Abdominal Pain, Diarrhea of ​​COVID-19 Associated with H pylori Infection

Among patients with coronavirus 2019 (COVID-19) who experienced abdominal pain and diarrhea, there was a significant likelihood that Helicobacter pylori (H pylori) infection, according to the results of a study published in Journal of Pediatric Gastroenterology and Nutrition.1

It is now known that acute acute respiratory syndrome coronavirus-2 (SARS-CoV-2), binds to angiotensin-converting enzyme-2 (ACE-2) receptors.2 These receptors are particularly expressed in the intestine, suggesting that SARS-CoV-2 infection may lead to gastrointestinal symptoms in patients with COVID-19.

As in H pylori increases ACE-2 receptor expression in the gastrointestinal tract, a group of researchers in Turkey conducted an investigation from June 1, 2020, to July 20, 2020 to determine the effects of H pylori on the clinical presentation and course of COVID-19 infections.1

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COVID-19 positive patients, confirmed by polymerase chain reaction, were included in the analysis. Bank samples were collected and the presence of H pylori determined by antigen testing tests.

A total of 108 patients (mean age, 49.54 years) were included in the analysis: 77 patients tested negative for H pylori infection and 31 patients were positive. Compared to patients who tested negative, patients with H pylori infections are significantly more frequent abdominal pain (P = .007) and distraction (P = .006). However, COVID-19 severity, disease outcome, and number of hospitalized days were not significantly related. H pylori infections

Investigators reported that the association between H pylori infection and abdominal pain and diarrhea in patients with COVID-19 are mediated by ACE-2 receptors. “[T]here is an urgent need for studies examining the availability of H pylori and the expression of ACE-2 receptors in the lungs and in the upper respiratory system, ”the investigators said.1


  1. Balamtekin N, Artuk C, Arslan M, Gulsen M. The effect of Helicobacter pylori in the presentation and clinical course of coronavirus disease 2019 infection. JPGN. 2021; 72 (4): 511-513. doi: 10.1097 / MPG.0000000000003005
  2. Lan J, Ge J, Yu J, et al. The structure of the SARS-CoV-2 spike receptor-binding domain bound to the ACE2 receptor. Nature. 2020; 581 (7807): 215-220. duha. 10.1038 / s41586-020-2180-5

This article originally appeared Gastroenterology Advisor

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