Publication Name	World Journal of Virology
Manuscript ID	80792
Country	Greece

Category	Infectious Diseases
Manuscript Type	Review
Article Title	Intestinal barrier dysfunction as a key driver of severe COVID-19
Manuscript Source	Invited Manuscript
All Author List	Efthymios P Tsounis, Christos Triantos, Christos Konstantakis, Markos Marangos and Stelios F Assimakopoulos
Funding Agency and Grant Number
Corresponding Author	Stelios F Assimakopoulos, MD, PhD, Associate Professor, Division of Infectious Diseases, Department of Internal Medicine, Medical School, University of Patras, University Hospital of Patras, Rion, Patras 26504, Greece. sassim@upatras.gr
Key Words	COVID-19; SARS-CoV-2; Intestinal barrier; Dysbiosis; Immunothrombosis; Gut-lung axis
Core Tip	Severe coronavirus disease 2019 (COVID-19) is associated with a multi-layered disruption of gut barrier integrity. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) inflicts direct cytopathic or indirect immune-mediated injury to intestinal epithelial and endothelial cells and enhances paracellular permeability by downregulating tight junction proteins. SARS-CoV-2 induces profound gut microbiome alterations accompanied by dysregulation of mucosal immune responses. Gut dysbiosis attenuates, through the gut-lung axis, the ability of the respiratory immune system to elicit vigorous responses to contain SARS-CoV-2. Additionally, intestinal barrier dysfunction promotes endothelial activation and predisposes to detrimental COVID-19-related thrombotic complications. Finally, bacterial translocation and endotoxemia contribute to over-exuberant immune responses and hyper-inflammation in severe COVID-19.
Citation	Tsounis EP, Triantos C, Konstantakis C, Marangos M, Assimakopoulos SF. Intestinal barrier dysfunction as a key driver of severe COVID-19. World J Virol 2023; 12(2): 68-90

Received	2022-10-12 20:22
Peer-Review Started	2022-10-12 20:25
To Make the First Decision
Return for Revision	2022-11-03 15:45
Revised	2022-11-08 09:44
Second Decision	2023-01-16 03:46
Accepted by Journal Editor-in-Chief
Accepted by Company Editor-in-Chief	2023-01-16 20:25
Articles in Press	2023-01-16 20:25
Publication Fee Transferred
Edit the Manuscript by Language Editor	2022-12-29 23:04
Typeset the Manuscript	2023-03-17 03:00

ISSN	2220-3249 (online)
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