As a new infectious disease, COVID-19 is spread through the respiratory tract in most cases. Its source and pathological mechanism are not clear. The most common clinical feature is pulmonary infection. Also, a lot patients have gastrointestinal symptoms. Angiotensin-converting enzyme 2 (ACE2) is a functional cellular receptor for SARS-CoV-2, which is like SARS-CoV, a coronavirus associated with severe acute respiratory syndrome (SARS) outbreak in 2003. The tissues and cells expressing ACE2 are potential targets for SARS-CoV-2 infection, and the high expression of ACE2 in intestinal epithelial cells marks that SARS-CoV-2 may directly infect intestinal epithelial cells. Recent studies also suggest that SARS-CoV-2 existed and replicated in intestinal environment for a long time. The interaction between SARS-CoV-2 and RAS system leads to the decrease of local anti-inflammatory ability. The virus cycle leads to excessive imbalance of immune response and cytokine release. The downregulation of ACE2 after viral infection leads to gastrointestinal dysfunction. The above are the causes of gastrointestinal symptoms. Here, we reviewed the possible causes and mechanisms of gastrointestinal symptoms caused by COVID-19. Additionally, we discussed the influence of gastrointestinal symptoms on the prognosis of patients.
【저자키워드】 Cytokine storm, Angiotensin-converting enzyme 2 (ACE2), Coronavirus disease 2019 (COVID-19), gastrointestinal tract, RAS system, gut–lung axis, 【초록키워드】 COVID-19, SARS-CoV-2, viral infection, ACE2, coronavirus, immune response, Anti-inflammatory, SARS-CoV, SARS-COV-2 infection, Local, Infectious disease, RAS, Spread, outbreak, Patient, target, respiratory tract, expression, mechanism, Pulmonary infection, Interaction, gastrointestinal symptoms, dysfunction, acute respiratory syndrome, tissue, enzyme, downregulation, cytokine release, intestinal epithelial cells, cellular receptor, infect, Gastrointestinal symptom, virus cycle, recent, Cell, decrease, intestinal, pathological mechanism, caused, functional, cause, replicated, expressing, intestinal epithelial cell, prognosis of patients, 【제목키워드】 COVID-19, Gastrointestinal,