Peculiar Histopathological Alterations of Enterocytes in a Patient Co-infected with Severe Acute Respiratory Syndrome Coronavirus 2 and Mycobacterium Tuberculosis: A Case Study

Abstract

The ongoing novel coronavirus disease 2019 (COVID-19) is principally defined by its respiratory symptoms. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can affect the gastrointestinal tract (GIT) and although the pathogenesis of COVID-19 is understood, the exact pathological alterations following infection require further investigation. Here, we report our histopathological findings from a right hemicolectomy specimen from a patient coinfected with COVID-19 and Mycobacterium tuberculosis. Our observations showed that the novel SARS-CoV-2 can affect the GIT, causing epithelial injury and pathological alterations attributed to its ability to infect absorptive enterocytes by interacting with the angiotensin converting enzyme-2 (ACE2) receptor. These pathological findings are regarded as viral cytopathic changes and should be considered when evaluating gastrointestinal specimens from COVID-19-infected patients.

The Spectrum of Digestive Tract Histopathologic Findings in the Setting of Severe Acute Respiratory Syndrome Coronavirus-2 Infection: What Pathologists Need to Know

“…2D). 42 It is worth mentioning that in rare instances, COVID-19 might induce acute graft-versus-host disease-like changes in the intestine, characterized by prominent villous atrophy, mucosal sloughing, extensive crypt loss, increased crypts cell apoptosis, and crypt abscesses with lymphoplasmacytic infiltration in the LP. 43 Moreover, COVID-19 might induce a pauci-inflammatory thrombogenic vasculopathy mimicking lupus enteritis.…”