Русский
Gastrointestinal lesions in COVID-19
DOI: https://dx.doi.org/10.18565/therapy.2023.2.22-30
Belova G.V.
1) Peoples’ Friendship University of Russia, Moscow; 2) Multidisciplinary Medical Center of the Bank of Russia, Moscow
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.
Literature
1. Баклаушев В.П., Кулемзин С.В., Горчаков А.А. с соавт. COVID-19. Этиология, патогенез, диагностика и лечение. Клиническая практика. 2020; 11(1): 7–20. [Baklaushev V.P., Kulemzin S.V., Gorchakov A.A. et al. COVID-19. Etiology, pathogenesis, diagnosis and treatment. Klinicheskaya praktika = Clinical Practice. 2020; 11(1): 7–20 (In Russ.)].https://dx.doi.org/1017816/clinprakt263. EDN: COJLTB. 2. Jonsdottir H.R., Deikman R. Coronaviruses and the human respiratory tract: A universal system for virus-host interaction studies. Virol J. 2016; 24: 13. https://dx.doi.org/10.1186/s12985-016-0479-5. 3. Временные методические рекомендации: профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19). Версии 1–15. Минздрав России. Доступ: http://www.rosminzdrav.ru/ (дата обращения – 01.03.2023). [Interim guidelines: prevention, diagnosis, and treatment of novel coronavirus infection (COVID-19). Versions 1–15.URL: http://www.rosminzdrav.ru/ (date of access – 01.03.2023) (In Russ.)]. 4. Турчина М.С., Мишина А.С., Веремейчик А.Л., Резников Р.Г. Клинические особенности поражения желудочно-кишечного тракта у больных с новой коронавирусной инфекцией COVID-19. Актуальные проблемы медицины. 2021; 44(1): 5–15. [Turchina M.S., Mishina A.S., Veremeychik A.L., Reznikov R.G. Clinical features of gastrointestinal tract lesions in patients with new coronavirus infection COVID-19. Aktual’nyye problemy meditsiny = Actual Problems of Medicine. 2021; 44(1): 5–15 (In Russ.)].https://dx.doi.org/10.52575/2687-0940-2021-44-1-5-15. EDN: VWHVOO. 5. D’Amico G., Garcia-Tsao G., Pagliaro L. et al. Natural history and prognostic survival rates in cirrhosis of the liver: a systematic review of 118 studies. J Hepatol. 2006; 44(1): 217–31. https://dx.doi.org/10.1016/j.jhep.2005.10.013. 6. Hoffmann M., Kleine-Weber H., Schroeder S. et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020; 181(2): 271–80.e8. https://dx.doi.org/10.1016/j.cell.2020.02.052. 7. Сарсенбаева А.С., Лазебник Л.Б. Диарея при COVID-19 у взрослых. Экспериментальная и клиническая гастроэнтерология. 2020; (6): 42–54. [Sarsenbaevа A.S., Lazebnik L.B. Diarrhea when COVID-19 in adults. Eksperimental’naya i klinicheskaya gastroenterologiya = Experimental and Clinical Gastroenterology. 2020; (6): 42–54 (In Russ.)].https://dx.doi.org/10.31146/1682-8658-ecg-178-6-42-54. EDN: STLJBF. 8. Cheung J.Y., Wang J.F., Zhang X.Q. et al. Methylene blue counteracts cyanide cardiotoxicity: Cellular mechanisms. J Appl Physiol. 2018; 124(5): 1164–76. https://dx.doi.org/10.1152/japplphysiol.00967.2017. 9. Ардатская М.Д., Бельмер С.В., Добрица В.П. с соавт. Дисбиоз (дисбактериоз) кишечника: современное состояние проблемы, комплексная диагностика и лечебная коррекция. Экспериментальная и клиническая гастроэнтерология. 2015; (5): 13–50. [Ardatskaya M.D., Belmer S.V., Dobritsa V.P. et al. Colon dysbacteriosis (dysbiosis): Modern state of the problem, comprehensive diagnosis and treatment correction. Eksperimental’naya i klinicheskaya gastroenterologiya = Experimental and Clinical Gastroenterology. 2015; (5): 13–50 (In Russ.)]