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gastrointestinal symptoms in patients with COVID-19: Is there a relationship with mortality and new variations of SARS-CoV-2?

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World Journal of Gastroenterology 2021年第37期27卷 6345-6347页

作者： Igor Braga Ribeiro Diogo Turiani Hourneaux de Moura Eduardo Guimarães Hourneaux de Moura Departamento de Gastroenterologia Serviço de Endoscopia Gastrointestinal do Hospital das Clínicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao Paulo 05403-010Brazil

Coronavirus disease 2019(COVID-19)is caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Although,respiratory symptoms are typical the digestive system is also a susceptible target with gastrointestinal symptoms present even in the absence of respiratory symptoms.The gastrointestinal symptoms of COVID-19 include diarrhea,abdominal pain,anorexia,and nausea among other symptoms.Some questions that remain to be answered include:Do patients with gastrointestinal symptoms have a higher mortality?SARS-CoV-2 variants are already a global reality:Do these variants present with a greater prevalence of gastrointestinal symptoms?Do patients with these symptoms warrant more intensive care unit care?

关键词： COVID-19 SARS-CoV-2 gastrointestinal symptoms Intensive care unit Variant

A systematic scoping review of study methodology for randomized controlled trials investigating probiotics in athletic and physically active populations

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Journal of Sport and Health Science 2024年第1期13卷 61-71页

作者： Alex E.Mohr David B.Pyne Geovana Silva Fogaça Leite Deborah Akins Jamie Pugh College of Health Solutions Arizona State UniversityPhoenixAZ 85004USA Research Institute for Sport and Exercise University of CanberraCanberraACT 2617Australia Laboratory of Functional Fermented Food Faculty of Pharmaceutical SciencesUniversity of São PauloSão Paulo 05508-030Brazil Research Institute for Sport and Exercise Sciences Liverpool John Moores UniversityLiverpool L33AFUK

Background:The purported ergogenic and health effects of probiotics have been a topic of great intrigue among researchers,practitioners,and the lay public alike.There has also been an increased research focus within the realm of sports science and exercise medicine on the athletic gut microbiota.However,compared to other ergogenic aids and dietary supplements,probiotics present unique study challenges.The objectives of this systematic scoping review were to identify and characterize study methodologies of randomized controlled trials investigating supplementation with probiotics in athletes and physically active individuals.Methods:Four databases(MEDLINE,CINAHL,Cochrane CENTRAL,and Cochrane Database of Systematic Reviews)were searched for randomized controlled studies involving healthy athletes or physically active individuals.An intervention with probiotics and inclusion of a control and/or placebo group were essential.Only peer-reviewed articles in English were considered,and there were no date restrictions.Results were extracted and presented in tabular form to detail study protocols,characteristics,and outcomes.Bias in randomized controlled trials was determined with the RoB 2.0 tool.Results:A total of 45 studies were included in the review,with 35 using a parallel group design and 10 using a cross-over design.Approximately half the studies used a single probiotic and the other half a multi-strain preparation.The probiotic dose ranged from 2×10^(8)to 1×10^(11)colony forming units daily,and the length of intervention was between 7 and 150 days.Fewer than half the studies directly assessed gastrointestinal symptoms,gut permeability,or the gut microbiota.The sex ratio of participants was heavily weighted toward males,and only 3 studies exclusively investigated females.Low-level adverse events were reported in only 2 studies,although the methodology of reporting varied widely.The risk of bias was generally low,although details on randomization were lacking in some studies.Conclusion:There is a substantial body of

关键词： Exercise Experimental methodology gastrointestinal symptoms Gut microbiota Probiotic supplementation

Microbiome and intestinal pathophysiology in post-acute sequelae of COVID-19

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Genes & Diseases 2024年第3期11卷 220-231页

作者： Jilei Zhang Yongguo Zhang Yinglin Xia Jun Sun Division of Gastroenterology and Hepatology Department of MedicineUniversity of Ilinois ChicagoIL60612USA Uic Cancer Center Department of Microbiology and ImmunologyUniversity of Ilinois ChicagoChicagoIL60612USA Jesse Brown VA Medical Center ChicagoIL60612USA

