COVID-19 and Hartnup disease: an affair of intestinal amino acid malabsorption.

Department of Biomedical Technology and Translational Medicine, Center for Study and Research on Obesity, University of Milan, Milan, 20129, Italy. enzo.nisoli@unimi.it. Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy. Department of Molecular and Translational Medicine, University of Brescia, Brescia, 25123, Italy. alessandra.valerio@unibs.it.

Eating and weight disorders : EWD. 2021;(5):1647-1651

Abstract

Since the outbreak of COVID-19, clinicians have tried every effort to fight the disease, and multiple drugs have been proposed. However, no proven effective therapies currently exist, and different clinical phenotypes complicate the situation. In clinical practice, many severe or critically ill COVID-19 patients developed gastrointestinal (GI) disturbances, including vomiting, diarrhoea, or abdominal pain, even in the absence of cough and dyspnea. Understanding the mechanism of GI disturbances is warranted for exploring better clinical care for COVID-19 patients. With evidence collected from clinical studies on COVID-19 and basic research on a rare genetic disease (i.e., Hartnup disorder), we put forward a novel hypothesis to elaborate an effective nutritional therapy. We hypothesize that SARS-CoV-2 spike protein, binding to intestinal angiotensin-converting enzyme 2, negatively regulates the absorption of neutral amino acids, and this could explain not only the GI, but also systemic disturbances in COVID-19. Amino acid supplements could be recommended.Level of evidence No level of evidence: Hypothesis article.