{"id":38912,"date":"2021-01-21T12:55:47","date_gmt":"2021-01-21T12:55:47","guid":{"rendered":"https:\/\/allaboutibs.com\/gastrointestinalni-problemy-s-pripravkem-covid-19\/"},"modified":"2024-04-30T09:23:14","modified_gmt":"2024-04-30T09:23:14","slug":"gastrointestinalni-problemy-s-pripravkem-covid-19","status":"publish","type":"post","link":"https:\/\/allaboutibs.com\/cs\/gastrointestinalni-problemy-s-pripravkem-covid-19\/","title":{"rendered":"Gastrointestin\u00e1ln\u00ed probl\u00e9my s p\u0159\u00edpravkem COVID-19"},"content":{"rendered":" \n

Nov\u00fd koronavirus (SARS-CoV-2) se v sou\u010dasn\u00e9 dob\u011b \u0161\u00ed\u0159\u00ed po cel\u00e9m sv\u011bt\u011b a ovliv\u0148uje n\u00e1s mnoha r\u016fzn\u00fdmi zp\u016fsoby. Denn\u011b \u010dteme o v\u0161ech tragick\u00fdch \u00famrt\u00edch a v\u00e1\u017en\u011b nemocn\u00fdch lidech, ale v\u011bt\u0161ina posti\u017een\u00fdch virem se na\u0161t\u011bst\u00ed uzdrav\u00ed. Typick\u00fdmi p\u0159\u00edznaky viru jsou such\u00fd ka\u0161el, hore\u010dka a du\u0161nost, ale bylo tak\u00e9 prok\u00e1z\u00e1no, \u017ee se u COVID-19 \u010dasto objevuj\u00ed gastrointestin\u00e1ln\u00ed pot\u00ed\u017ee.<\/p> \n \n

\u010cast\u00e9 gastrointestin\u00e1ln\u00ed probl\u00e9my spojen\u00e9 s COVID-19<\/h2> \n \n

V \u010dasopise The British Medical Journal byl ned\u00e1vno zve\u0159ejn\u011bn p\u0159ehled 20 133 pacient\u016f l\u00e9\u010den\u00fdch v britsk\u00fdch nemocnic\u00edch (1). Tento \u010dl\u00e1nek uv\u00e1d\u00ed, \u017ee u COVID-19 jsou b\u011b\u017en\u00e9 r\u016fzn\u00e9 p\u0159\u00edznaky z gastrointestin\u00e1ln\u00edho traktu, jako jsou bolesti b\u0159icha, pr\u016fjem a zvracen\u00ed.<\/p> \n \n

Pr\u016fjmem trp\u011blo 20,4 % (22,0 % \u017een a 19,3 % mu\u017e\u016f) a nevolnost\u00ed \/ zvracen\u00edm 19,8 % (23,5 % \u017een a 17,3 % mu\u017e\u016f).<\/p> \n \n

Tyto p\u0159\u00edznaky se tak um\u00edstily v prvn\u00ed des\u00edtce (na 8. a 9. m\u00edst\u011b) mezi nej\u010dast\u011bj\u0161\u00edmi p\u0159\u00edznaky COVID-19, alespo\u0148 u osob, kter\u00e9 byly o\u0161et\u0159ov\u00e1ny v nemocnic\u00edch ve Spojen\u00e9m kr\u00e1lovstv\u00ed. Bolest b\u0159icha se um\u00edstila na 13. m\u00edst\u011b mezi nej\u010dast\u011bj\u0161\u00edmi p\u0159\u00edznaky a postihovala 10,2 % (11,4 % \u017een a 9,3 % mu\u017e\u016f).<\/p> \n \n

\n
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Gastrointestinal problems such as diarrhea, nausea and vomiting are common symptoms of COVID-19 according to a study of over 20,000 patients from various hospitals in the UK (1). The figure shows the proportion of patients who presented the respective symptoms.<\/p><\/div> \n \n<\/figure> \n \n

N\u011bkdy jsou jedin\u00fdmi p\u0159\u00edznaky gastrointestin\u00e1ln\u00ed pot\u00ed\u017ee.<\/h2> \n \n

Seznam r\u016fzn\u00fdch p\u0159\u00edznak\u016f je dlouh\u00fd a nest\u00e1v\u00e1 se, \u017ee by se u stejn\u00e9ho pacienta vyskytovaly v\u0161echny p\u0159\u00edznaky sou\u010dasn\u011b. Naprost\u00e1 v\u011bt\u0161ina (p\u0159ibli\u017en\u011b 70 %) m\u011bla st\u00e1le jeden nebo v\u00edce b\u011b\u017en\u00fdch p\u0159\u00edznak\u016f: hore\u010dku, ka\u0161el a\/nebo du\u0161nost.<\/p> \n \n