Long CoVID,also known for post-acute sequelae of CovID-19,describes the people who have the signs and symptoms that continue or develop after the acute coviD-19 phase.Long CovID patients suffer from an inflammation or host responses towards the virus approx-imately 4 weeks after initial infection with the SARS CoV-2 virus and continue for an unchar-acterized duration.Anyone infected with CovID-19 before could experience long-CcovID conditions,including the patients who were infected with SARS CoV-2 virus confirmed by tests and those who never knew they had an infection early.People with long CoviD may experience health problems from different types and combinations of symptoms over time,such as fa-tigue,dyspnea,cognitive impairments,and gastrointestinal(Gl)symptoms(e.g.,nausea,vom-iting,diarrhea,decreased or loss of appetite,abdominal pain,and dysgeusia).The critical role of the microbiome in these Gl symptoms and long CovID were reported in clinical patients and experimental models.Here,we provide an overall view of the critical role of the Gl tract and microbiome in the development of long COVID,including the clinical Gl symptoms in patients,dysbiosis,viral-microbiome interactions,barrier function,and inflammatory bowel disease patients with long CovID.We highlight the potential mechanisms and possible treatment based on Gl health and microbiome.Finally,we discuss challenges and future direction in the long CoVID clinic and research.

关键词： gastrointestinal symptoms Gl tract Gut microbiome Inflammatorybowel diseases Intestinal barrier Long CoVID Metabolites Tight junctions

Pathophysiological mechanisms underlying gastrointestinal symptoms in patients with COVID-19

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World Journal of Gastroenterology 2021年第19期27卷 2341-2352页

作者： Byungchang Jin Rajan Singh Se Eun Ha Hannah Zogg Paul J Park Seungil Ro Department of Physiology and Cell Biology University of Nevada School of MedicineRenoNV 89557United States Department of Medicine Renown HealthRenoNV 89557United States

gastrointestinal(GI)symptoms,such as diarrhea,abdominal pain,vomiting,and anorexia,are frequently observed in patients with coronavirus disease 2019(COVID-19).However,the pathophysiological mechanisms connecting these GI symptoms to severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infections remain elusive.Previous studies indicate that the entry of SARS-CoV-2 into intestinal cells leads to downregulation of angiotensin converting enzyme 2(ACE2)receptors resulting in impaired barrier function.While intestinal ACE2 functions as a chaperone for the amino acid transporter B0AT1,the B0AT1/ACE2 complex within the intestinal epithelium acts as a regulator of gut microbiota composition and function.Alternations to the B0AT1/ACE2 complex lead to microbial dysbiosis through increased local and systemic immune responses.Previous studies have also suggested that altered serotonin metabolism may be the underlying cause of GI disorders involving diarrhea.The findings of elevated plasma serotonin levels and high fecal calprotectin in COVID-19 patients with diarrhea indicate that the viral infection evokes a systemic inflammatory response that specifically involves the GI.Interestingly,the elevated proinflammatory cytokines correlate with elevated serotonin and fecal calprotectin levels further supporting the evidence of GI inflammation,a hallmark of functional GI disorders.Moreover,the finding that rectal swabs of COVID-19 patients remain positive for SARS-CoV-2 even after the nasopharynx clears the virus,suggests that viral replication and shedding from the GI tract may be more robust than that of the respiratory tract,further indicating fecal-oral transmission as another important route of viral spread.This review summarized the evidence for pathophysiological mechanisms(impaired barrier function,gut inflammation,altered serotonin metabolism and gut microbiota dysbiosis)underlying the GI symptoms in patients with COVID-19.

