Severe Ulcerative Colitis as a Complication of Mild COVID-19 Infection in a Vaccinated Patient

Mora, Maria Camila Fonseca; Abushahin, Ashraf; Gupta, Rohit; Winters, Harry; Khan, Gulam Muhammad

doi:10.7759/cureus.25783

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…Furthermore, gastrointestinal involvement is associated with a worse intrahospital prognosis and requires intensive care[ 32 ]. Nevertheless, severe gastrointestinal disorders related to COVID-19 have been reported[ 33 - 35 ]. Additionally, suspicions have been raised regarding the possible role of SARS-CoV-2 in triggering the onset of de novo IBD[ 36 ].…”

Section: Telemedicine: General Considerationsmentioning

confidence: 99%

Telemedicine in inflammatory bowel diseases: A new brick in the medicine of the future?

Gravina,

Pellegrino,

Durante

et al. 2023

World J Methodol

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The documentation of psychological trauma is obviously a challenge to clinicians while they are diving deep into remote events related to their clients or patients. The potential role of psychological trauma in the early developmental stages, and even the existence of adverse childhood experiences, is important to prove, yet it is difficult to do so. A diverse range of methods have been applied, all of which presumably benchmark a big therapeutic step; however, these enthusiastic methods frequently do not last for long. While hypnosis supporters, Freudian and Neo-Freudian disciples can be acute enough to enhance and uncover suppressed memories, modern psychiatry relies mostly on diversely structured interviews. Functional magnetic resonance and its related subtleties might help, but the questions that remain unanswered are numerous and confusing. Connecting early experiences with long-term memory while identifying psychological trauma its importance for the individual’s growth trajectory; thus, it remains an intriguing issue.

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Section: Telemedicine: General Considerationsmentioning

confidence: 99%

Telemedicine in inflammatory bowel diseases: A new brick in the medicine of the future?

Gravina,

Pellegrino,

Durante

et al. 2023

World J Methodol

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Post-COVID-19 polyautoimmunity – Fact or coincidence: A case report

2023

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COVID-19 exhibits diverse and systemic clinical symptoms, much like systemic autoimmune diseases, and there are notable similarities in the immune responses seen in both conditions. There are rare reports of ulcerative colitis and autoimmune hepatitis triggered by COVID-19 infection. Reported herein is a case of a previously healthy patient who was diagnosed with chronic colitis resembling ulcerative colitis, autoimmune pancreatitis, and suspected immune-mediated hepatitis (AIH-like hepatitis) 2 months after a COVID-19 infection. A 33-year-old COVID-19-vaccinated male, presented with abdominal pain, nausea, and vomiting for 2 days. He also had bloody diarrhea that persisted for 2 months after recovering from a COVID-19 infection. A diagnosis of acute pancreatitis was confirmed by markedly elevated serum amylase and lipase and a CT scan of the abdomen. Colonoscopy and histopathology findings also confirmed a diagnosis of chronic colitis resembling ulcerative colitis (Mayo Endoscopy Subscore 3). Marked improvement in bloody diarrhea was observed within 72 h of treatment with IV prednisolone. MRI of the abdomen performed due to an unresolved clinical picture of pancreatitis revealed a bulky pancreas showing delayed diffuse homogenous enhancement, findings possibly consistent with autoimmune pancreatitis. Investigation for elevated liver transaminases showed high titers of antinuclear antibodies and anti-smooth muscle (anti-actin) antibodies while viral hepatitis markers were negative. The patient had already been started on steroid therapy before the lab results were available, with rapid normalization of liver enzymes following treatment. A liver biopsy was not performed. The patient is currently on mesalazine 4 gr/day, and azathioprine 100 mg/day – oral steroids had been tapered and discontinued. Seven months after the initial diagnosis, the patient remains symptom-free. A high level of suspicion for autoimmune disorders is required when assessing patients with a history of COVID-19 infection, although diagnostic pathways remain the same, with generally good response and remission rates to conventional treatment.

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A New Onset of Ulcerative Colitis Post-COVID-19: A Case Report

Xia¹,

Dissanayake²,

Badov³

2023

Cureus

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Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can cause not only respiratory symptoms but also gastrointestinal symptoms. In addition, there is increased concern about the autoimmune complications of coronavirus disease 2019 . This report describes a 21-year-old non-smoking Caucasian male with a history of acute pancreatitis but no other medical issues or family history who developed a new onset of ulcerative colitis after the second episode of COVID-19. He had three doses of the BNT162b2 mRNA COVID-19 vaccine. Two months after the first episode of COVID-19, he had the third dose of the vaccine. Nine months after the third dose, he had the second episode of COVID-19, during which he was mildly unwell for three days, recovered, and did not require any anti-viral medication or antibiotics. One week post the second episode of COVID-19, he developed diarrhoea and abdominal pain. It then progressed to bloody diarrhea. We diagnosed ulcerative colitis based on his clinical symptoms, biopsy changes, and the exclusion of other causes. This case raises awareness of developing ulcerative colitis concurrently with or following COVID-19. It is essential to thoroughly investigate COVID-19 patients who have diarrhea or bloody diarrhea and not consider it a common gastroenteritis or a simple gastrointestinal manifestation of COVID-19. Although we cannot confirm the association with a case study, further research is needed to confirm the causal or incidental relationship and observe any increased incidence of ulcerative colitis in the future as secondary to COVID-19.

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Severe Ulcerative Colitis as a Complication of Mild COVID-19 Infection in a Vaccinated Patient

Cited by 3 publications

References 7 publications

Telemedicine in inflammatory bowel diseases: A new brick in the medicine of the future?

Telemedicine in inflammatory bowel diseases: A new brick in the medicine of the future?

Post-COVID-19 polyautoimmunity – Fact or coincidence: A case report

A New Onset of Ulcerative Colitis Post-COVID-19: A Case Report

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