COVID-19 INFECTION AND PROTEIN MALABSORPTION: IS THIS ACQUIRED HARTNUP’S DISEASE?
Dr. Hemant J. Mehta1*, Dr. Jalil D. Parkar, Dr. Pralhad P. Prabhudesai, Dr. Pallavi S. Tanpure and Dr. Rishabh P. Khanna
ABSTRACT
Many severe Covid-19 patients develop gastrointestinal (GI) disturbances. Understanding the mechanism of GI disturbances is warranted for exploring better clinical care for Covid-19 patients. The Hartnup’s disease is a rare autosomal recessive inherited disease. Hartnup’s disease includes neurologic manifestations, or psychiatric symptoms, together with the GI disturbances which are described in severe Covid-19 cases. It is hypothesized that Covid-19 may share a pathophysiological mechanism with the Hartnup’s disease. It is hypothesized that SARS-CoV-2 spike protein, binding to intestinal angiotensin-converting enzyme 2 (ACE2), negatively regulates the absorption of neutral amino acids, and this could explain gastrointestinal (GI) and systemic disturbances in Covid-19. Amino acid supplements could be recommended. We are reporting 3 cases of post-acute Covid-19 syndrome (PASC) who were found to have low Serum Creatinine values, diarrhea, and neuropsychiatric symptoms, had protein malabsorption and responded to supplementations of amino acids, with tryptophan and niacin. Thus, we would like to go with the existing hypothesis that Covid-19 may share a pathophysiological mechanism with the Hartnup’s disease.
Keywords: Covid-19, diarrhea, malnutrition, low blood urea nitrogen and serum creatinine, acquired Hartnup’s disease, amino acid supplements.
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