. EDN: TYRLOT. 10. Ye Q., Wang B., Zhang T. et al. The mechanism and treatment of gastrointestinal symptoms in patients with COVID-19. Am J Physiol Gastrointest Liver Physiol. 2020; 319(2): G245–G252. https://dx.doi.org/10.1152/ajpgi.00148.2020. 11. Mao R., Qiu Y., He J.-S. et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: A systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020; 5(7): 667–78.https://dx.doi.org/10.1016/S2468-1253 (20) 30126-6. 12. Yandrapu H., Marcinkiewicz M., Sarosiek I. et al. Role of saliva in esophageal defense: Implications in patients with nonerosive reflux disease. Am J Med Sci. 2015; 5(349): 385–91. https://dx.doi.org/10.1097/MAJ.0000000000000443. 13. Пахомова И.Г. Пациент с ГЭРБ после перенесенной новой коронавирусной инфекции. Рациональная фармакотерапия на клиническом примере. РМЖ. 2021; 29(6): 18–22. [Pakhomova I.G. A patient with GERD after suffering a new coronavirus infection. Rational pharmacotherapy by clinical example. Russkiy meditsinskiy zhurnal = Russian Medical Journal. 2021; 29(6): 18–22 (In Russ.)]. EDN: NMYXHZ. 14. Denson J.L., Gillet A.S., Zu Y. et al. Metabolic syndrome and acute respiratory distress syndrome in hospitalized patients with COVID-19. JAMA Netw Open. 2021; 4(12): e2140568. https://dx.doi.org/10.1001/jamanetworkopen.2021.4056. 15. Алексеева О.П., Пикулев Д.В. Гастроэзофагеальная рефлюксная болезнь и ишемическая болезнь сердца – существует ли синдром взаимного отягощения? Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2019; 29(4): 66–73. [Alekseeva O.P., Pikulev D.V. Gastroesophageal reflux disease and coronary artery disease – is there a mutual burden syndrome? Rossiyskiy zhurnal gastroenterologii, gepatologii, koloproktologii = Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2019; 29(4): 66–73 (In Russ.)]. https://dx.doi.org/10.22416/1382-4376-2019-29-4-66-73. EDN: MDIDPM. 16. Mohammed S.B., Gadad A., Nayak B.S., Beharry V. Prognosis of the midlife-elderly from ECG testing to gastroesophageal reflux disease and coronary artery disease. J Fam Med Dis Prev. 2016; (2): 029. https://dx.doi.org/10.23937/2469-5793/1510029. 17. Л.Б. Лазебник, Г.В. Белова. Практическое применение «систематизирующей классификации мультифокальных повреждений слизистой оболочки пищеварительного тракта НПВП и антитромботическими препаратами» совместно с иными клиническими рекомендациями РНМОТ для оптимизации принятия решений. Терапия. 2019; 5(6): 10–18. [L.B. Lazebnik, G.V. Belova. Practical application of the «systematizing classification of multifocal lesions of the mucous membrane of the digestive tract with NSAIDs and antithrombotic drugs» in conjunction with other clinical recommendations of the RHMOT to optimize decision making. Terapiya = Therapy. 2019; 5(6): 10–18. https://dx.doi.org/10.18565/therapy.2019.6.10-18. EDN: SIJDWR. 18. Пахомова И.Г., Хорошинина Л.П. НПВП-индуцированная эзофагопатия: просто ГЭРБ или еще одна нозологическая единица? Фарматека. 2016; (15) :39–43. [Pakhomova I.G., Horoshinina L.P. NSAID-induced esophagopathy: Just GERD or another nosological unit? Farmateka. 2016; (15) :39–43 (In Russ.)]. EDN: WWVQML. 19. Пахомова И.Г., Зиновьева Е.Н. Гастроэзофагеальная рефлюксная болезнь у полиморбидного пациента: особенности терапии. РМЖ. 2017; 25(10): 760–764. [Pakhomova I.G., Zinovieva E.N. Gastroesophageal reflux disease in a polymorbid patient: features of therapy. Russkiy meditsinskiy zhurnal = Russian Medical Journal. 