Susceptibility Factors of Stomach for SARS-CoV-2 and Treatment Implication of Mucosal Protective Agent in COVID-19

Frontiers in Medicine

article

Min Zhang¹  Chao Feng²  Xingchen Zhang³  Shuofeng Hu²  Yuan Zhang⁴  Min Min⁵  Bing Liu⁵  Xiaomin Ying²  Yan Liu⁵ 

[1] State Key Laboratory of Kidney Diseases, Department of Nephrology, The First Medical Center, National Clinical Research Center for Kidney Diseases, Chinese PLA Institute of Nephrology, Chinese PLA General Hospital;Center for Computational Biology, Institute of Military Cognition and Brain Sciences, Academy of Military Medical Sciences;Department of Pharmacy, The Central Hospital of Wuhan Affiliated to Tongji Medical College of Huazhong University of Science and Technology;Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology;The Fifth Medical Center of Chinese PLA General Hospital

关键词: single-cell RNA sequencing;    COVID-19;    SARS-CoV-2;    H pylori infection;    intestinal metaplasia;   

DOI  :  10.3389/fmed.2020.597967

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objectives: This work aims to study the gastrointestinal (GI) symptoms in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients and the susceptibility factors of the stomach for SARS-CoV-2. Materials and Methods: We investigated the SARS-CoV-2 susceptibility by analyzing the expression distribution of viral entry-associated genes, ACE2 and TMPRSS2 , in single-cell RNA sequencing data derived from 12 gastric mucosa samples. We also analyzed the epidemiological, demographic, clinical, and laboratory data of 420 cases with SARS-CoV-2-caused coronavirus disease 2019 (COVID-19). Results:ACE2 and TMPRSS2 are specifically expressed in enterocytes which are mainly from gastric mucosa samples with Helicobacter pylori ( H. pylori ) infection history and intestinal metaplasia (IM). A total of 420 patients were surveyed, of which 62 were with and 358 were without GI symptoms. There is a significant difference in average hospital stay ( p < 0.001) and cost ( p < 0.001) between the two groups. Among 23 hospitalized patients including seven with upper GI symptoms and 16 with lower GI symptoms, six (85.7%) and five (31.3%) had H. pylori infection history, respectively ( p = 0.03). Of 18 hospitalized patients with initial upper GI symptoms, none of the eight patients with mucosal protective agent therapy (e.g., sucralfate suspension gel, hydrotalcite tablets) had diarrhea subsequently, whereas six out of 10 patients without mucosal protective agent therapy had diarrhea subsequently ( p = 0.01). Conclusion: IM and H. pylori infection history may be susceptibility factors of SARS-CoV-2, and the mucosal protective agent may be useful for the blockade of SARS-CoV-2 transmission from the stomach to the intestine.

【 授权许可】

CC BY