Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiology, Prevention, and Management.
Identifieur interne : 001757 ( Main/Corpus ); précédent : 001756; suivant : 001758Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiology, Prevention, and Management.
Auteurs : Ferdinando D'Amico ; Daniel C. Baumgart ; Silvio Danese ; Laurent Peyrin-BirouletSource :
- Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [ 1542-7714 ] ; 2020.
English descriptors
- KwdEn :
- Betacoronavirus (isolation & purification), Child (MeSH), Coronavirus Infections (complications), Diarrhea (epidemiology), Diarrhea (pathology), Diarrhea (physiopathology), Diarrhea (therapy), Disease Management (MeSH), Disease Transmission, Infectious (prevention & control), Feces (virology), Humans (MeSH), Incidence (MeSH), Infection Control (methods), Pandemics (MeSH), Peptidyl-Dipeptidase A (metabolism), Pneumonia, Viral (complications), Serine Endopeptidases (metabolism), Spike Glycoprotein, Coronavirus (metabolism), Virus Attachment (MeSH), Virus Internalization (MeSH).
- MESH :
- chemical , metabolism : Peptidyl-Dipeptidase A, Serine Endopeptidases, Spike Glycoprotein, Coronavirus.
- complications : Coronavirus Infections, Pneumonia, Viral.
- epidemiology : Diarrhea.
- isolation & purification : Betacoronavirus.
- methods : Infection Control.
- pathology : Diarrhea.
- physiopathology : Diarrhea.
- prevention & control : Disease Transmission, Infectious.
- therapy : Diarrhea.
- virology : Feces.
- Child, Disease Management, Humans, Incidence, Pandemics, Virus Attachment, Virus Internalization.
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) pandemic is a worldwide emergency. An increasing number of diarrhea cases is reported. Here we investigate the epidemiology, clinical presentation, molecular mechanisms, management, and prevention of SARS-CoV-2 associated diarrhea. We searched on PubMed, EMBASE, and Web of Science up to March 2020 to identify studies documenting diarrhea and mechanism of intestinal inflammation in patients with confirmed diagnosis of SARS-CoV-2 infection. Clinical studies show an incidence rate of diarrhea ranging from 2% to 50% of cases. It may precede or trail respiratory symptoms. A pooled analysis revealed an overall percentage of diarrhea onset of 10.4%. SARS-CoV uses the angiotensin-converting enzyme 2 (ACE2) and the serine protease TMPRSS2 for S protein priming. ACE2 and TMPRSS2 are not only expressed in lung, but also in the small intestinal epithelia. ACE2 is expressed furthermore in the upper esophagus, liver, and colon. SARS-CoV-2 binding affinity to ACE2 is significantly higher (10-20 times) compared with SARS-CoV. Several reports indicate viral RNA shedding in stool detectable longer time period than in nasopharyngeal swabs. Current treatment is supportive, but several options appear promising and are the subject of investigation. Diarrhea is a frequent presenting symptom in patients infected with SARS-CoV-2. Increasing evidence indicates possible fecal oral transmission, indicating the need for a rapid and effective modification of the screening and diagnostic algorithms. The optimal methods to prevent, manage, and treat diarrhea in COVID-19 infected patients are subjects of intensive research.