2017; 25(10): 760–764 (In Russ.)]. EDN: ZMRMUD. 20. Suresh Kumar V.C., Mukherjee S., Harne P.S. et al. Novelty in the gut: A systematic review and meta-analysis of the gastrointestinal manifestations of COVID-19. BMJ Open Gastroenterol. 2020; 7(1): e000417. https://dx.doi.org/10.1136/bmjgast-2020-000417. 21. Blevins C.H., Iyer P.G., Vela M.F., Katzka D.A. The esophageal epithelial barrier in health and disease. Clin Gastroenterol Hepatol. 2018; 16(5): 608–17. https://dx.doi.org/10.1016/j.cgh.2017.06.035. 22. Ивашкин В.Т., Трухманов А.С., Гоник М.И. Применение ребамипида в лечении гастроэзофагеальной рефлюксной болезни. Терапевтический архив. 2020; 92(4): 98–104. [Ivashkin V.T., Trukhmanov A.S., Gonik M.I. The use of rebamipide in the treatment of gastroesophageal reflux disease. Terapevticheskiy arkhiv = Therapeutic Archive. 2020; 92(4): 98–104 (In Russ.)].https://dx.doi.org/10.26442/00403660.2020.04.000568. EDN: MOKUHE. 23. Драпкина О.М., Маев И.В., Бакулин И.Г. с соавт. Временные методические рекомендации: «Болезни органов пищеварения в условиях пандемии новой коронавирусной инфекции (COVID-19)». Профилактическая медицина. 2020; 23(3–2): 120–152. [Drapkina O.M., Mayev I.V., Bakulin I.G. et al. Interim guidelines: «Diseases of the digestive organs in the context of a new coronavirus infection pandemic (COVID-19)». Profilakticheskaya meditsina = Preventive Medicine. 2020; 23(3–2): 120–152 (In Russ.)].https://dx.doi.org/10.17116/profmed202023032120. EDN: MGLBCN. 24. Forrest J.A., Finlayson N.D., Shearman D.J. Endoscopy in gastrointestinal bleeding. Lancet. 1974; 2(7877): 394–97. https://dx.doi.org/10.1016/s0140-6736(74)91770-x. 25. Щербаков П.Л., Валиулин И.Р., Малиновская В.В. с соавт. Диагностика и лечение поражений желудочно-кишечного тракта у больных в отдаленном постковидном периоде. Экспериментальная и клиническая гастроэнтерология. 2022; (11): 234–41. [Shcherbakov P.L., Valiulin I.R., Malinovskaya V.V., Pasechnik D.G. et al. Diagnosis and treatment of gastrointestinal involvement in the late post-COVID. Eksperimental’naya i klinicheskaya gastroenterologiya = Experimental and Clinical Gastroenterology. 2022; (11): 234–41 (In Russ.)]. https://dx.doi.org/10.31146/1682-8658-ecg-207-11-234-241. EDN: VMJGRA. 26. Kopito R.R., Sitia R. Aggressive bodies and Russell bodies. Symptoms of cellular indigestion? EMBO Rep. 2000; 1(3): 225–31.https://dx.doi.org/10.1093/embo-reports/kvd052. 27. Ohtsuki U., Akagi T., Moriwaki S., Hatano M. Plasma cell granuloma of the stomach combined with gastric cancer. Arch Pathol Jpn. 1983; 33(6): 1251–57. https://dx.doi.org/10.1111/j.1440-1827.1983.tb02170.x. 28. Tazawa K., Tsutsumi U. Local accumulation of Russell body-containing plasma cells in the gastric mucosa with Helicobacter pylori infection: «Russell body gastritis». Patol Int. 1998; 48(3): 242–44. https://dx.doi.org/10.1111/j.1440-1827.1998.tb03901.x. 29. Erbersdobler A., Petri S., Locke G. Russell’s body gastritis: An unusual, tumor-like lesion of the gastric mucosa. Arch Pathol Lab Med. 2004; 128(8): 915–17. https://dx.doi.org/10.5858/2004-128-915-RBGAUT.
About the Autors
Galina V. Belova, 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. Address: 117873, Moscow, 66 Sevastopol`sky Avenue. E-mail: belovagv@inbox.ru
Similar Articles