关键词： COVID-19 gastrointestinal symptoms Gut microbiota dysbiosis Impaired barrier function Serotonin Angiotensin converting enzyme 2 receptor

Clinical characteristics of patients with COVID-19 presenting with gastrointestinal symptoms as initial symptoms: Retrospective case series

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World Journal of Clinical Cases 2020年第14期8卷 2950-2958页

作者： Yun Yang Yuan-Chao Li Si-Cong Wang Qing-Qing Dai Xue-Song Jiang Shu Zuo Liu Jia Jun-Bo Zheng Hong-Liang WangDepartment of Critical Care Medicine the Second Affiliated Hospital of Harbin Medical University Harbin 150001Heilongjiang ProvinceChina Department of Critical Care Medicine the Cancer Hospital of Harbin Medical UniversityHarbin 150081Heilongjiang ProvinceChina

BACKGROUND A large number of pneumonia cases due to coronavirus disease 2019(COVID-19)have been first reported in China.Meanwhile,the virus is sweeping all around the world and has infected millions of people.Fever and pulmonary symptoms have been noticed as major and early signs of infection,whereas gastrointestinal symptoms were also observed in a significant portion of patients.The clinical investigation of disease onset was underestimated,especially due to the neglection of cases presenting with gastrointestinal symptoms.AIM To characterize the clinical features of coronavirus-infected patients with gastrointestinal symptoms as initial symptoms.METHODS This is a retrospective,single-center case series of the general consecutive hospitalized patients with confirmed COVID-19 at Wuhan Union Hospital from February 2,2020 to February 13,2020.According to their initial symptoms,these patients were classified into two groups.Patients in group one presented with pulmonary symptoms(PS)as initial symptoms,and group two presented with gastrointestinal symptoms(GS).Epidemiological,demographic,clinical,laboratory,and treatment data were collected for analysis.RESULTS Among the 50 patients recruited,no patient has been admitted to intensive care units,and no patient died during the study.The duration of hospitalization was longer in the GS group than in the PS group(12.13±2.44 vs 10.00±2.13,Pgastrointestinal symptoms as initial symptoms need more days of viral shedding and hospitalization than the patients presenting with pulmonary symptoms.

关键词： COVID-19 Initial symptoms gastrointestinal symptoms Hospitalization Viral transmission

Prevalence and Determinants of gastrointestinal symptoms in Adults on Maintenance Hemodialysis in Cameroon

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Open Journal of Nephrology 2020年第3期10卷 212-222页

作者： Francois Folefack Kaze Mathurin Pierre Kowo Ethel Ngweh-Awah Anyu Ndikum Hermine Danielle Menye Ebana Fouda Victorine Nzana Emmanuelle Ndjong Marie Patrice Halle Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Departement of Internal Medicine Yaounde University Teaching Hospitals Yaounde Cameroon Higher Institute of Health Sciences Bangangté Cameroon Department of Clinical Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Introduction: gastrointestinal symptoms (GIS) are common in patients on maintenance hemodialysis and constitute an important cause of morbidity. Objectives: To determine the prevalence of GIS and identify their determinants in adults on maintenance hemodialysis in Cameroon. Patients and Methods: This hospital-based cross-sectional study was conducted from January to May 2017 at the Yaounde University Teaching Hospital dialysis center. All conscious consenting adults’ patients who provided a written informed consent and have been on hemodialysis for more than three months with an arterio-venous fistula were recruited. All chronic hemodialysis patients of the center dialyze 4 hours twice a week. All patients with dementia were excluded. We collected demographic, clinical, and paraclinical data and used Rome IV modified GIS rating scale. Parametric and non-parametric tests were used to compare variables. Results: We included 83 (72.3% males) participants with a mean (SD) age of 50 (12) years. Hypertension (31.3%), chronic glomerulonephritis (26.5%) and diabetes mellitus (20.5%) were the leading baseline nephropathy. There were 31 (37.3%) participants with psychiatric disorders including anxiety (45.2%) and depression (54.8%). The biological abnormalities were increased parathormone (20.5%), hypocalcemia (24.1%), hyperphosphatemia (32.5%), increased C-reactive protein (46.4%) and anemia (68.7%). The GIS was reported in 73 (87.9%) participants. Diarrhea (47%), constipation (38.6%), vomiting (38.6%), anorexia (33.7%) and nausea (31.3%) were the main GIS observed. The presence of hypertension was the only association with the GIS (p = 0.02). We did not find any association between GIS and age, gender, diabetes mellitus, psychiatric disorders and duration in dialysis (all p > 0.1). Conclusion: We reported a high prevalence of GIS in this mainly young adult population. This could be related to their under-dialysis status and suggest the i