Na za\u010d\u00e1tku leto\u0161n\u00edho roku bylo v jin\u00e9, podstatn\u011b men\u0161\u00ed studii se 74 pacienty z \u010c\u00edny zji\u0161t\u011bno, \u017ee 21 pacient\u016f (28,38 %) vykazovalo pouze p\u0159\u00edznaky z gastrointestin\u00e1ln\u00edho traktu v podob\u011b nevolnosti, zvracen\u00ed a\/nebo pr\u016fjmu (2). Tito pacienti nem\u011bli obvykl\u00e9 p\u0159\u00edznaky, jako je ka\u0161el, ale p\u0159esto m\u011bli infekci COVID-19 (SARS-Cov-2). M\u016f\u017ee b\u00fdt obt\u00ed\u017en\u00e9 porovn\u00e1vat r\u016fzn\u00e9 studie z r\u016fzn\u00fdch zem\u00ed a r\u016fzn\u00fdch situac\u00ed, ale v ka\u017ed\u00e9m p\u0159\u00edpad\u011b se zd\u00e1, \u017ee skute\u010dn\u011b m\u016f\u017eete m\u00edt virov\u00e9 onemocn\u011bn\u00ed a pouze ur\u010dit\u00e9 p\u0159\u00edznaky z gastrointestin\u00e1ln\u00edho traktu.<\/p> \n \n

Virus z\u016fst\u00e1v\u00e1 ve stolici po dlouhou dobu.<\/h2> \n \n

N\u011bkolik studi\u00ed v\u0161ak tak\u00e9 uk\u00e1zalo, \u017ee i u t\u011bch, kte\u0159\u00ed nemaj\u00ed \u017e\u00e1dn\u00e9 probl\u00e9my v tr\u00e1vic\u00edm traktu, se virus st\u00e1le \u010dasto nach\u00e1z\u00ed ve stolici. Bylo dokonce mo\u017en\u00e9 pou\u017e\u00edt vzorky z odpadn\u00edch vod k posouzen\u00ed, jak se infekce vyv\u00edj\u00ed.<\/p> \n \n

Endoskopie prok\u00e1zala, \u017ee virus se m\u016f\u017ee vyskytovat na r\u016fzn\u00fdch m\u00edstech tr\u00e1vic\u00edho traktu, nap\u0159\u00edklad v j\u00edcnu, \u017ealudku, dvan\u00e1ctn\u00edku a kone\u010dn\u00edku. Zd\u00e1 se tak\u00e9, \u017ee virus m\u016f\u017ee po ur\u010ditou dobu z\u016fstat v tr\u00e1vic\u00edm traktu, i kdy\u017e opustil d\u00fdchac\u00ed cesty. V jedn\u00e9 studii m\u011bla polovina pacient\u016f virus ve stolici 11 dn\u00ed pot\u00e9, co byly vzorky z d\u00fdchac\u00edch cest na virus negativn\u00ed (4).<\/p> \n \n

Virus vstupuje do bun\u011bk<\/h2> \n \n

Je zn\u00e1mo, \u017ee virus vstupuje do bun\u011bk prost\u0159ednictv\u00edm receptoru (receptoru na bu\u0148k\u00e1ch) zvan\u00e9ho ACE2. Tento receptor se nach\u00e1z\u00ed ve st\u0159evech a pod\u00edl\u00ed se na regulaci z\u00e1n\u011btu. Zd\u00e1 se tak\u00e9, \u017ee bu\u0148ky za\u017e\u00edvac\u00edho traktu maj\u00ed jin\u00e9 vlastnosti, kter\u00e9 umo\u017e\u0148uj\u00ed viru proniknout do nich. Bu\u0148ky v tr\u00e1vic\u00edm traktu, stejn\u011b jako bu\u0148ky v plic\u00edch, produkuj\u00ed mimo jin\u00e9 ur\u010dit\u00e9 enzymy, kter\u00e9 virus pot\u0159ebuje k napaden\u00ed bun\u011bk.<\/p> \n \n

COVID-19 a IBD<\/h2> \n \n

Souvislost mezi virem a z\u00e1n\u011btem ve st\u0159evech vyvolala ot\u00e1zku, zda lid\u00e9 se z\u00e1n\u011btliv\u00fdm onemocn\u011bn\u00edm st\u0159ev (IBD Crohnova choroba a ulcer\u00f3zn\u00ed kolitida) mohou b\u00fdt vystaveni viru v\u00edce ne\u017e ostatn\u00ed, a to v d\u016fsledku zm\u011bn\u011bn\u00e9 exprese receptoru ACE2 ve st\u0159evech zp\u016fsoben\u00e9 z\u00e1n\u011btem. Aby v\u0161ak bylo mo\u017en\u00e9 tuto souvislost potvrdit, je t\u0159eba prov\u00e9st dal\u0161\u00ed v\u00fdzkum. Dnes nen\u00ed zn\u00e1mo, pro\u010d jsou gastrointestin\u00e1ln\u00ed pot\u00ed\u017ee s COVID-19 tak \u010dast\u00e9 a zda m\u016f\u017ee b\u00fdt gastrointestin\u00e1ln\u00ed trakt alternativn\u00ed cestou, kterou se virus dost\u00e1v\u00e1 do t\u011bla. Jednou z ot\u00e1zek, kter\u00e9 n\u00e1s tr\u00e1p\u00ed, je nap\u0159\u00edklad to, jak se viru poda\u0159\u00ed p\u0159ekonat extr\u00e9mn\u00ed pH, kter\u00e9mu je vystaven v tr\u00e1vic\u00edm traktu. My na alltomibs.com samoz\u0159ejm\u011b sledujeme v\u00fdvoj tohoto viru a jeho \u00fa\u010dinky na gastrointestin\u00e1ln\u00ed trakt.<\/p> \n

