COVID-19 and pneumatosis intestinalis: An early sign of intestinal ischemia

Hassan, Wesam; Ramadan, Haidi Karam‐Allah

doi:10.1016/j.dld.2020.10.036

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…Acomprehensive assessment, including clinical parameters and laboratorial (white blood count and C-reactive protein) and radiological data, should be made to evaluate the possible presence of a SARS-CoV-2 gastrointestinal infection and to monitor and evaluate the severity and prognosis of the disease [21,22]. Abdominal radiological findings are not specific and have a poor pathological correlation in the literature [23].…”

Section: Discussionmentioning

confidence: 99%

Intestinal Ischemia: Unusual but Fearsome Complication of COVID-19 Infection

et al. 2022

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The pathophysiology of gastrointestinal damage in coronavirus disease (COVID-19) is probably multifactorial. It is not clear whether the etiology of intestinal ischemia may be directly related to viral replication or may result from hyper-coagulability following SARS-CoV-2 infection.To confirm a pathogenic role of COVID-19, we retrospectively investigated the presence of SARS-CoV-2 virus in the ischemic bowel of five COVID-19 patients undergoing emergency surgery for intestinal ischemia in the period of March 2020–May 2021. Immunohistochemical positivity with weak intensity was observed in four out of five cases, but only one case was strongly positive both at immunohistochemistry and at molecular analysis. The histological alterations in the intestinal tissue samples showed similarity with the well-known alterations described in typical targetorgans of the virus (e.g., the lung). This observation suggests a similar mechanism of action of the virus. Further larger studies are, thus, required to confirm this preliminary finding. Clinicians should carefully monitor all COVID-19 patients for the possible presence of a SARS-CoV-2 intestinal infection, a potential cause of ischemia and bowel perforation.

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Section: Discussionmentioning

confidence: 99%

Intestinal Ischemia: Unusual but Fearsome Complication of COVID-19 Infection

et al. 2022

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Pneumatosis Intestinalis Due to COVID-19 Infection in Kidney Transplant Recipient: A Case Report

Łaski

Biernat

Kaska

2021

Transplantation Proceedings

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Background Pneumatosis intestinalis (PI) is a rare condition usually occurring among adults who have undergone solid organ transplant and are taking steroid therapy. The coronavirus disease 2019 (COVID-19) virus uses angiotensin-converting enzyme 2 in gastrointestinal epithelium as a receptor for entry process. Due to the steroid intake, the COVID-19 virus is present in the patient's gastrointestinal tract for extended period of time. It may therefore increase the possibility of PI in such patients. It is usually asymptomatic, with a clinical spectrum ranging from indolent to life-threatening. Unfortunately, there are no algorithms concerning diagnosis and treatment of PI. Aim of study The aim of this study is to highlight the problem of PI induced by COVID-19, especially in high-risk groups such as solid organs recipients. Conclusion On the basis of the presented case of a severe course of COVID-19–induced PI, we conclude that laparotomy with bowel resection can be a feasible and a safe option for treatment.

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Intestinal ischemic manifestations of SARS-CoV-2: Results from the ABDOCOVID multicentre study

Norsa

Bonaffini

Caldato

et al. 2021

WJG

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BACKGROUND Intestinal ischemia has been described in case reports of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (coronavirus disease 19, COVID-19). AIM To define the clinical and histological, characteristics, as well as the outcome of ischemic gastrointestinal manifestations of SARS-CoV-2 infection. METHODS A structured retrospective collection was promoted among three tertiary referral centres during the first wave of the pandemic in northern Italy. Clinical, radiological, endoscopic and histological data of patients hospitalized for COVID-19 between March 1 st and May 30 th were reviewed. The diagnosis was established by consecutive analysis of all abdominal computed tomography (CT) scans performed. RESULTS Among 2929 patients, 21 (0.7%) showed gastrointestinal ischemic manifestations either as presenting symptom or during hospitalization. Abdominal CT showed bowel distention in 6 patients while signs of colitis/enteritis in 12. Three patients presented thrombosis of main abdominal veins. Endoscopy, when feasible, confirmed the diagnosis (6 patients). Surgical resection was necessary in 4/21 patients. Histological tissue examination showed distinctive features of endothelial inflammation in the small bowel and colon. Median hospital stay was 9 d with a mortality rate of 39%. CONCLUSION Gastrointestinal ischemia represents a rare manifestation of COVID-19. A high index of suspicion should lead to investigate this complication by CT scan, in the attempt to reduce its high mortality rate. Histology shows atypical feature of ischemia with important endotheliitis, probably linked to thrombotic microangiopathies.

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COVID-19 and pneumatosis intestinalis: An early sign of intestinal ischemia

Cited by 4 publications

References 10 publications

Intestinal Ischemia: Unusual but Fearsome Complication of COVID-19 Infection

Intestinal Ischemia: Unusual but Fearsome Complication of COVID-19 Infection

Pneumatosis Intestinalis Due to COVID-19 Infection in Kidney Transplant Recipient: A Case Report

Intestinal ischemic manifestations of SARS-CoV-2: Results from the ABDOCOVID multicentre study

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