ABSTRACT
Organs such as the mouth, nose and eyes are the gateway for the coronavirus. If favorable conditions for the increase of infection are created in the oral mucosa with a decrease in immunity, the virus binds to the ACE-2 molecule (angiotensin-converting enzyme 2 membrane protein) and affects the epithelium. In the future, if the oral cavity is not protected, not only the mucous membrane of the oral cavity, but also the tissues around the teeth and the throat, as well as petechiae and stomach ulcers, can be observed [1, 2, 6, 7]. The process of development of ulcers in the oral cavity: painful inflammation of the papillae of the tongue (day), then the appearance of an erythematous spot (day), which turns into irregular and asymptomatic ulcers;therefore, many patients may be unaware of an oral ulcer due to the absence of pain (Chaux-Bodard et al., 2020). The burning sensation in the mouth (22.4%) could be due to several causes (eg, candida infection, dry mouth, mouth ulceration, or medications). A viral infection can weaken the immune system, causing secondary infections such as oral thrush. Candidiasis is the most common opportunistic infection in HIV (Nokta, 2008) and has also been reported in Covid-19 (dos Santos et al., 2020). The manifestation of oral lesions in patients with Covid-19 may be related to the direct or indirect effect of SARSCoV-2 on the oral mucosa, hypersensitivity to drugs taken during Covid-19 infection, the patient's susceptibility to the disease itself, or the duration of hospitalization. The SARS-CoV-2 virus infects human cells through angiotensin converting enzyme (ACE-2) receptors, since ACE-2 acts as the primary host cell receptor for this virus [4, 5, 8]. The oral cavity is an open biological system, in which there is a constant balance between pathogenic factors, such as viruses, bacteria, and the body's defenses. However, such an important balance is often attacked, both due to the multiplication and accelerated development of microorganisms and viruses, and due to the weakening of the very factors of general and especially local immune defense [3]. Immunoglobulins and lytic enzymes play an important role in the body's defense system;they are a component of immunity that-provides protection against pathogens (a wide range of bacteria, fungi, viruses), and also participate in the development of inflammation processes, maintenance and regulation of the adaptive immune system. One of the important components of the complex mechanism of innate immunity are neutrophils, when activated by pathogenic or opportunistic microorganisms, a wide range of anti-inflammatory cytokines is secreted. Copyright © 2022, Anka Publishers. All rights reserved.
ABSTRACT
COVID-19 infection may present with gastrointestinal lesions in up to 25% of patients. One of the target organs of the SARS-CoV-2 virus is the intestine. The pathogenesis of intestinal damage in a new coronavirus infection remains unclear and requires further in-depth study. Possible mechanisms include a direct cytotoxic effect of the virus, a persistent reduction in butyrate-producing bacteria, side effects of drugs, Clostridioides difficile infection, microvascular thrombosis, and the immune-mediated inflammatory reactions in the intestine. The most common symptom of intestinal damage during coronavirus infection, both in the acute phase and in the post-COVID period, is diarrhea. The impact of many aggressive factors on the intestines can form both long-term functional disorders and be the cause of the onset of organic diseases. Treatment should be aimed at possible causes of intestinal damage (Clostridioides difficile), as well as reducing inflammation, restoring intestinal permeability, cytoprotection of mucosal cells, replenishing butyric acid deficiency. When choosing a therapy for intestinal disorders, preference should be given to drugs with a pleiotropic effect in order to influence various possible pathogenetic mechanisms.
Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Butyric Acid , Diarrhea , Intestines/pathology , InflammationABSTRACT
BACKGROUND: The novel coronavirus infection COVID-19 can be manifested by damage to the organs of the gastrointestinal tract (GIT). Damage to the gastrointestinal tract by the SARS-CoV-2 virus leads to a violation of the microbial-tissue complex of the mucous membrane of the digestive tract. A common gastroenterological manifestation of COVID-19 is diarrhea. AIM: Study of the clinical features of gastroenterological disorders and the possibility of optimizing the treatment of diarrheal syndrome in patients with COVID-19 with a mild form of viral infection. MATERIALS AND METHODS: The observation group consisted of 230 patients with mild COVID-19: K-group (n=115) with respiratory symptoms, I group (n=115) with gastrointestinal manifestations in combination and without signs of respiratory damage. In order to compare the effectiveness of treatment of diarrheal syndrome, patients of group I are randomized into 2 subgroups: Ia (n=58) prebiotic treatment (Zacofalk) and Ib (n=57) enterosorbents. RESULTS: The development of gastrointestinal symptoms with SARS-CoV-2 infection is significantly more often noted in comorbid patients (67%). Gastrointestinal symptoms were dominated by diarrhea (93.9%) and flatulence (76.5%), in 1/3 of patients they were the first manifestos of infection. It was established that in 98.4% of patients of group I (against 42.6% of the K-group) signs of infectious intoxication were detected. In patients with gastrointestinal lesions, an elongation of the febrile period by 91.5 days was noted, a later (6 days) verification of the viral etiology of the disease. It was found that in patients of group I, the regression of clinical symptoms, the duration of viral disease, the dynamics of antibody formation, the prognosis for the development of IBS-like disorders in the post-infectious period depended on the treatment. In patients taking (Zacofalk), these indicators were significantly better. CONCLUSION: In mild cases, to reduce the severity of viral intestinal damage, for effective relief of intestinal symptoms, to reduce the risk of IBS-like symptoms, it is advisable to prescribe (Zacofalk) in an initial dose of 3 tablets per day.