COVID-19 can mimic acute cholecystitis and is associated with the presence of viral RNA in the gallbladder wall

Balaphas, Alexandre; Gkoufa, Kyriaki; Meyer, Jérémy; Peloso, Andréa; Bornand, Aurélie; McKee, Thomas; Toso, Christian; Popeskou, Sotirios Georgios

doi:10.1016/j.jhep.2020.08.020

Cited by 55 publications

(70 citation statements)

References 10 publications

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“…114 However, a case report on a resected gallbladder after cholecystitis highlighted the presence of SARS-CoV-2 within the tissue, thus confirming viral presence. 113 Pancreatic involvement, defined as an increase in serum amylase and/or lipase or overt acute pancreatitis, has also been described in few reports or case series. [115][116][117][118] In the largest retrospective case series, elevated serum lipase was found in 14/83 cases (16.8%), and this was correlated with higher rates of admission to the intensive care unit and need for intubation.…”

Section: Biliary and Pancreatic Manifestationsmentioning

confidence: 99%

Implications of SARS‐CoV‐2 infection for neurogastroenterology

Marasco

Lenti

Cremon

et al. 2021

Neurogastroenterology Motil

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Health Organization reported more than 32 million cases and 995 thousands deaths from 235 countries related to this pandemic. 2 The clinical course of SARS-CoV-2 infection can span a wide range from asymptomatic to a rapidly progressing and life-threatening disease, most commonly associated with a variety of symptoms, such as fever, cough, dyspnea, pneumonia, acute respiratory distress syndrome, systemic inflammatory response syndrome, and multiple

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Section: Biliary and Pancreatic Manifestationsmentioning

confidence: 99%

Implications of SARS‐CoV‐2 infection for neurogastroenterology

Marasco

Lenti

Cremon

et al. 2021

Neurogastroenterology Motil

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“…There is evidence of viral replication in gallbladder epithelial cells, which are very similar to bile duct cells and express ACE-2, being a permissive target of SARS-CoV-2 infection [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Long-Term SARS-CoV-2 Infection Associated with Viral Dissemination in Different Body Fluids Including Bile in Two Patients with Acute Cholecystitis

Scutari

Piermatteo

Manuelli

et al. 2020

Life

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Our study aimed to investigate the kinetics of SARS-CoV-2 RNA in bile and in different body fluids of two SARS-CoV-2 positive patients with acute cholecystitis by innovative droplet digital PCR (ddPCR) assays. For each patient, nasopharyngeal- and rectal swabs, bile, urine, and plasma samples were collected at different time points for SARS-CoV-2 RNA quantification by two ddPCR assays. For both patients, ddPCR revealed persistent and prolonged detection of viral RNA in the nasopharyngeal swab despite triple-negative or single-positive results by qRT-PCR. In Patient 1, SARS-CoV-2 RNA dropped more rapidly in bile and rectal-swab and declined slowly in nasopharyngeal swab and plasma, becoming undetectable in all compartments 97 days after symptoms started. Conversely, in patient 2, SARS-CoV-2 RNA was detected, even if at low copies, in all body samples (with the exception of urine) up to 75 days after the onset of symptoms. This study highlights that SARS-CoV-2 RNA can persist for a prolonged time in respiratory samples and in several biological samples despite negativity to qRT-PCR, supporting SARS-CoV-2’s ability to provoke persistent and disseminated infection and therefore to contribute to extra-pulmonary clinical manifestations.

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“…Thereare several reports of acute cholecystitis. One recent report provides well-documented presentations of two COVID-19 patients with acute acalculous cholecystitis, both presenting before the overt appearance of COVID-19 disease [ 84 ]. Radiological evidence supported by post-mortem evidence in one of the cases indicates the involvement of the gallbladder and biliary tract in the SARS-CoV-2 infection.…”

Section: Gi Emergencies In Covid-19 Patientsmentioning

confidence: 99%

COVID-19 and Gastrointestinal Disease: Implications for the Gastroenterologist

Hunt

East

Lanas

et al. 2020

Dig Dis

110

107

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COVID-19 was initially considered to be a respiratory disease but soon after the pandemic established it became clear that the SARS-CoV-2 virus which caused the disease could lead to serious systemic consequences affecting most of the major organs including the digestive tract, liver and pancreas. This review brings together the new information which is clinically relevant to the gastroenterologist including the origins of the disease, mechanisms of tissue damage and how this affects specific patient groups, including those with inflammatory bowel disease, comorbidities and the role of immunosuppression, chronic liver disease and the risk of decompensation for those with cirrhosis. The impact of COVID-19 for gastrointestinal emergencies is addressed together with the implications for the conduct of endoscopic and other interventional and diagnostic procedures. The importance of fully understanding the pharmacology and therapeutic implications of drugs commonly used by the gastroenterologist and their relationship with COVID-19 are also highlighted. The risk for drug-drug interactions is considerable in patients seriously ill with COVID-19 who are often requiring mechanical ventilation and life-support. Some re-purposed drugs used against SARS-CoV-2 can cause or aggravate some of the COVID-19 GI symptoms and also can induce iatrogenic liver injury. Ongoing clinical studies will hopefully identify effective drugs with a risk-benefit ratio which will be more favorable than many recently tried treatments.

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COVID-19 can mimic acute cholecystitis and is associated with the presence of viral RNA in the gallbladder wall

Cited by 55 publications

References 10 publications

Implications of SARS‐CoV‐2 infection for neurogastroenterology

Implications of SARS‐CoV‐2 infection for neurogastroenterology

Long-Term SARS-CoV-2 Infection Associated with Viral Dissemination in Different Body Fluids Including Bile in Two Patients with Acute Cholecystitis

COVID-19 and Gastrointestinal Disease: Implications for the Gastroenterologist

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