DOI: 10.1016/j.cgh.2020.04.001
PubMed: 32278065
PubMed Central: PMC7141637
Links to Exploration step
pubmed:32278065Le document en format XML
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Baumgart</name><affiliation><nlm:affiliation>Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Danese, Silvio" sort="Danese, Silvio" uniqKey="Danese S" first="Silvio" last="Danese">Silvio Danese</name><affiliation><nlm:affiliation>Department of Biomedical Sciences, Humanitas University, Milan, Italy; IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Center, IRCCS, Milan, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Peyrin Biroulet, Laurent" sort="Peyrin Biroulet, Laurent" uniqKey="Peyrin Biroulet L" first="Laurent" last="Peyrin-Biroulet">Laurent Peyrin-Biroulet</name><affiliation><nlm:affiliation>Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France. 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Baumgart</name><affiliation><nlm:affiliation>Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Danese, Silvio" sort="Danese, Silvio" uniqKey="Danese S" first="Silvio" last="Danese">Silvio Danese</name><affiliation><nlm:affiliation>Department of Biomedical Sciences, Humanitas University, Milan, Italy; IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Center, IRCCS, Milan, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Peyrin Biroulet, Laurent" sort="Peyrin Biroulet, Laurent" uniqKey="Peyrin Biroulet L" first="Laurent" last="Peyrin-Biroulet">Laurent Peyrin-Biroulet</name><affiliation><nlm:affiliation>Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France. Electronic address: peyrinbiroulet@gmail.com.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association</title><idno type="eISSN">1542-7714</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Betacoronavirus (isolation & purification)</term><term>Child (MeSH)</term><term>Coronavirus Infections (complications)</term><term>Diarrhea (epidemiology)</term><term>Diarrhea (pathology)</term><term>Diarrhea (physiopathology)</term><term>Diarrhea (therapy)</term><term>Disease Management (MeSH)</term><term>Disease Transmission, Infectious (prevention & control)</term><term>Feces (virology)</term><term>Humans (MeSH)</term><term>Incidence (MeSH)</term><term>Infection Control (methods)</term><term>Pandemics (MeSH)</term><term>Peptidyl-Dipeptidase A (metabolism)</term><term>Pneumonia, Viral (complications)</term><term>Serine Endopeptidases (metabolism)</term><term>Spike Glycoprotein, Coronavirus (metabolism)</term><term>Virus Attachment (MeSH)</term><term>Virus Internalization (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en"><term>Peptidyl-Dipeptidase A</term><term>Serine Endopeptidases</term><term>Spike Glycoprotein, Coronavirus</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Diarrhea</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Infection Control</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Diarrhea</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Diarrhea</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Disease Transmission, Infectious</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Diarrhea</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Feces</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Child</term><term>Disease Management</term><term>Humans</term><term>Incidence</term><term>Pandemics</term><term>Virus Attachment</term><term>Virus Internalization</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) pandemic is a worldwide emergency. An increasing number of diarrhea cases is reported. Here we investigate the epidemiology, clinical presentation, molecular mechanisms, management, and prevention of SARS-CoV-2 associated diarrhea. We searched on PubMed, EMBASE, and Web of Science up to March 2020 to identify studies documenting diarrhea and mechanism of intestinal inflammation in patients with confirmed diagnosis of SARS-CoV-2 infection. Clinical studies show an incidence rate of diarrhea ranging from 2% to 50% of cases. It may precede or trail respiratory symptoms. A pooled analysis revealed an overall percentage of diarrhea onset of 10.4%. SARS-CoV uses the angiotensin-converting enzyme 2 (ACE2) and the serine protease TMPRSS2 for S protein priming. ACE2 and TMPRSS2 are not only expressed in lung, but also in the small intestinal epithelia. ACE2 is expressed furthermore in the upper esophagus, liver, and colon. SARS-CoV-2 binding affinity to ACE2 is significantly higher (10-20 times) compared with SARS-CoV. Several reports indicate viral RNA shedding in stool detectable longer time period than in nasopharyngeal swabs. Current treatment is supportive, but several options appear promising and are the subject of investigation. Diarrhea is a frequent presenting symptom in patients infected with SARS-CoV-2. Increasing evidence indicates possible fecal oral transmission, indicating the need for a rapid and effective modification of the screening and diagnostic algorithms. The optimal methods to prevent, manage, and treat diarrhea in COVID-19 infected patients are subjects of intensive research.