REED - Revista Española de Enfermedades Digestivas

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Year 2020 / Volume 112 / Number 5
Rapid reviews

COVID-19, coronavirus, SARS-CoV-2 and the small bowel

383-388

DOI: 10.17235/reed.2020.7137/2020

Klaus Mönkemüller, Lucia Fry, Steffen Rickes,

Abstract

Although SARS-CoV-2 may primarily enter the cells of the lungs, the small bowel may also be an important entry or interaction site, as the enterocytes are rich in angiotensin converting enzyme (ACE)-2 receptors. The initial gastrointestinal symptoms that appear early during the course of Covid-19 support this hypothesis. Furthermore, SARS-CoV virions are preferentially released apically and not at the basement of the airway cells. Thus, in the setting of a productive infection of conducting airway epithelia, the apically released SARS-CoV may be removed by mucociliary clearance and gain access to the GI tract via a luminal exposure. In addition, post-mortem studies of mice infected by SARS-CoV have demonstrated diffuse damage to the GI tract, with the small bowel showing signs of enterocyte desquamation, edema, small vessel dilation and lymphocyte infiltration, as well as mesenteric nodes with severe hemorrhage and necrosis. Finally, the small bowel is rich in furin, a serine protease which can separate the S-spike of the coronavirus into two “pinchers” (S1 and 2). The separation of the S-spike into S1 and S2 is essential for the attachment of the virion to both the ACE receptor and the cell membrane. In this special review, we describe the interaction of SARS-CoV-2 with the cell and enterocyte and its potential clinical implications.

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03/06/2021 17:05:53
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Mönkemüller K, Fry L, Rickes S. COVID-19, coronavirus, SARS-CoV-2 and the small bowel. 7137/2020

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Publication history

Received: 14/04/2020

Accepted: 26/04/2020

Online First: 28/04/2020

Published: 08/05/2020

Article revision time: 6 days

Article Online First time: 14 days

Article editing time: 24 days

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