- ACE2 is expressed abundantly in the gastrointestinal tract, especially the ileum and colon
- When SARS-CoV-2 binds to ACE2 receptors, it is believed that it disrupts the microbiome of the intestinal tract
- There are GI symptoms of COVID-19 (e.g. anorexia, nausea, vomiting, diarrhea, and abdominal pain) that may impact the ability for a patient to eat. If oral intake is not possible, enteral nutrition is preferred (studies have shown that this method decreases length of hospital stay, costs, mortality rate, and septic complications)
- Simulating the digestive system is important because a lack of nutrients in the intestines can result in lymphoid tissue and decline of the immune system, as well as increased bacterial translocation. Therefore parenteral nutrition is not recommended
- A few journals indicate that EN is extremely beneficial for patients Crohn's disease and Inflammatory Bowel Disease
- Probiotics are being used in addition to primary treatments to mitigate the damage done to the gut microbiota done by antibacterial and antiviral treatments


Understanding the GI Tract, COVID‐19, and Related Nutrition Issues

- Nutrition Delivery and Access
- Timing of Nutrition Delivery
- Nutrition in the Prone Position
- The Challenge of GI Intolerance

Innovating Nutrition Practices in the COVID‐19 Pandemic

- Understanding the GI Tract, COVID‐19, and Related Nutrition Issues
- Innovating Nutrition Practices in the COVID‐19 Pandemic

Smith College

Even though COVID-19 is primarily viewed as a reparatory illness, it has also been found to affect the gastrointestinal system. Therefore, there is an increasing need for a focus on gastroenterology to establish proper nutrition therapies. To develop these nutrition therapies, a better understanding of preexisting gastrointestinal diseases is vital, as well as consideration of the challenges and obstacles of nutrition therapy.

Gastrointestinal Manifestations of COVID-19: Impact on Nutrition Practices

Aguila, E., Cua, I., Fontanilla, J., Yabut, V., & Causing, M. (2020). Gastrointestinal Manifestations of COVID-19: Impact on Nutrition Practices. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 35(5), 800–805. https://doi.org/10.1002/ncp.10554

Gastrointestinal Manifestations of COVID‐19: Impact on Nutrition Practices

- a review based on case reports, retrospective clinical studies, review articles, and society recommendations
- a substantial amount of searching for references, papers, reports, and articles with cross‐referencing was done
- search terms used: “2019‐nCoV,” “SARS‐CoV‐2,” or “COVID‐19,” combined with “nutrition,” “gastrointestinal,” and “digestive system”

Methods of Gastrointestinal Manifestations of COVID‐19: Impact on Nutrition Practices

Results of Gastrointestinal Manifestations of COVID‐19: Impact on Nutrition Practices

It has been revealed that nutrition therapy for COVID‐19 patients is largely dependent on the effect of SARS-CoV-2 infection on the digestive system. Oral diet or EN are the preferred routes of feeding due to the many benefits to the health of the digestive system. GI intolerance can be detrimental to the nutrition goals of the patient, but can be remedied with alternative methods of feeding, frequency and amount of feeding, and/or alternative food options. Though certain methods are preferred, it is important to keep in mind the safety of healthcare workers, therefore feeding should be adjusted to control the spread of the virus. 

Learn Before

Related

Learn After