Intestinal Damage in COVID-19: SARS-CoV-2 Infection and Intestinal Thrombosis

Xiaoming Wu; Haijiao Jing; Chengyue Wang; Yufeng Wang; Nan Zuo; Tao Jiang; Valerie A Novakovic; Jialan Shi

doi:10.3389/fmicb.2022.860931

Intestinal Damage in COVID-19: SARS-CoV-2 Infection and Intestinal Thrombosis

Front Microbiol. 2022 Mar 22:13:860931. doi: 10.3389/fmicb.2022.860931. eCollection 2022.

Authors

Xiaoming Wu¹, Haijiao Jing¹, Chengyue Wang¹, Yufeng Wang¹, Nan Zuo¹, Tao Jiang², Valerie A Novakovic³, Jialan Shi^{1

3

4}

Affiliations

¹ Department of Hematology, The First Hospital, Harbin Medical University, Harbin, China.
² Department of General Surgery, The First Hospital, Harbin Medical University, Harbin, China.
³ Department of Research, VA Boston Healthcare System, Harvard Medical School, Boston, MA, United States.
⁴ Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, United States.

Abstract

The intestinal tract, with high expression of angiotensin-converting enzyme 2 (ACE2), is a major site of extrapulmonary infection in COVID-19. During pulmonary infection, the virus enters the bloodstream forming viremia, which infects and damages extrapulmonary organs. Uncontrolled viral infection induces cytokine storm and promotes a hypercoagulable state, leading to systemic microthrombi. Both viral infection and microthrombi can damage the gut-blood barrier, resulting in malabsorption, malnutrition, and intestinal flora entering the blood, ultimately increasing disease severity and mortality. Early prophylactic antithrombotic therapy can prevent these damages, thereby reducing mortality. In this review, we discuss the effects of SARS-CoV-2 infection and intestinal thrombosis on intestinal injury and disease severity, as well as corresponding treatment strategies.

Keywords: COVID-19; antithrombotic therapy; blood transmission; intestinal infection; intestinal thrombosis.

Publication types

Review