Gastrointestinal lesions in COVID-19

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Abstract

The vast majority of coronaviruses, including SARS-CoV-2, are characterized by the involvement of the digestive system. The virus infects the epithelial cells of the gastrointestinal tract (GIT), causing lesions of varying severity. However, fever, intoxication, respiratory symptoms, dominating the clinical picture, push gastrointestinal manifestations into the background, which may be the reason for the loss of the «golden hour” in this group of patients, when pathogenetic mechanisms can still be stopped and the severe course of the disease can be prevented.

Purpose of the work: to study the complications of the novel coronavirus infection from the GIT in patients in the acute period of COVID-19 damage and in the post-COVID period.

Material and methods. An analysis of the world literature was carried out using the TripDataBase search system, which allowed us to study, analyze and structure the described assumptions about the pathogenetic mechanisms of gastrointestinal lesions in COVID-19, as well as analyze and structure clinical, including endoscopic, materials provided by institutions health care in Moscow and Saint Petersburg, who were directly involved in the fight against the COVID-19 pandemic.

Results. The ability of the SARS-CoV-2 virus to directly infect enterocytes, the use by patients and healthcare workers of justified or unreasonably massive antibiotic therapy, anticoagulants, NSAIDs, targeted therapy, proton pump inhibitors against the background of gerontological problems and directly related comorbidity during the period treatment of a new coronavirus infection created an incredible, previously unseen, mix of problems, which was directly reflected in the gastrointestinal tract lesions identified during endoscopic examination of patients in the COVID/post-COVID period and made it necessary to introduce new terms in endoscopic semiotics.

Conclusion. The presented data confirm that the new coronavirus infection COVID-19 is an extremely complex, «insidious» pathology, which has both a direct damaging effect and the ability to trigger mechanisms of a latent, previously unmanifested pathology, which is sometimes systemic in nature.

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About the authors

Galina V. Belova

Peoples’ Friendship University of Russia; Multidisciplinary Medical Center of the Bank of Russia

Author for correspondence.
Email: belovagv@inbox.ru

MD, professor, professor of the Department of endoscopy, endoscopic and laser surgery of the Faculty of continuing medical education, Peoples’ Friendship University of Russia, consultant endoscopist at Multidisciplinary Medical Center of the Bank of Russia

Russian Federation, 117198, Moscow, st. Miklukho-Maclay, 6; 117873, Moscow,66 Sevastopol`sky Avenue

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