ArticleGastroenterology2021
Intestinal Host Response to SARS-CoV-2 Infection and COVID-19 Outcomes in Patients With Gastrointestinal Symptoms.
Open access · bronzeAbstract readMulticenter Study
In one paragraph
Article in Gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 106 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
106citing papers in PubMed, 1 pooled it
9.4field-weighted citation impact, top 2% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
106 citing papers in PubMed, 1 synthesis or guideline pooled it, 157 citations in OpenAlex.
- Are gastrointestinal symptoms associated with higher risk of Mortality in COVID-19 patients? A systematic review and meta-analysis.BMC gastroenterology · 2022Pooled it
- Probiotic Therapy of Gastrointestinal Symptoms During COVID-19 Infection: A Randomized, Double-Blind, Placebo-Controlled, Remote Study.Nutrients · 2024Trial
- Cardiovascular Disease as a Risk Amplifier of COVID-19 Severity and a Potential Correlations to Long-Term Gastrointestinal Sequelae.Journal of racial and ethnic health disparities · 2026Article
- Article
- Article
- Eosinophil-associated intestinal immune responses following SARS-CoV-2 infection in K18-hACE2 mice.PloS one · 2026Article
- Lessons from irritable bowel syndrome: potential for understanding and managing post-COVID.Frontiers in immunology · 2026Review
- New insights into the role of metallothioneins in obesity and diabetes.International journal of obesity (2005) · 2025Review
- A survey of SARS-CoV-2 tropism.Infectious diseases & immunity · 2025Review
- Emerging Therapies in Inflammatory Bowel Disease: A Comprehensive Review.Journal of clinical medicine · 2025Review
- Gut Microbiota and COVID-19: Unraveling the Gut-Lung Axis and Immunomodulatory Therapies.ACS infectious diseases · 2025Review
- SARS-CoV-2 causes gastric damage: structural and ultrastructural evaluation.Journal of molecular histology · 2025Article
- Article
- Identification of immune-related hub genes and potential molecular mechanisms involved in COVID-19 via integrated bioinformatics analysis.Scientific reports · 2024Article
- SARS-CoV-2 infection perturbs the gastrointestinal tract and induces modest microbial translocation across the intestinal barrier.Journal of virology · 2024Article
- Long-term gastrointestinal and hepatobiliary outcomes of COVID-19: A multinational population-based cohort study from South Korea, Japan, and the UK.Clinical and molecular hepatology · 2024Article
- Interactions of SARS-CoV-2 with Human Target Cells-A Metabolic View.International journal of molecular sciences · 2024Review
- SARS-CoV-2 tropism to intestinal but not gastric epithelial cells is defined by limited ACE2 expression.Stem cell reports · 2024Article
- Gastrointestinal symptoms in COVID-19 and disease severity: a Japanese registry-based retrospective cohort study.Journal of gastroenterology · 2024Article
- A new perspective on gut-lung axis affected through resident microbiome and their implications on immune response in respiratory diseases.Archives of microbiology · 2024Review
46 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
53 authors at 6 institutions in 3 countries.
Alexandra E LivanosPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Divya JhaPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Francesca CossariniPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Division of Infectious Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Ana S Gonzalez-ReicheDepartment of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
Minami TokuyamaPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Teresa AydilloDepartment of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York; Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
Tommaso L ParigiDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Mark S LadinskyDivision of Biology and Biological Engineering, California Institute of Technology, Pasadena, California.
Irene RamosDepartment of Neurology and Center for Advanced Research on Diagnostic Assays, Icahn School of Medicine at Mount Sinai, New York, New York.
Katie DunleavyDepartment of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Brian LeeHuman Immune Monitoring Center (HIMC) Icahn School of Medicine at Mount Sinai New York, New York, New York.
Rebekah E DixonThe Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Steven T ChenPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
Gustavo Martinez-DelgadoPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Satish NagulaThe Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Emily A BruceDivision of Immunobiology, Department of Medicine, University of Vermont, Larner College of Medicine, Burlington, Vermont.
Huaibin M KoThe Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Pathology, Molecular and Cell Based Medicine Icahn School of Medicine at Mount Sinai, New York, New York.
Benjamin S GlicksbergDepartment of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York; The Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, New York.
