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March 04, 2021
1 min read
Source / Disclosures
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Disclosures:
Mehandru reports receiving research grants from Genentech and Takeda, as well as financial ties to Genentech, Morphic, and Takeda unrelated to the study.
COVID-19 patients with gastrointestinal symptoms had reduced mortality, according to research published in Gastroenterology.
Saurabh Mehandru, MD, from the Institute for Precision Immunology at the Icahn School of Medicine at Mount Sinai, explored how an intestinal infection with SARS-CoV-2 affects the pathogenesis of the disease.
First, they collected intestinal biopsies from 19 COVID-19 patients and 10 uninfected control individuals for microscopic examination, CyTOF analysis, and RNA sequencing.
The researchers detected SARS-CoV-2 in the epithelial cells of the small intestine in 14 of the 16 patients in the study. In their analysis, they found low levels of inflammation, down-regulation of key inflammatory genes, and reduced frequencies of pro-inflammatory dendritic cells compared to controls.
In a separate patient cohort, investigators examined disease severity and mortality in hospitalized patients with and without gastrointestinal symptoms in both the United States (n = 634) and Italy (n = 287).
Mehandru and colleagues found that patients presenting with gastrointestinal symptoms had a significant reduction in disease severity and mortality regardless of comorbid disease, similar nasopharyngeal SARS-CoV-2 viral load, and other factors.
Mehandru said that they were surprised by their findings.
“We can only hypothesize why,” he said in a press release. “It could be that the virus traveled to the gastrointestinal tract and was neutralized by significant enzyme activity or the presence of immunoglobulin IgA in the intestinal tract and, as a result, did not trigger the degree of inflammation that we sometimes see in the lungs. The finding surprised us because the receptor that the virus uses to enter the body, ACE 2, is abundantly expressed in intestinal epithelial cells ”.
The researchers wrote that something in the gut could play a role in attenuating the inflammation associated with SARS-CoV-2.
“Looking ahead, our study points to the need to better understand how infection in the intestines is related to prolonged COVID symptoms and the emergence of viral variants, which will require further investigation,” Mehandru said in the statement.
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