Covid-19, Coronavirus, SARS-CoV-2 and the small bowel

Klaus Mönkemüller, Lucia C. Fry and Steffen Rickes

Published: Revista Española de Enfermedades Digestivas, 26/04/2020 ©Copyright 2020. SEPD y © ARÁN EDICIONES, S.L.
This study shed further light on the infectious mechanism of SARS-CoV-2 and its potential interactions with the gut enterocytes. It forwards the hypothesis that the small bowel may serve as a viral entry site or as a potentiating organ of COVID-19, including magnification of the systemic inflammatory response, since the small bowel is the largest lymphoid organ of the body.


  • “…Furthermore, patients with underlying malnourishment or a vitamin deficiency such as the elderly may be more susceptible to the detrimental ACE2 blockage effects of SARS-CoV-2.” (emphasis added)
  • “…it would be important to evaluate whether there is a tryptophan or B3 deficiency in Covid-19 patients. If so, rapid substitution of tryptophan or niacinamide could help to prevent or ameliorate the vicious circle of the malnutrition-inflammation-immunodeficiency cascade.” (emphasis added)
  • “More importantly, their studies showed that these abnormalities and the colitis were rapidly restored by the administration of tryptophan or nicotinamide (vitamin B3), the latter is the standard therapy for pellagra…” (emphasis added)

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