V\u00edce informac\u00ed o gastrointestin\u00e1ln\u00edch p\u0159\u00edznac\u00edch a COVID-19 najdete na str\u00e1nk\u00e1ch theromefoundation.org<\/a>.<\/p> \n \n

Referenser<\/h2> \n \n

1 Docherty AB, Harrison EM, Green CA a kol. Charakteristiky 20 133 pacient\u016f ve Velk\u00e9 Brit\u00e1nii hospitalizovan\u00fdch s kovidem-19 pomoc\u00ed protokolu klinick\u00e9 charakteristiky ISARIC WHO: prospektivn\u00ed observa\u010dn\u00ed kohortov\u00e1 studie. BMJ<\/em>. 2020;369:m1985. Zve\u0159ejn\u011bno 2020 kv\u011bten 22. doi:10.1136\/bmj.m1985 L\u00c4NK<\/a><\/p> \n \n

2 Jin X, Lian JS, Hu JH a kol. Epidemiologick\u00e1, klinick\u00e1 a virologick\u00e1 charakteristika 74 p\u0159\u00edpad\u016f koronavirov\u00e9 infekce 2019 (COVID-19) s gastrointestin\u00e1ln\u00edmi p\u0159\u00edznaky. St\u0159eva<\/em>. 2020;69(6):1002\u20101009. doi:10.1136\/gutjnl-2020-320926 L\u00c4NK<\/a><\/p> \n \n

3 Ng SC, Tilg H. COVID-19 a gastrointestin\u00e1ln\u00ed trakt: v\u00edce, ne\u017e se zd\u00e1 na prvn\u00ed pohled. Gut<\/em>. 2020;69(6):973-974. doi:10.1136\/gutjnl-2020-321195 L\u00c4NK<\/a><\/p> \n \n

4 Wu Y, Guo C, Tang L a kol. Dlouhodob\u00e1 p\u0159\u00edtomnost virov\u00e9 RNA SARS-CoV-2 ve vzorc\u00edch stolice. Lancet Gastroenterol Hepatol<\/em>. 2020;5(5):434-435. doi:10.1016\/S2468-1253(20)30083-2 L\u00c4NK<\/a><\/p> \n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Nov\u00fd koronavirus (SARS-CoV-2) se v sou\u010dasn\u00e9 dob\u011b \u0161\u00ed\u0159\u00ed po cel\u00e9m sv\u011bt\u011b a ovliv\u0148uje n\u00e1s mnoha r\u016fzn\u00fdmi zp\u016fsoby. Denn\u011b \u010dteme o v\u0161ech tragick\u00fdch \u00famrt\u00edch a v\u00e1\u017en\u011b nemocn\u00fdch lidech, ale v\u011bt\u0161ina posti\u017een\u00fdch virem se na\u0161t\u011bst\u00ed uzdrav\u00ed. Typick\u00fdmi p\u0159\u00edznaky viru jsou such\u00fd ka\u0161el, hore\u010dka a du\u0161nost, ale bylo tak\u00e9 prok\u00e1z\u00e1no, \u017ee se u COVID-19 \u010dasto objevuj\u00ed gastrointestin\u00e1ln\u00ed […]<\/p>\n","protected":false},"author":2,"featured_media":38916,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[318],"tags":[],"class_list":["post-38912","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-dalsi-strevni-potize","et-has-post-format-content","et_post_format-et-post-format-standard"],"yoast_head":"\nGastrointestin\u00e1ln\u00ed probl\u00e9my s p\u0159\u00edpravkem COVID-19 - all about IBS<\/title>\n<meta name=\"description\" content=\"Naprost\u00e1 v\u011bt\u0161ina (p\u0159ibli\u017en\u011b 70 %) m\u011bla st\u00e1le jeden nebo v\u00edce b\u011b\u017en\u00fdch p\u0159\u00edznak\u016f: hore\u010dku, ka\u0161el a\/nebo du\u0161nost.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/allaboutibs.com\/cs\/gastrointestinalni-problemy-s-pripravkem-covid-19\/\" \/>\n<meta property=\"og:locale\" content=\"cs_CZ\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Gastrointestin\u00e1ln\u00ed probl\u00e9my s p\u0159\u00edpravkem COVID-19 - 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