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Alimentary System is Directly Attacked by SARS-COV-2 and Further Prevents Immune Dysregulation Caused by COVID-19
Yunhan Jiang
West China Hospital, Sichuan University
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2759-2328
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Background. SARS-COV-2 causes digestive system symptom, the effect of which remains equivocal.
Methods. Patients with COVID-19 were classified into 4 groups according to symptom. The study traced the onset and duration of symptoms, compared laboratory examinations and conducted bioinformatic analysis. Immune indices were further analyzed.
Results. By March 16, 25 patients with COVID-19 and 13 with suspect COVID-19 were admitted to West China Hospital, Sichuan University. Digestive system symptom group had the highest level of ESR (mm/h, P＜0.0001), serum ferritin (ng/ml, P＜0.0001), hepatic enzymes (P＜0.05), and retentive lymphocyte count/percentage (P＜0.05) and its subsets (P＜0.05). Combined group (respiratory combined with subsequent digestive system symptom) had the highest level of IL-6 (pg/ml, P=0.0046), CRP (mg/L, P=0.0004) and moderate lymphocyte depletion. Respiratory system symptom and asymptomatic groups suffered the most from lymphocyte depletion (P＜0.05). Bioinformatic analysis indicated co-expression of binding related proteins of SARS-COV-2 (ACE2, TMPRSS2 and Furin) in small intestine. CD147 was extensively expressed in alimentary tract. CTSL, PIKfyve, TPC2 and CTSB could be detected with ≥moderate expressions in a variety of organs including alimentary system.
Conclusions. Alimentary system is directly attacked by SARS-COV-2 other than hyperinflammation and immune dysregulation. Involvement of alimentary system might further protect mild and moderate cases from lymphocyte depletion caused by COVID-19.
Keywords
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Coronavirus Disease 2019 (COVID-19), Alimentary system, Immune dysregulation, Bioinformatic analysis
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On 07 Oct, 2020
Review #1 received
Received 06 Oct, 2020
Reviewer #1 agreed
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On 17 Sep, 2020
Submission checks complete
On 16 Sep, 2020
Editor invited
On 16 Sep, 2020
No comments provided
Editorial decision: Revise Before Review
On 01 Sep, 2020
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On 13 Aug, 2020
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On 12 Aug, 2020
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On 12 Aug, 2020
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This preprint is under consideration at Gut Pathogens. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Alimentary System is Directly Attacked by SARS-COV-2 and Further Prevents Immune Dysregulation Caused by COVID-19
Yunhan Jiang
West China Hospital, Sichuan University
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2759-2328
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 2
Posted 18 Sep, 2020
No community comments so far
Editorial decision: Major revision
On 05 Nov, 2020
Review #3 received
Received 04 Nov, 2020
Reviewer #3 agreed
On 28 Oct, 2020
Review #2 received
Received 20 Oct, 2020
Reviewer #2 agreed
On 07 Oct, 2020
Review #1 received
Received 06 Oct, 2020
Reviewer #1 agreed
On 29 Sep, 2020
Reviewers invited
Invitations sent on 26 Sep, 2020
Editor assigned
On 17 Sep, 2020
Submission checks complete
On 16 Sep, 2020
Editor invited
On 16 Sep, 2020
No comments provided
Editorial decision: Revise Before Review
On 01 Sep, 2020
Editor assigned
On 13 Aug, 2020
First submitted
On 12 Aug, 2020
Submission checks complete
On 12 Aug, 2020
Editor invited
On 12 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background. SARS-COV-2 causes digestive system symptom, the effect of which remains equivocal.
Methods. Patients with COVID-19 were classified into 4 groups according to symptom. The study traced the onset and duration of symptoms, compared laboratory examinations and conducted bioinformatic analysis. Immune indices were further analyzed.
Results. By March 16, 25 patients with COVID-19 and 13 with suspect COVID-19 were admitted to West China Hospital, Sichuan University. Digestive system symptom group had the highest level of ESR (mm/h, P＜0.0001), serum ferritin (ng/ml, P＜0.0001), hepatic enzymes (P＜0.05), and retentive lymphocyte count/percentage (P＜0.05) and its subsets (P＜0.05). Combined group (respiratory combined with subsequent digestive system symptom) had the highest level of IL-6 (pg/ml, P=0.0046), CRP (mg/L, P=0.0004) and moderate lymphocyte depletion. Respiratory system symptom and asymptomatic groups suffered the most from lymphocyte depletion (P＜0.05). Bioinformatic analysis indicated co-expression of binding related proteins of SARS-COV-2 (ACE2, TMPRSS2 and Furin) in small intestine. CD147 was extensively expressed in alimentary tract. CTSL, PIKfyve, TPC2 and CTSB could be detected with ≥moderate expressions in a variety of organs including alimentary system.
Conclusions. Alimentary system is directly attacked by SARS-COV-2 other than hyperinflammation and immune dysregulation. Involvement of alimentary system might further protect mild and moderate cases from lymphocyte depletion caused by COVID-19.
Figure 1
Figure 2
Figure 3