Covid-19 Clinical Care: Acute Gastrointestinal Injury Occurs In Almost 86 Percent Of Critical Condition Covid-19 Patients, Often Leading To Sepsis And Death
Covid-19 Clinical Care
: A new study conducted by medical researchers from Nanjing Medical University involving three hospitals and more than 1314 Covid-19 patients of which the focus was on 83 critically ill patients revealed that almost 86 percent or more of these critically ill patients suffered from acute gastrointestinal injury (AGI) .
This observed phenomenon indicated that SARS-CoV-2 was more virulent than SARS-CoV, and gastrointestinal tract was also a vital target organ of the virus.
However, the underlying mechanisms of SARS-CoV-2 causing organs dysfunction were unknown yet. Gastrointestinal injury was often caused by an inflammatory reaction, infection or sepsis, severe trauma, shock, pancreatitis, and other critical diseases.
The pre-print none peer-reviewed study by conducted a team of medical researchers lead by Dr Jia-Kui Sun. https://www.medrxiv.org/content/10.1101/2020.03.25.20043570v1.full.pdf+html
As the receptor for SARS-CoV, angiotensin-converting enzyme 2 (ACE2) was suggested to be also the receptor for SARS-CoV-2 . ACE2 was expressed in endothelial cells and smooth muscle cells of almost all organs, especially in lung alveolar cells. That's why the COVID-19 patients were susceptible to ARDS (Acute Respiratory Disease syndrome) and even MODS.
The study findings also showed that ARDS incidence was very high (92.8%), and AGI grades were significantly positive correlated.
It was also reported that ACE2 was highly expressed in small intestine, especially in proximal and distal enterocytes. ACE2 expression in the epithelial cells was required for maintaining antimicrobial peptide expression, amino acid homeostasis, and the ecology of gut microbiome in the intestine.
Often it was seen that patients in the higher stages of acute gastrointestinal injury often developed sepsis that lead to also organ failure and ultimately death.
The clinical symptoms associated the early manifestations of AGI should be taken seriously in clinical treatment.
Doctors and healthcare professionals should pay attention to the signs of a start of gastrointestinal issues in Covid-19 patients.
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