Assessment of the integrity of the intestinal epithelial barrier in patients infected with SARS-COVID-2: a multicenter study

Abstract

Changes in functioning of the gastrointestinal tract (nausea, vomiting, diarrhea and abdominal discomfort) have been described in pandemics by coronavirus in 2003 and 2019. Accordingly, experimental data in rodents confirm that respiratory viral infections promote disorders of the intestinal functions including increased motility, loss/malabsorption of fluids, inflammation of the intestinal mucosa and changes in the composition of the microbiome. In addition, patients who have gastrointestinal symptoms at the initial phase of SARS-CoV-2 infection have a worsening of their clinical condition, with increased need for intensive care procedures, higher fever and mechanical ventilation. However, there are no reports whether in these pathological conditions there is an impairment of the barrier function of the intestinal mucosa. In several other pathologies (sepsis, inflammatory bowel diseases, celiac disease), the rupture of intestinal tight junctions may turn the intestine into a source of potentially pathogenic microorganisms, contributing to the worst clinical prognosis, activation of the systemic inflammatory response and development of secondary bacterial infections. For these reasons, the present study proposes to evaluate, for the first time, the integrity of the intestinal epithelium in patients infected with SARS-CoV-2, by the quantification of biomarkers and bacterial translocation in the systemic circulation and also in urine. (AU)