Girish NadkarniDepartment of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; The Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, New York; The Charles Bronfman Institute of Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; The Mount Sinai Clinical Intelligence Center, Icahn School of Medicine at Mount Sinai, New York, New York.
Elisabet PujadasDepartment of Pathology, Molecular and Cell Based Medicine Icahn School of Medicine at Mount Sinai, New York, New York.
Jason ReidyDepartment of Pathology, Molecular and Cell Based Medicine Icahn School of Medicine at Mount Sinai, New York, New York.
Steven NaymagonThe Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Ari GrinspanThe Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Jawad AhmadThe Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Michael TankelevichPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Yaron BramDivision of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, New York, New York.
Ronald GordonDepartment of Pathology, Molecular and Cell Based Medicine Icahn School of Medicine at Mount Sinai, New York, New York.
Keshav SharmaPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Jane HouldsworthDepartment of Pathology, Molecular and Cell Based Medicine Icahn School of Medicine at Mount Sinai, New York, New York.
Graham J BrittonPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
Alice Chen-LiawPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
Matthew P SpindlerPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
Tamar PlittPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
Pei WangDepartment of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
Andrea CeruttiPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Catalan Institute for Research and Advanced Studies, Barcelona, Spain; Program for Inflammatory and Cardiovascular Disorders, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.
Jeremiah J FaithPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
Jean-Frederic ColombelPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Ephraim KenigsbergPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
Carmen ArgmannDepartment of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
Miriam MeradPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Human Immune Monitoring Center (HIMC) Icahn School of Medicine at Mount Sinai New York, New York, New York; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
Sacha GnjaticPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Human Immune Monitoring Center (HIMC) Icahn School of Medicine at Mount Sinai New York, New York, New York; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Pathology, Molecular and Cell Based Medicine Icahn School of Medicine at Mount Sinai, New York, New York.
Noam HarpazDepartment of Pathology, Molecular and Cell Based Medicine Icahn School of Medicine at Mount Sinai, New York, New York.
Silvio DaneseDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Carlos Cordon-CardoDepartment of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Pathology, Molecular and Cell Based Medicine Icahn School of Medicine at Mount Sinai, New York, New York.
Adeeb RahmanPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York; Human Immune Monitoring Center (HIMC) Icahn School of Medicine at Mount Sinai New York, New York, New York; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
Robert E SchwartzDivision of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, New York, New York.
Nikhil A KumtaThe Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Alessio AghemoDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Pamela J BjorkmanDivision of Biology and Biological Engineering, California Institute of Technology, Pasadena, California.
Francesca PetraliaDepartment of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: francesca.Petralia@mssm.edu.
Harm van BakelDepartment of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York; Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: harm.vanbakel@mssm.edu.
Adolfo Garcia-SastreDivision of Infectious Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York; Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: adolfo.Garcia-Sastre@mssm.edu.
Saurabh MehandruPrecision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: saurabh.mehandru@mssm.edu.
Icahn School of Medicine at Mount Sinai · USHumanitas University · ITCalifornia Institute of Technology · USCornell University · USInstitució Catalana de Recerca i Estudis Avançats · ESUniversity of Vermont · US
Funding
Regulation of IgA class switching in the intestinal mucosaP01AI061093 · NIAID · MOUNT SINAI SCHOOL OF MEDICINE OF NYU · PI CUNNINGHAM-RUNDLES, CHARLOTTE · 2004 to 2021
