Figure 6. Severe GI disease in COVID-19 (A. Dysregulated mucosal immune mechanisms are seen in severe COVID-19 with cytokine storm due to increased levels of IL-1beta, IL-6, IL-7, IL-8, IL-9, IL-10, MCP-1, TNF-alpha, IFN-gamma causing mucosal injury. B. Pyroptosis- Pro-inflammatory form of cell death mediated through caspases and it causes further release of cytokines. C. Hemophagocytic lymphohistiocytosis- Cytokines like IL-1 beta by tissue macrophages cause overactivation of histiocytes and lymphocytes leading to hypercytokinaemia and multiorgan failure. D. Endothelitis and thrombosis- Endothelial inflammation induced either by direct viral infection of the endothelium or immune-mediated, can result in widespread endothelial dysfunction associated with apoptosis and microcirculatory dysfunction with thrombosis.) : Gastrointestinal Symptoms and Immune Response in COVID 19 - Review of a Cat and Mouse Game Theory : Science and Education Publishing

Figure 6. Severe GI disease in COVID-19 (A. Dysregulated mucosal immune mechanisms are seen in severe COVID-19 with cytokine storm due to increased levels of IL-1beta, IL-6, IL-7, IL-8, IL-9, IL-10, MCP-1, TNF-alpha, IFN-gamma causing mucosal injury. B. Pyroptosis- Pro-inflammatory form of cell death mediated through caspases and it causes further release of cytokines. C. Hemophagocytic lymphohistiocytosis- Cytokines like IL-1 beta by tissue macrophages cause overactivation of histiocytes and lymphocytes leading to hypercytokinaemia and multiorgan failure. D. Endothelitis and thrombosis- Endothelial inflammation induced either by direct viral infection of the endothelium or immune-mediated, can result in widespread endothelial dysfunction associated with apoptosis and microcirculatory dysfunction with thrombosis.)

American Journal of Medical Case Reports. 2021, 9(1), 24-31 doi:10.12691/ajmcr-9-1-8