J, Han B, Wang J. COVID-19: Gastrointestinal Manifestations and Potential Fecal-Oral Transmission. Gastroenterology 2020; 158:1518-1519.
15. Wolfel R, Corman VM, Guggemos W, et al. Virological assessment of hospitalized patients with COVID-2019. Nature 2020; 581:465-469.
16. Xu Y, Li X, Zhu B, et al. Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nat Med 2020; 26:502-505.
17. Xiao F, Tang M, Zheng X, et al. Evidence for Gastrointestinal Infection of SARS-CoV-2. Gastroenterology 2020; 158:1831-1833.
18. Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell 2020; 181:271-280.
19. Verdecchia P, Cavallini C, Spanevello A, et al. The pivotal link between ACE2 deficiency and SARS-CoV-2 infection. Eur J Intern Med 2020; 76:14-20.
20. Hamming I, Timens W, Bulthuis ML, et al. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol 2004; 203:631-7.
21. Zhang H, Kang Z, Gong H, et al. Digestive system is a potential route of COVID-19: an analysis of single-cell coexpression pattern of key proteins in viral entry process. Gut 2020; 69:1010-1018.
22. Gheblawi M, Wang K, Viveiros A, et al. Angiotensin-Converting Enzyme 2: SARS-CoV-2 Receptor and Regulator of the Renin-Angiotensin System: Celebrating the 20th Anniversary of the Discovery of ACE2. Circ Res 2020; 126:1456-1474.
23. Hoel H, Heggelund L, Reikvam DH, et al. Elevated markers of gut leakage and inflammasome activation in COVID-19 patients with cardiac involvement. J Intern Med 2021; 289:523-531.
24. Trottein F, Sokol HJCr. Potential causes and consequences of gastrointestinal disorders during a SARS-CoV-2 infection. Cell Rep 2020; 32:107915.
25. Hashimoto T, Perlot T, Rehman A, et al. ACE2 links amino acid malnutrition to microbial ecology and intestinal inflammation. Nature 2012; 487:477-81.
26. Perlot T, Penninger JM. ACE2- from the renin-angiotensin system to gut microbiota and malnutrition. Microbes Infect 2013; 15:866-73.
27. Gu S, Chen Y, Wu Z, et al. Alterations of the Gut Microbiota in Patients with COVID-19 or H1N1 Influenza. Clin Infect Dis 2020; 71:2669-2678.
28. Yeoh YK, Zuo T, Lui GC, et al. Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19. Gut 2021; 70:698-706.
29. Zuo T, Zhang F, Lui GC, et al. Alterations in Gut Microbiota of patients with COVID-19 during time of hospitalization. Gastroenterology 2020; 159:944-955.
30. Kotfis K, Skonieczna-Zydecka K. COVID-19: gastrointestinal symptoms and potential sources of SARS-CoV-2 transmission. Anaesthesiol Intensive Ther 2020; 52:171-172.
31. Gao QY, Chen YX, Fang JY. 2019 Novel coronavirus infection and gastrointestinal tract. J Dig Dis 2020; 21:125-126.
32. Guillemard E, Tanguy J, Flavigny A, et al. Effects of consumption of a fermented dairy product containing the probiotic Lactobacillus casei DN-114 001 on common respiratory and gastrointestinal infections in shift workers in a randomized controlled trial. J Am Coll Nutr 2010; 29:455-68.
33. Guo Q, Goldenberg JZ, Humphrey C, et al. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev 2019; 4:CD004827.
34. Goldenberg JZ, Yap C, Lytvyn L, et al. Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database Syst Rev 2017; 12:CD006095.
35. Liu F, Ye S, Zhu X, et al. Gastrointestinal disturbance and effect of fecal microbiota transplantation in discharged COVID-19 patients. J Med Case Rep 2021; 15:60.

Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	Türkçe
Konular	Eczacılık ve İlaç Bilimleri
Bölüm	Derlemeler
Yazarlar	Zinnet Şevval Aksoyalp 0000-0002-7822-3154 Nergiz Hacer Turgut 0000-0003-1700-2451 Kemal Buharalıoğlu 0000-0001-6077-1550
Yayımlanma Tarihi	11 Ağustos 2022
Gönderilme Tarihi	1 Eylül 2021
Yayımlandığı Sayı	Yıl 2022 Cilt: 31 Sayı: 2

Kaynak Göster

APA	Aksoyalp, Z. Ş., Turgut, N. H., & Buharalıoğlu, K. (2022). KORONAVİRÜS HASTALIĞI 2019 (COVID-19)’DA GASTROİNTESTİNAL BELİRTİLERİN ÖNEMİ VE OLASI MEKANİZMALARI. Sağlık Bilimleri Dergisi, 31(2), 263-267. https://doi.org/10.34108/eujhs.987842
AMA	Aksoyalp ZŞ, Turgut NH, Buharalıoğlu K. KORONAVİRÜS HASTALIĞI 2019 (COVID-19)’DA GASTROİNTESTİNAL BELİRTİLERİN ÖNEMİ VE OLASI MEKANİZMALARI. JHS. Ağustos 2022;31(2):263-267. doi:10.34108/eujhs.987842
Chicago	Aksoyalp, Zinnet Şevval, Nergiz Hacer Turgut, ve Kemal Buharalıoğlu. “KORONAVİRÜS HASTALIĞI 2019 (COVID-19)’DA GASTROİNTESTİNAL BELİRTİLERİN ÖNEMİ VE OLASI MEKANİZMALARI”. Sağlık Bilimleri Dergisi 31, sy. 2 (Ağustos 2022): 263-67. https://doi.org/10.34108/eujhs.987842.
EndNote	Aksoyalp ZŞ, Turgut NH, Buharalıoğlu K (01 Ağustos 2022) KORONAVİRÜS HASTALIĞI 2019 (COVID-19)’DA GASTROİNTESTİNAL BELİRTİLERİN ÖNEMİ VE OLASI MEKANİZMALARI. Sağlık Bilimleri Dergisi 31 2 263–267.
IEEE	Z. Ş. Aksoyalp, N. H. Turgut, ve K. Buharalıoğlu, “KORONAVİRÜS HASTALIĞI 2019 (COVID-19)’DA GASTROİNTESTİNAL BELİRTİLERİN ÖNEMİ VE OLASI MEKANİZMALARI”, JHS, c. 31, sy. 2, ss. 263–267, 2022, doi: 10.34108/eujhs.987842.
ISNAD	Aksoyalp, Zinnet Şevval vd. “KORONAVİRÜS HASTALIĞI 2019 (COVID-19)’DA GASTROİNTESTİNAL BELİRTİLERİN ÖNEMİ VE OLASI MEKANİZMALARI”. Sağlık Bilimleri Dergisi 31/2 (Ağustos 2022), 263-267. https://doi.org/10.34108/eujhs.987842.
JAMA	Aksoyalp ZŞ, Turgut NH, Buharalıoğlu K. KORONAVİRÜS HASTALIĞI 2019 (COVID-19)’DA GASTROİNTESTİNAL BELİRTİLERİN ÖNEMİ VE OLASI MEKANİZMALARI. JHS. 2022;31:263–267.
MLA	Aksoyalp, Zinnet Şevval vd. “KORONAVİRÜS HASTALIĞI 2019 (COVID-19)’DA GASTROİNTESTİNAL BELİRTİLERİN ÖNEMİ VE OLASI MEKANİZMALARI”. Sağlık Bilimleri Dergisi, c. 31, sy. 2, 2022, ss. 263-7, doi:10.34108/eujhs.987842.
Vancouver	Aksoyalp ZŞ, Turgut NH, Buharalıoğlu K. KORONAVİRÜS HASTALIĞI 2019 (COVID-19)’DA GASTROİNTESTİNAL BELİRTİLERİN ÖNEMİ VE OLASI MEKANİZMALARI. JHS. 2022;31(2):263-7.

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