Is the Intestine a Portal of Entry for the Serious COVID-19 Complications of Endotoxemia and Thrombosis?

Alpers, David H.

doi:10.14309/ctg.0000000000000367

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…In various studies with adults, it has been reported that increased intestinal permeability causes clinical conditions such as endothelial damage, cytokine storm, microbial translocation, endotoxemia and thrombosis which are seen in the course of SARS‐CoV‐2 infection. 32 , 33 , 34 , 35 Increased intestinal permeability may be occurred due to local damage to the intestines by SARS‐CoV‐2 virus. Indeed, in our study, serum zonulin levels were found to be higher in SARS‐CoV‐2 infection group compared to the controls.…”

Section: Discussionmentioning

confidence: 99%

“…However, claudin‐5 levels were significantly lower in the SARS‐CoV‐2 infection group compared to the control group. In various studies with adults, it has been reported that increased intestinal permeability causes clinical conditions such as endothelial damage, cytokine storm, microbial translocation, endotoxemia and thrombosis which are seen in the course of SARS‐CoV‐2 infection 32–35 . Increased intestinal permeability may be occurred due to local damage to the intestines by SARS‐CoV‐2 virus.…”

Section: Discussionmentioning

confidence: 99%

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Zonulin and claudin‐5 levels in multisystem inflammatory syndrome and SARS‐CoV‐2 infection in children

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Yazar

et al. 2022

J Paediatrics Child Health

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Aim: SARS-CoV-2 infection in children is generally asymptomatic or mild; however, it can lead to a life-threatening clinical condition, multisystem inflammatory syndrome in children (MIS-C), days or weeks after the infection. Increased intestinal permeability isa possible triggering factor at the onset of the hyperinflammation associated with MIS-C. Zonulin and claudin-5 are involved in intestinal permeability. In this study, we aimed to investigate serum zonulin and claudin-5 levels in SARS-CoV-2 infection and MIS-C disease. Methods: The study group consisted of children diagnosed with MIS-C or SARS-CoV-2 infection who presented to a university hospital paediatric emergency or infectious diseases departments. The control group included well patients seen at the General Pediatrics units for routine follow-up. Serum zonulin and claudin-5 levels were measured at the time of diagnosis. Results: Fifteen patients were included in the MIS-C group, 19 in the SARS-CoV-2 infection group and 21 in the control group. The mean zonulin level in the MIS-C group was significantly higher than in the control group (P < 0.001). Mean Claudin-5 levels were Psignificantly lower in the SARS-CoV-2 infection group than in the control group (P < 0.001). Conclusion:These results indicate that increased intestinal permeability may be involved in the pathogenesis of SARS-CoV-2 infection and MIS-C disease. Larger clinical trials are needed to clarify the role of serum zonulin and claudin-5 on intestinal permeability in MIS-C and SARS-CoV-2 infection in children.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Zonulin and claudin‐5 levels in multisystem inflammatory syndrome and SARS‐CoV‐2 infection in children

Kılıç

Akın

Yazar

et al. 2022

J Paediatrics Child Health

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“…Notably, ACE-2 expression increases in patients with IBD, particularly in the colonic tissue of patients with UC [ 8 , 15 ], which might enable SARS-CoV-2 infection and cause poor outcomes [ 16 ]. The intestine might serve as an entry point for serious COVID-19 complications, such as endotoxemia and thrombosis [ 17 ]. In addition, a significant proportion of patients with IBD are treated with IBD drugs, including mesalazine, corticosteroids, immunomodulators (IMs), and anti-TNF, which may be associated with low immunity in patients and increased risk of COVID-19 infection and adverse outcomes [ 18 – 21 ].…”

Section: Introductionmentioning

confidence: 99%

Risk of adverse outcomes in inflammatory bowel disease patients infected with SARS-CoV-2: a systematic review and meta-analysis

Chen

Hu²,

Cheng³

et al. 2022

Int J Colorectal Dis

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Background Between people with and without inflammatory bowel disease (IBD), there was no statistically significant difference in the probability of contracting the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). However, the risk of adverse outcomes in IBD patients after virus infection remains unclear. Methods Eligible studies conducted from January 1, 2020 to March 17, 2022 were obtained by searching PubMed, Embase, and Web of Science. Information was collected in tables from the included studies. Random-effects and fixed-effects models were used as measures for the pooled estimates. All data were estimated by R version 4.1.3. Results Twenty-four studies were included. The risk ratio (RR) of adverse outcomes in COVID-19 patients with IBD increased by 32% (RR 1.32; 95% CI 1.06–1.66) relative to COVID-19 patients without IBD. The RR of mortality was higher in COVID-19 patients with IBD from Europe (RR 1.72; 95% CI 1.11–2.67) than in those that were not from Europe (RR 1.00; 95% CI 0.79–1.26; χ 2 = 4.67; P = 0.03). Patients with ulcerative colitis were at higher risk of adverse outcomes after SARS-CoV-2 infection than patients with Crohn’s disease patients (RR1.38; 95% CI 1.27–1.50). The IBD drugs treatment was associated with the risk of adverse outcomes, the pooled odds ratio (OR) of mesalazine (1.79; 95% CI 1.59–2.02), immunomodulators (1.30; 95% CI 1.10–1.53), and anti-TNF (0.47; 95% CI 0.41–0.53) were assessed. Conclusion COVID-19 patients with IBD had an increased risk of adverse outcomes than those without IBD, whereas anti-TNF treatment might reduce the risk. Supplementary Information The online version contains supplementary material available at 10.1007/s00384-022-04265-w.

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Is the Intestine a Portal of Entry for the Serious COVID-19 Complications of Endotoxemia and Thrombosis?

Cited by 2 publications

References 13 publications

Zonulin and claudin‐5 levels in multisystem inflammatory syndrome and SARS‐CoV‐2 infection in children

Zonulin and claudin‐5 levels in multisystem inflammatory syndrome and SARS‐CoV‐2 infection in children

Risk of adverse outcomes in inflammatory bowel disease patients infected with SARS-CoV-2: a systematic review and meta-analysis

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