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Infection of Human Cells by SARS-CoV-2 and Molecular Overview of Gastrointestinal, Neurological, and Hepatic Problems in COVID-19 Patients

期刊

JOURNAL OF CLINICAL MEDICINE
卷 10, 期 21, 页码 -

出版社

MDPI
DOI: 10.3390/jcm10214802

关键词

gut flora; neurological symptoms; coronavirus disease 19; angiotensin-converting enzyme-2; spike protein; hepatic derangements

资金

  1. Iran National Science Foundation (INSF) [98029520]
  2. Russian Foundation for Basic Research (RFBR) [20-54-56005 Iran_t]
  3. Research Council of University of Tehran
  4. Research Council of IAU Jahrom Branch

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The gastrointestinal tract plays a crucial role in SARS-CoV-2 infection due to the overexpression of ACE2 cell receptors, which increases intestinal permeability to pathogens. Unlike liver cells, the gut has lower expression of ACE2, reducing the likelihood of liver infection by SARS-CoV-2. Additionally, there is an interconnected relationship between the lungs, brain, and gastrointestinal tract during severe COVID-19.
The gastrointestinal tract is the body's largest interface between the host and the external environment. People infected with SARS-CoV-2 are at higher risk of microbiome alterations and severe diseases. Recent evidence has suggested that the pathophysiological and molecular mechanisms associated with gastrointestinal complicity in SARS-CoV-2 infection could be explained by the role of angiotensin-converting enzyme-2 (ACE2) cell receptors. These receptors are overexpressed in the gut lining, leading to a high intestinal permeability to foreign pathogens. It is believed that SARS-CoV-2 has a lesser likelihood of causing liver infection because of the diminished expression of ACE2 in liver cells. Interestingly, an interconnection between the lungs, brain, and gastrointestinal tract during severe COVID-19 has been mentioned. We hope that this review on the molecular mechanisms related to the gastrointestinal disorders as well as neurological and hepatic manifestations experienced by COVID-19 patients will help scientists to find a convenient solution for this and other pandemic events.

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