$29.8MUsing Dengue Controlled Human Infection Model to Identify Adaptive Immune Correlates of ProtectionP20GM125498 · NIGMS · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI Ellen Kozelka · 2018 to 2026
$24.9MHigh-Dimensional Immune Monitoring of NCI-Supported Immunotherapy TrialsU24CA224319 · NCI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Sacha Gnjatic, Seunghee Kim-Schulze · 2017 to 2026
$21.5MPersonalized Immunotherapy of Patients with Ovarian CancerP01CA190174 · NCI · SLOAN-KETTERING INST CAN RESEARCH · PI SABBATINI, PAUL J, SPRIGGS, DAVID R · 2015 to 2019
$10.5MGenetic Viral and Host Adaptations to Breach Species Barriers of HCVR01AI107301 · NIAID · PRINCETON UNIVERSITY · PI Thomas Pietschmann, Alexander Ploss · 2013 to 2026
$6.0MDetermination of mucosal immune responses to, and infection of the gastrointestinal tract by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)R01DK123749 · NIDDK · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI CERUTTI, ANDREA, FAITH, JEREMIAH JAMES · 2020 to 2024
$4.9MMulti-level analysis of influenza virus polymerase and its role in pathogenesisR01AI113186 · NIAID · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI MARAZZI, IVAN, VAN BAKEL, HARM · 2015 to 2019
$3.0MCharacterizing and predicting colitis in immune checkpoint blockade-treated cancer patientsU01DK124165 · NIDDK · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI COLOMBEL, JEAN-FREDERIC, FAITH, JEREMIAH JAMES · 2020 to 2024
$2.9MOptimization of the engineered 3D hepatic microenvironment enhances pluripotent stem cell derived hepatocyteR01DK121072 · NIDDK · WEILL MEDICAL COLL OF CORNELL UNIV · PI SCHWARTZ, ROBERT E · 2020 to 2024
$2.6MImmunology Training GrantT32AI007605 · NIAID · MOUNT SINAI SCHOOL OF MEDICINE OF NYU · PI LIRA, SERGIO A. · 2001 to 2017
$2.2MBig Omics Data Engine 2 SupercomputerS10OD026880 · OD · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KOVATCH, PATRICIA · 2019 to 2019
$2.0MTransforming Genomics with 5 PB Big Omics Data Engine Cray CS300-AC SupercomputerS10OD018522 · OD · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KOVATCH, PATRICIA · 2014 to 2014
$1.9MNCI NIH HHS F30 CA243210NCI NIH HHS P01 CA190174NCI NIH HHS R01 CA234614NCI NIH HHS U24 CA224319NIAID NIH HHS HHSN272201400008CNIAID NIH HHS P01 AI061093NIAID NIH HHS R01 AI107301NIAID NIH HHS R01 AI113186NIAID NIH HHS T32 AI007605NIDDK NIH HHS R01 DK121072NIDDK NIH HHS R01 DK123749NIDDK NIH HHS U01 DK124165NIGMS NIH HHS P20 GM125498NIH HHS S10 OD018522NIH HHS S10 OD026880
Abstract
BACKGROUND &
aimsGiven that gastrointestinal (GI) symptoms are a prominent extrapulmonary manifestation of COVID-19, we investigated intestinal infection with SARS-CoV-2, its effect on pathogenesis, and clinical significance.
methodsHuman intestinal biopsy tissues were obtained from patients with COVID-19 (n = 19) and uninfected control individuals (n = 10) for microscopic examination, cytometry by time of flight analyses, and RNA sequencing. Additionally, disease severity and mortality were examined in patients with and without GI symptoms in 2 large, independent cohorts of hospitalized patients in the United States (N = 634) and Europe (N = 287) using multivariate logistic regressions.
resultsCOVID-19 case patients and control individuals in the biopsy cohort were comparable for age, sex, rates of hospitalization, and relevant comorbid conditions. SARS-CoV-2 was detected in small intestinal epithelial cells by immunofluorescence staining or electron microscopy in 15 of 17 patients studied. High-dimensional analyses of GI tissues showed low levels of inflammation, including down-regulation of key inflammatory genes including IFNG, CXCL8, CXCL2, and IL1B and reduced frequencies of proinflammatory dendritic cells compared with control individuals. Consistent with these findings, we found a significant reduction in disease severity and mortality in patients presenting with GI symptoms that was independent of sex, age, and comorbid illnesses and despite similar nasopharyngeal SARS-CoV-2 viral loads. Furthermore, there was reduced levels of key inflammatory proteins in circulation in patients with GI symptoms.
conclusionsThese data highlight the absence of a proinflammatory response in the GI tract despite detection of SARS-CoV-2. In parallel, reduced mortality in patients with COVID-19 presenting with GI symptoms was observed. A potential role of the GI tract in attenuating SARS-CoV-2-associated inflammation needs to be further examined.
Indexed as
Immunity, MucosalAgedAged, 80 and overCase-Control StudiesCells, CulturedCOVID-19CytokinesFemaleGastrointestinal DiseasesHost-Pathogen InteractionsHumansInflammation MediatorsIntestinal MucosaItalyMaleMiddle AgedCytokinesInflammation MediatorsCOVID-19GI infectionGI symptomshost immune responseoutcomesSARS-CoV-2
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