Digestive disorder symptoms in COVID-19 may be similar in form to post-infectious functional gastrointestinal disorder (PI-FGID). To cause clinical effects, SARS-CoV-2 must reach the bowels and gastric hypochlorhydria may facilitate such transit. Asian elderly are predisposed to greater infection rate and severity of COVID-19, and the high prevalence of gastric atrophy and intake of proton-pump inhibitor in this aged group might explain the risk. Persistence shedding of SARS-CoV-2 in stools indicates that faecal transmission should not be disregarded. Gut involvement in COVID-19 is mediated by angiotensin-converting enzyme 2 (ACE2) receptor, which serves as the entry point for SARS-CoV-2 in the small bowel. ACE2 dysregulation has an impact on the homeostasis of gut microbiota and altered inflammatory response. Liver injury is variable in COVID-19 and is likely a result of by-stander effects rather than actual viropathic process. Further research is needed to understand if gut involvement is a cause or effect of SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2, ACE2, liver, gastrointestinal tract, 【초록키워드】 risk, Transmission, Symptom, angiotensin-converting enzyme 2, Prevalence, Stool, severity of COVID-19, Research, gut microbiota, receptor, infection rate, inhibitor, homeostasis, Inflammatory response, Injury, Gut, dysregulation, Asian, disorder, bowel, Effect, Effects, greater, facilitate, functional, indicate, explain, gastric atrophy, hypochlorhydria, 【제목키워드】 Effect, cause, Involvement,