ABSTRACT
COVID-19 is a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Early reported symptoms include fever, cough, and respiratory symptoms. There were few reports of digestive symptoms. However, with COVID-19 spreading worldwide, symptoms such as vomiting, diarrhoea, and abdominal pain have gained increasing attention. Research has found that angiotensin-converting enzyme 2 (ACE2), the SARS-CoV-2 receptor, is strongly expressed in the gastrointestinal tract and liver. Whether theoretically or clinically, many studies have suggested a close connection between COVID-19 and the digestive system. In this review, we summarize the digestive symptoms reported in existing research, discuss the impact of SARS-CoV-2 on the gastrointestinal tract and liver, and determine the possible mechanisms and aetiology, such as cytokine storm. In-depth exploration of the relationship between COVID-19 and the digestive system is urgently needed.
Subject(s)
COVID-19/complications , Gastrointestinal Diseases/etiology , Liver Diseases/etiology , Pandemics , SARS-CoV-2/pathogenicity , Angiotensin-Converting Enzyme 2/metabolism , Anorexia/etiology , Antiviral Agents/adverse effects , Bile Ducts/metabolism , Bile Ducts/virology , COVID-19/epidemiology , COVID-19/immunology , COVID-19/pathology , Chemical and Drug Induced Liver Injury/etiology , Comorbidity , Cytokine Release Syndrome/etiology , Cytopathogenic Effect, Viral , Gastrointestinal Diseases/epidemiology , Gastrointestinal Microbiome , Gastrointestinal Tract/metabolism , Gastrointestinal Tract/pathology , Gastrointestinal Tract/virology , Humans , Immunosuppressive Agents/adverse effects , Liver/metabolism , Liver/pathology , Liver/virology , Liver Diseases/epidemiology , Liver Transplantation , Non-alcoholic Fatty Liver Disease/etiology , Non-alcoholic Fatty Liver Disease/pathology , Non-alcoholic Fatty Liver Disease/virology , Postoperative Complications , Receptors, Virus/metabolismABSTRACT
BACKGROUND: Numerous studies have suggested that friendly walking environments positively affect physical activity and health. Creating friendly walking environments in urban areas is a complex and wide-ranging topic, and no study has yet established a set of assessment indicators by drawing on the expertise of various disciplines. This study uses a multiple-criteria decision-making technique to elucidate the environmental factors that affect the friendliness of the walking environment. METHODS: We conducted a two-phase expert questionnaire survey. Experts from the government sector, as well as the academic disciplines of urban planning, transportation, architecture, and landscape design, were recruited to establish a set of walking environment indicators; the degrees of importance assigned to these indicators by the experts were subsequently compared. In phase 1, the fuzzy Delphi method was used by 20 experts, whose responses were used to identify four dimensions and 22 indicators. In phase 2, an analytical network process approach was performed by 16 experts to determine the weights of the dimensions and indicators. RESULTS: The results revealed that all of the experts ranked the four dimensions in the order of safety > facilities > aesthetics > land use mix. Of the 22 indicators, land use-diversity, land use-access, sidewalk width, sidewalk continuity, and cleanliness were considered the most important. CONCLUSIONS: The results provide a reference for the management of walking environments by promoting pedestrian-oriented environments and public health.