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32278065</PMID><DateCompleted><Year>2020</Year><Month>06</Month><Day>30</Day></DateCompleted><DateRevised><Year>2020</Year><Month>06</Month><Day>30</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1542-7714</ISSN><JournalIssue CitedMedium="Internet"><Volume>18</Volume><Issue>8</Issue><PubDate><Year>2020</Year><Month>07</Month></PubDate></JournalIssue><Title>Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association</Title><ISOAbbreviation>Clin. Gastroenterol. Hepatol.</ISOAbbreviation></Journal><ArticleTitle>Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiology, Prevention, and Management.</ArticleTitle><Pagination><MedlinePgn>1663-1672</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1542-3565(20)30481-X</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.cgh.2020.04.001</ELocationID><Abstract><AbstractText>The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) pandemic is a worldwide emergency. An increasing number of diarrhea cases is reported. Here we investigate the epidemiology, clinical presentation, molecular mechanisms, management, and prevention of SARS-CoV-2 associated diarrhea. We searched on PubMed, EMBASE, and Web of Science up to March 2020 to identify studies documenting diarrhea and mechanism of intestinal inflammation in patients with confirmed diagnosis of SARS-CoV-2 infection. Clinical studies show an incidence rate of diarrhea ranging from 2% to 50% of cases. It may precede or trail respiratory symptoms. A pooled analysis revealed an overall percentage of diarrhea onset of 10.4%. SARS-CoV uses the angiotensin-converting enzyme 2 (ACE2) and the serine protease TMPRSS2 for S protein priming. ACE2 and TMPRSS2 are not only expressed in lung, but also in the small intestinal epithelia. ACE2 is expressed furthermore in the upper esophagus, liver, and colon. SARS-CoV-2 binding affinity to ACE2 is significantly higher (10-20 times) compared with SARS-CoV. Several reports indicate viral RNA shedding in stool detectable longer time period than in nasopharyngeal swabs. Current treatment is supportive, but several options appear promising and are the subject of investigation. Diarrhea is a frequent presenting symptom in patients infected with SARS-CoV-2. Increasing evidence indicates possible fecal oral transmission, indicating the need for a rapid and effective modification of the screening and diagnostic algorithms. The optimal methods to prevent, manage, and treat diarrhea in COVID-19 infected patients are subjects of intensive research.</AbstractText><CopyrightInformation>Copyright © 2020 AGA Institute. Published by Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>D'Amico</LastName><ForeName>Ferdinando</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Biomedical Sciences, Humanitas University, Milan, Italy; Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Baumgart</LastName><ForeName>Daniel C</ForeName><Initials>DC</Initials><AffiliationInfo><Affiliation>Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Danese</LastName><ForeName>Silvio</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Biomedical Sciences, Humanitas University, Milan, Italy; IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Center, IRCCS, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Peyrin-Biroulet</LastName><ForeName>Laurent</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France. Electronic address: peyrinbiroulet@gmail.com.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D000078182">Systematic Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>04</Month><Day>08</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Clin Gastroenterol Hepatol</MedlineTA><NlmUniqueID>101160775</NlmUniqueID><ISSNLinking>1542-3565</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D064370">Spike Glycoprotein, Coronavirus</NameOfSubstance></Chemical><Chemical><RegistryNumber>EC 3.4.15.1</RegistryNumber><NameOfSubstance UI="D007703">Peptidyl-Dipeptidase A</NameOfSubstance></Chemical><Chemical><RegistryNumber>EC 3.4.17.-</RegistryNumber><NameOfSubstance UI="C413524">angiotensin converting enzyme 2</NameOfSubstance></Chemical><Chemical><RegistryNumber>EC 3.4.21.-</RegistryNumber><NameOfSubstance UI="D012697">Serine Endopeptidases</NameOfSubstance></Chemical><Chemical><RegistryNumber>EC 3.4.21.-</RegistryNumber><NameOfSubstance UI="C421305">TMPRSS2 protein, human</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Clin Gastroenterol Hepatol. 2020 Sep;18(10):2385-2387</RefSource><PMID Version="1">32425705</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName><QualifierName UI="Q000302" MajorTopicYN="Y">isolation & 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