AUTHOR=Wu Xiaoming , Jing Haijiao , Wang Chengyue , Wang Yufeng , Zuo Nan , Jiang Tao , Novakovic Valerie A. , Shi Jialan 

TITLE=Intestinal Damage in COVID-19: SARS-CoV-2 Infection and Intestinal Thrombosis

JOURNAL=Frontiers in Microbiology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2022.860931

DOI=10.3389/fmicb.2022.860931

ISSN=1664-302X

ABSTRACT=<p>The intestinal tract, with high expression of angiotensin-converting enzyme 2 (ACE2), is a major site of extrapulmonary infection in COVID-19. During pulmonary infection, the virus enters the bloodstream forming viremia, which infects and damages extrapulmonary organs. Uncontrolled viral infection induces cytokine storm and promotes a hypercoagulable state, leading to systemic microthrombi. Both viral infection and microthrombi can damage the gut–blood barrier, resulting in malabsorption, malnutrition, and intestinal flora entering the blood, ultimately increasing disease severity and mortality. Early prophylactic antithrombotic therapy can prevent these damages, thereby reducing mortality. In this review, we discuss the effects of SARS-CoV-2 infection and intestinal thrombosis on intestinal injury and disease severity, as well as corresponding treatment strategies.</p>