ABSTRACT
Background: Gut ecosystem has profound effects on host physiology and health. Gastrointestinal (GI) symptoms were frequently observed in patients with COVID-19. Compared with other organs, gut antiviral response can result in more complicated immune responses because of the interactions between the gut microbiota and host immunity. However, there are still large knowledge gaps in the impact of COVID-19 on gut molecular profiles and commensal microbiome, hindering our comprehensive understanding of the pathogenesis of SARS-CoV-2 and the treatment of COVID-19.Results: We performed longitudinal stool multi-omics profiling to systemically investigate the molecular phenomics alterations of gut ecosystem in COVID-19. Gut proteomes of COVID-19 were characterized by disturbed immune, proteolysis and redox homeostasis. The expression and glycosylation of proteins involved in neutrophil degranulation and migration were suppressed, while those of proteases were upregulated. The variable domains of Ig heavy chains were downregulated and the overall glycosylation of IgA heavy chain constant regions, IgGFc-binding protein, and J chain were suppressed with glycan-specific variations. There was a reduction of beneficial gut bacteria and an enrichment of bacteria derived deleterious metabolites potentially associated with multiple types of diseases (such as ethyl glucuronide). The reduction of Ig heave chain variable domains may contribute to the increase of some Bacteroidetes species. Many bacteria ceramide lipids with a C17-sphingoid based were downregulated in COVID-19. In many cases, the gut phenome did not restore two months after symptom onset.Conclusions: Our study indicates widely disturbed gut molecular profiles which may play a role in the development of symptoms in COVID-19. Our findings also emphasis the need for ongoing investigation of the long-term gut molecular and microbial alterations during COVID-19 recovery process. Considering the gut ecosystem as a potential target could offer a valuable approach in managing the disease.
Subject(s)
COVID-19 , Severe Acute Respiratory Syndrome , Gastrointestinal DiseasesABSTRACT
Background: More than 230,000 cases of coronavirus disease (COVID-19) have been reported worldwide. We sought to discuss the impact of new electronic communication tools with patients in diagnosis and treatment of these cases.Methods: We recruited adult patients from Jan 20 to Feb 26, 2020, with laboratory-confirmed SARS-CoV-2 infection from The Fifth Affiliated Hospital, Sun Yat-sen University, in Zhuhai, China. 47 eligible patients were enrolled and randomly classified into either a test or control group. All of them were treated with standard therapeutic regimen and routine ward-round. The test group was subdivided into three subgroups. The first subgroup was arranged an extra 5min on-line ward-round by WeChat voice call once daily for basic disease communication. The second subgroup was given an extra 10min voice call once daily for further detail, similarly, the third subgroup was given an extra 10min than the second group every three days. The main end point was the duration of positive-to-negative conversion of SARS-CoV-2 RNA.Results: 47 patients were included in the final analysis. The median time from disease diagnosed to the endpoint of test group was 7.0 days (interquartile range, 3.8 to 10.8), whereas the control group was 10.0 days (interquartile range, 6.5 to 14.5). It showed significant reduced the duration time of virus from positive to negative by the NAT (nucleic acid testing) (P=0.032), especially compared the 10 minutes group (3.0 days, interquartile range, 3.0 to 7.5) to control group (P=0.0065).Conclusions: The patients with SARS-CoV-2 infection might benefit from the use of the new electronic communication mode. It’s very valuable to reduce the shortage of medical protection resources and the risk of occupation.
Subject(s)
COVID-19 , Coronavirus InfectionsABSTRACT
The new coronavirus (SARS-CoV-2) outbreak originating from Wuhan, China, poses a threat to global health. While it's evident that the virus invades respiratory tract and transmits from human to human through airway, other viral tropisms and transmission routes remain unknown. We tested viral RNA in stool from 73 SARS-CoV-2-infected hospitalized patients using rRT-PCR. 53.42% of the patients tested positive in stool. 23.29% of the patients remained positive in feces even after the viral RNA decreased to undetectable level in respiratory tract. The viral RNA was also detected in gastrointestinal tissues. Furthermore, gastric, duodenal and rectal epithelia showed positive immunofluorescent staining of viral host receptor ACE2 and viral nucleocapsid protein in a case of SARS-CoV-2 infection. Our results provide evidence for gastrointestinal infection of SARS-CoV-2, highlighting its potential fecal-oral transmission route.