关键词： gastrointestinal symptoms Adults Hemodialysis Cameroon

Association of Perceived Stress and gastrointestinal symptoms in College Students: A Systematic Review

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Open Journal of Gastroenterology 2021年第12期11卷 275-284页

作者： Hamna Akram Ameer Sushil Pokhrel Maurice H. Dick Nabeel Riaz Ahmed Arowa Abdelgadir Vaishnavi Kuilkarni Abanti Chatterjee Safeera Khan California Institute of Behavioral Neurosciences and Psychology California USA

Stress and anxiety are common entities in college students, and only a handful of students can handle these stressors appropriately, while others may show physical signs and symptoms. The main purpose of this systematic review was to examine the association between perceived stress and gastrointestinal symptoms. A detailed search was conducted using five databases: PubMed, Research Gate, Science Direct, American Journal of Gastroenterology, and Google scholar. Ten papers were finalized after the application of various inclusion and exclusion criteria. The Newcastle Ottawa scale was used to evaluate the quality of the included articles as all the included articles were cross-sectional studies. The systematic review of these finalized articles found that most studies revealed the prevalence of gastrointestinal symptoms in college students and were linked to perceived stress.

关键词： gastrointestinal symptoms Perceived Stress

Weight Loss and gastrointestinal symptoms in Advanced Cancer Patients Treated with Platinum-based Chemotherapy

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Journal of Nutritional Oncology 2020年第2期5卷 97-104页

作者： Hui Gao Dong Bo Liu Jin Tong Jing Han Bo Liu Si Xian Zhu Liu Huang Ying Yao Shi Ying Yu Qiang Fu Department of Oncology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Clinical Nutrition Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Peripherally Inserted Central Venous Catheters(PICC) Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

Objective This study assessed the weight loss changes and gastrointestinal symptoms in patients with advanced tumors receiving platinum-containing chemotherapy.Methods We retrospectively reviewed 297 patients with advanced cancers[124 gastrointestinal(GI)cancer patients,119 lung cancer patients and 54 head and neck cancer(HNC)patients]receiving first-line chemotherapy at Tongji Hospital.The patients’changes in body weight,body mass index(BMI),and biochemical parameters(serum haemoglobin and albumin levels)were compared before and after two chemotherapy cycles.Results More than half[54.88%(163/297)]of the patients had experienced unintentional weight loss in the 6 months before chemotherapy,and weight loss≥5%and≥10%of the body mass was noted in 35.69%and 20.20%of the patients,respectively.After two cycles of platinum-based chemotherapy,the proportions of patients with a>5%reduction in body weight among patients with GI,lung,and head and neck cancers were 47.5%(59/124),44.53%(53/119),and 46.2%(25/54),respectively.The patients with GI and lung cancers were more vulnerable to extreme weight loss(≥10%)than those with HNC(P=0.025).The serum hemoglobin levels were also remarkably decreased relative to those before chemotherapy(all Psymptoms reported by all patients included anorexia(61.28%),vomiting(52.53%),and nausea(51.18%).A higher proportion of patients with≥10%weight loss experienced anorexia and vomiting(OR=12.21 and 3.61,P=0.008 and 0.047,respectively).Conclusions For advanced cancer patients receiving platinum-based chemotherapy,the GI symptoms are the major factor related to their nutritional status.Appropriate nutritional screening,evaluation and treatment should be applied during the treatment of cancer in order to reduce GI symptoms and improve the patient’s nutritional status.

关键词： Weight loss Platinum-based chemotherapy gastrointestinal symptoms Hemoglobin

Immune Response,Viral Shedding Time,and Clinical Characterization in COVID-19 Patients With gastrointestinal symptoms

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Immune Response,Viral Shedding Time,and Clinical Characteriz...