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Coronavirus can attack both your gut and lungs

May 14, 2020

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This story originally appeared in The Conversation

Coronavirus can attack both your gut and lungsCoronavirus can attack both your gut and lungs

By Martin Veysey, Program Director MBBS, Hull York Medical School, University of York

When we think of coronavirus symptoms, we think of the lungs – people with ventilators or with an uncomfortable cough who have difficulty breathing. This is because a COVID-19 positive patient often has fever, persistent cough, muscle pain, and fatigue.

However, the molecule that attacks the virus in our body – the angiotensin converting enzyme 2 or ACE2 – is not only present in our lungs, but also in our gastrointestinal tract. This could account for the significant number of cases where patients experience gastrointestinal symptoms such as diarrhea, nausea and vomiting.

A recent comment published in Gut, a publication by the British Medical Journal, highlighted important evidence from China that shows that a patient with gastrointestinal problems such as diarrhea, nausea, and vomiting may have more than a quarter of them with no respiratory symptoms having.

In contrast to previous work, which showed that less than 4% of COVID-19 patients had gastrointestinal symptoms, this rate was 11%. Others have suggested that the rate could be as high as 60%.

According to new information, patients with gastrointestinal symptoms can develop more severe forms of the disease.

According to new research, patients with gastrointestinal symptoms can develop more severe forms of the disease / Image: Stephania Lecocq

In these small studies, the researchers also associated patients with gastrointestinal presentations with poorer results. Compared to patients without gastrointestinal symptoms, the patients had more serious illnesses, higher fevers and an increased risk of liver damage.

In one of those studies with a mild form of COVID-19, the researchers compared those with gastrointestinal or respiratory symptoms, or both, with those who showed only respiratory symptoms. They found that 23% of the patients only had gastrointestinal presentations, while 57% had both intestinal and respiratory diseases. It also took longer for those with digestive symptoms to get rid of the virus.

Intestinal invaders

Interestingly, the first reported case of coronavirus in the United States had nausea and vomiting and diarrhea episodes for two days in addition to its respiratory symptoms. The virus was detected in samples from the nose and throat of this patient, but was also isolated from the collected faecal samples.

There are a number of symptoms associated with COVID-19.

There are a number of symptoms associated with COVID-19 / Image: King’s College London

Analysis of gastrointestinal tract samples from 95 COVID-19 patients identified the virus in the esophagus, stomach, duodenum and rectum. The virus also appeared in about half of the stool samples collected.

The suggestion is that gastrointestinal symptoms are caused by the virus that invades ACE2-containing cells throughout the gut. This, along with the presence of the virus in the stool, suggests that the gastrointestinal tract is another possible route of infection and transmission.

SARS-CoV-2 appears to be detectable in stool for several days after it has been removed from airway samples. Patients who have recovered from COVID-19 or are asymptomatic may unwittingly spill the virus into their stools, possibly increasing the risk of transmission to others.

Why your microbiome is important

Why do symptoms in your gut mean you could have a worse case of COVID-19? The composition of your microbiome – the millions of bacteria and other organisms that normally live in our gastrointestinal tract – is likely a critical part of an individual’s response to COVID-19.

A group of researchers created a risk assessment based on blood biomarkers, which can be increased or decreased depending on the composition of your microbiome. They found that the higher the score, the worse the COVID-19 score will be. This association was stronger for the elderly. It may be that the health of our intestinal bacteria plays a crucial role in how our immune system reacts to diseases.

Therefore, maintaining a healthy microbiome is important to combat COVID-19.

How you do that? The key is to eat to feed your microbiome. It’s advisable to eat plant-based foods that you cook yourself and limit ultra-processed take-away foods while supplementing your diet with natural probiotics like kombucha, kimchi, and plain yogurt. This optimizes your microbiome not only for COVID-19, but also for your long-term health.

The feeling …

As the pandemic continues, we should all pay more attention to our courage. So far, much of the focus has been on breathing masks, intensive care and the consequences of the new coronavirus infection on the respiratory tract. However, if you have a new illness and vomiting or diarrhea and there is no other explanation, it can be COVID-19 and you may need to seek help.

And if it’s true that the gastrointestinal tract is another source of virus transmission in both symptomatic and asymptomatic people, it remains of paramount importance that people follow the advice to stay home and stay safe with a combination of protection, social distancing and flushing. normal hands.

After all, it is worth considering how a healthy microbiome can be obtained in these unprecedented and difficult times: eating well can improve the COVID-19 result.

Martin Veysey, MBBS program director at Hull York Medical School, University of York

This article is republished by The Conversation under a Creative Commons license. Read the original article.

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