COVID-19 and Gut Injury

Nutrients. 2022 Oct 20;14(20):4409. doi: 10.3390/nu14204409.


COVID-19 induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently a pandemic and it has led to more than 620 million patients with 6.56 million deaths globally. Males are more susceptible to COVID-19 infection and associated with a higher chance to develop severe COVID-19 than females. Aged people are at a high risk of COVID-19 infection, while young children have also increased cases. COVID-19 patients typically develop respiratory system pathologies, however symptoms in the gastrointestinal (GI) tract are also very common. Inflammatory cell recruitments and their secreted cytokines are found in the GI tract in COVID-19 patients. Microbiota changes are the key feature in COVID-19 patients with gut injury. Here, we review all current known mechanisms of COVID-19-induced gut injury, and the most acceptable one is that SARS-CoV-2 binds to angiotensin-converting enzyme 2 (ACE2) receptor on host cells in the GI tract. Interestingly, inflammatory bowel disease (IBD) is an inflammatory disorder, but the patients with IBD do not have the increased risk to develop COVID-19. There is currently no cure for COVID-19, but anti-viruses and monoclonal antibodies reduce viral load and shorten the recovery time of the disease. We summarize current therapeutics that target symptoms in the GI tract, including probiotics, ACE2 inhibitors and nutrients. These are promising therapeutic options for COVID-19-induced gut injury.

Keywords: ACE2; COVID-19; IBD; gut; microbiota; probiotics.

Publication types

  • Review

MeSH terms

  • Angiotensin-Converting Enzyme 2
  • Antibodies, Monoclonal
  • COVID-19* / physiopathology
  • Cytokines
  • Female
  • Gastrointestinal Diseases* / virology
  • Gastrointestinal Microbiome
  • Humans
  • Inflammatory Bowel Diseases
  • Male
  • SARS-CoV-2


  • Angiotensin-Converting Enzyme 2
  • Antibodies, Monoclonal
  • Cytokines