SARS-CoV-2 infection and the gut-liver axis.

Mohandas, Sundhar; Vairappan, Balasubramaniyan

Patients affected with Covid-19 that is caused by the severe acute respiratory syndrome coronavirus 2, manifest various gastrointestinal and hepatic abnormalities alongside respiratory disorder. The identification of this virus in the feces of more than 50% of infected individuals indicates the possibility of viral shedding and fecal to oral transmission. Preliminary reports have also identified alterations in the intestinal microbiota profile in the infected individuals. Moreover, Covid-19 patients manifest various degrees of liver injury characterized by alterations in liver function enzymes. Interestingly, the manifestation of digestive symptoms and liver abnormalities correlate with disease severity, the incidence of the critical outcome, and the recovery time of the patients. However, the pathogenic mechanisms behind Covid-19 induced abnormalities in the gut-liver axis seem multifactorial in origin. This review compiles the current knowledge sourced from pre-clinical and clinical research and summarizes the various gastrointestinal and hepatic dysfunction observed following infection with Covid-19 virus, and also explores the possible mechanistic link precipitating the abnormalities in the gut-liver axis. Furthermore, this review sheds light on possible therapeutic targets against these disorders. This article is protected by copyright. All rights reserved.