COVID-19-Associated Ischemic Colitis: A Rare Manifestation of COVID-19 Infection—Case Report and Review

Ramachandran, Rajarajeshwari; Then, Eric O.; Parvataneni, Swetha; Grantham, Tyler; Gaduputi, Vinaya

doi:10.1177/23247096211065625

Cited by 9 publications

(5 citation statements)

References 37 publications

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“…Examination of the small bowel with mesenteric thrombosis revealed prominent endothelium, direct viral invasion of endothelial cells, and diffuse endothelial swelling with mononuclear cell infiltration [ 124 ]. Patients with severe COVID-19 infection and receiving inotropic agents can develop nonocclusive colonic ischemia due to severe vasoconstriction and reduced mesenteric blood flow [ 127 ].…”

Section: Reviewmentioning

confidence: 99%

From Emergence to Endemicity: A Comprehensive Review of COVID-19

Naik,

Avula,

Palleti

et al. 2023

Cureus

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Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), later renamed coronavirus disease 2019 (COVID-19), was first identified in Wuhan, China, in early December 2019. Initially, the China office of the World Health Organization was informed of numerous cases of pneumonia of unidentified etiology in Wuhan, Hubei Province at the end of 2019. This would subsequently result in a global pandemic with millions of confirmed cases of COVID-19 and millions of deaths reported to the WHO. We have analyzed most of the data published since the beginning of the pandemic to compile this comprehensive review of SARS-CoV-2. We looked at the core ideas, such as the etiology, epidemiology, pathogenesis, clinical symptoms, diagnostics, histopathologic findings, consequences, therapies, and vaccines. We have also included the long-term effects and myths associated with some therapeutics of COVID-19. This study presents a comprehensive assessment of the SARS-CoV-2 virology, vaccines, medicines, and significant variants identified during the course of the pandemic. Our review article is intended to provide medical practitioners with a better understanding of the fundamental sciences, clinical treatment, and prevention of COVID-19. As of May 2023, this paper contains the most recent data made accessible.

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Section: Reviewmentioning

confidence: 99%

From Emergence to Endemicity: A Comprehensive Review of COVID-19

Naik,

Avula,

Palleti

et al. 2023

Cureus

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“…It is now well known that SARS-CoV-2 infection can cause gastrointestinal symptoms in 12% up to more than 60% of patients [ 3 , 4 ], and, in some, they can even precede or be present without respiratory symptoms [ 5 ]. Most common gastrointestinal symptoms of COVID-19 are diarrhea, nausea, and vomiting [ 6 ], and symptoms of hemorrhagic colitis were reported only in several cases so far [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Colitis as the Main Presentation of COVID-19: A Case Report

Fric

Borzan

et al. 2023

Medicina

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The main symptoms of coronavirus disease (COVID-19) are fever, cough, tiredness, and loss of smell and taste. Gastrointestinal symptoms are less common. A 38-year-old female patient, previously healthy, presented with a history of hematochezia up to 8 times per day, followed by abdominal cramps, urgency, and chills for two days. She did not have any respiratory symptoms and was previously vaccinated for COVID-19. She was afebrile, with normal vital signs. Blood samples showed normal complete blood count and increased C-reactive protein (CRP), fibrinogen, and D-dimer levels (66 mg/L, 4.1 g/L, and 2302 μ/L FEU, respectively). Stool samples for stool culture, C. difficile, and viral examination came back negative. On day 3, she reported a mild cough, fever and loss of smell and taste. Nasopharyngeal swab for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) PCR test came back positive. On day 6, the patient still had hematochezia accompanied by abdominal cramps, but fever and respiratory symptoms withdrew. CRP, fibrinogen, and D-dimers were still elevated, as well as liver enzyme levels. Sigmoidoscopy was performed with biopsies taken from sigmoid and rectum for histology and PCR SARS-CoV-2 testing. CT angiography showed no signs of thrombosis in mesenteric veins or arteries. PCR test for SARS-CoV-2 virus from rectal biopsy sample was positive. Patient was treated with methylprednisolone iv for two days and peroral prednisone afterwards, with mesalamine, metronidazole and enoxaparin. Sigmoidoscopy was repeated after two weeks showing only mild hyperemia. At that time, the patient had normal stool, normal CRP, liver enzyme, fibrinogen, and D-dimer levels, and normocytic anemia (hemoglobin level of 103 g/L). We wanted to show that severe gastrointestinal symptoms, such as hemorrhagic colitis, can be the main presentation of COVID-19, even in young patients with no prior comorbidities. In such a case, PCR test in biopsy samples can be performed to prove SARS-CoV-2 infection of bowel mucosa.

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“…suggesting the important role of microvascular obstruction in these patie [147,149,157,160,165,166]. In the recent review of Oja et al [160], the thrombosis of SMA was found in 24.9% of cases.…”

Section: Small Bowel Ischemia and Ischemic Colitismentioning

confidence: 95%

“…Almost half of the patients with small bowel ischemia in this study died. However, in most of the published cases of small bowel and colic ischemia, no evidence of arterial or venous acute thrombosis was found, suggesting the important role of microvascular obstruction in these patients [ 147 , 149 , 157 , 160 , 165 , 166 ]. In the recent review of Oja et al [ 160 ], the thrombosis of the SMA was found in 24.9% of cases.…”

Section: Vascular Abdominal Extrapulmonary Complicationsmentioning

confidence: 99%

“…In the recent review of Oja et al [ 160 ], the thrombosis of the SMA was found in 24.9% of cases. Ischemic colitis in COVID-19 patients is relatively rare and occurs as a result of colonic hypoperfusion secondary to the hemodynamic compromise in severe cases of COVID-19 infection [ 165 , 166 , 167 ] ( Figure 24 ). The left colon is most commonly affected and includes the watershed areas from the splenic flexure to the sigmoid colon.…”

Section: Vascular Abdominal Extrapulmonary Complicationsmentioning

confidence: 99%

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A Pictorial Essay Describing the CT Imaging Features of COVID-19 Cases throughout the Pandemic with a Special Focus on Lung Manifestations and Extrapulmonary Vascular Abdominal Complications

Brogna

Bignardi

Megliola³

et al. 2023

Biomedicines

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With the Omicron wave, SARS-CoV-2 infections improved, with less lung involvement and few cases of severe manifestations. In this pictorial review, there is a summary of the pathogenesis with particular focus on the interaction of the immune system and gut and lung axis in both pulmonary and extrapulmonary manifestations of COVID-19 and the computed tomography (CT) imaging features of COVID-19 pneumonia from the beginning of the pandemic, describing the typical features of COVID-19 pneumonia following the Delta variant and the atypical features appearing during the Omicron wave. There is also an outline of the typical features of COVID-19 pneumonia in cases of breakthrough infection, including secondary lung complications such as acute respiratory distress disease (ARDS), pneumomediastinum, pneumothorax, and lung pulmonary thromboembolism, which were more frequent during the first waves of the pandemic. Finally, there is a description of vascular extrapulmonary complications, including both ischemic and hemorrhagic abdominal complications.

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COVID-19-Associated Ischemic Colitis: A Rare Manifestation of COVID-19 Infection—Case Report and Review

Cited by 9 publications

References 37 publications

From Emergence to Endemicity: A Comprehensive Review of COVID-19

From Emergence to Endemicity: A Comprehensive Review of COVID-19

Colitis as the Main Presentation of COVID-19: A Case Report

A Pictorial Essay Describing the CT Imaging Features of COVID-19 Cases throughout the Pandemic with a Special Focus on Lung Manifestations and Extrapulmonary Vascular Abdominal Complications

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