1921
Volume 104, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Clinical manifestations and complications of SARS-CoV-2 are still emerging and variant. Gastrointestinal (GI) manifestations and complications are hugely under-recognized. The presence of angiotensin converting enzyme-2 receptors in the intestinal enterocytes, the receptors primarily involved in the pathogenesis of COVID-19 pneumonia, maybe the key factor contributing to the pathogenesis of GI manifestations. Ischemic colitis, although the most common ischemic pathology of the GI tract, is relatively rare, occurring as a result of colonic hypoperfusion. The innumerable causes of colonic ischemia are categorized into occlusive and nonocclusive pathologies. Here, we have discussed a case of severe COVID-19 pneumonia, developing ischemic colitis, as a rare GI complication. The cause of ischemia in COVID-19 pneumonia is multifactorial, including hypercoagulable state, coagulopathy leading to thromboembolic complications, and use of vasopressors in severely ill patients with hemodynamic compromise.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.20-1262
2020-11-03
2021-01-15
Loading full text...

Full text loading...

/deliver/fulltext/14761645/104/1/tpmd201262.html?itemId=/content/journals/10.4269/ajtmh.20-1262&mimeType=html&fmt=ahah

References

  1. WHO, 2020. WHO Director-General’s Opening Remarks at the Media Briefing on COVID-19 - 11 March 2020. Geneva, Switzerland: World Health Organization. Available at: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020. Accessed August 14, 2020.
    [Google Scholar]
  2. Lu R et al., 2020. Genomic characterization and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 395: 565574.
    [Google Scholar]
  3. Pan L et al., 2020. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study. Am J Gastroenterol 115: 766773.
    [Google Scholar]
  4. Cha MH et al., 2020. GI manifestations of COVID-19. World J Gastroenterol 26: 23232332.
    [Google Scholar]
  5. Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H, 2020. Evidence for gastrointestinal infection of SARS-Cov-2. Gastroenterology 158: 18311833.e8.
    [Google Scholar]
  6. Scharff JR, Longo WE, Vartanian SM, Jacobs DL, Bahadursingh AN, Kaminski DL, 2003. Ischemic colitis: spectrum of disease and outcome. Surgery 134: 624629; discussion 629–630.
    [Google Scholar]
  7. Huguier M, Barrier A, Boelle PY, Houry S, Lacaine F, 2006. Ischemic colitis. Am J Surg 192: 679684.
    [Google Scholar]
  8. Brandt LJ, Feuerstadt P, Longstreth GF, Boley SJ, 2015. ACG clinical guideline: epidemiology, risk factors, patterns of presentation, diagnosis, and management of colon ischemia (CI). Am J Gastroenterol 110: 1844.
    [Google Scholar]
  9. Theodoropoulou A, 2008. Ischemic colitis: clinical practice in diagnosis and treatment. World J Gastroenterol 14: 7302.
    [Google Scholar]
  10. Washington C, Carmichael JC, 2012. Management of ischemic colitis. Clin Colon Rectal Surg 25: 228235.
    [Google Scholar]
  11. Moszkowicz D, Mariani A, Tresallet C, Menegaux F, 2013. Ischemic colitis: the ABCs of diagnosis and surgical management. J Visc Surg 150: 1928.
    [Google Scholar]
  12. Green BT, Tendler DA, 2005. Ischemic colitis: a clinical review. South Med J 98: 217222.
    [Google Scholar]
  13. Greenwald DA, Brandt LJ, 1998. Colonic ischemia. J Clin Gastroenterol 27: 122128.
    [Google Scholar]
  14. MacDonald PH, 2002. Ischaemic colitis. Best Pract Res Clin Gastroenterol 16: 5161.
    [Google Scholar]
  15. Stamatakos M, Douzinas E, Stefanaki C, Petropoulou C, Arampatzi H, Safioleas C, Giannopoulos G, Chatziconstantinou C, Xiromeritis C, Safioleas M, 2009. Ischemic colitis: surging waves of update. Tohoku J Exp Med 218: 8392.
    [Google Scholar]
  16. Doulberis M, Panagopoulos P, Scherz S, Dellaporta E, Kouklakis G, 2016. Update on ischemic colitis: from etiopathology to treatment including patients of intensive care unit. Scand J Gastroenterol 51: 893902.
    [Google Scholar]
  17. Rezende-Neto JB, Rotstein OD, 2013. Abdominal catastrophes in the intensive care unit setting. Crit Care Clin 29: 10171044.
    [Google Scholar]
  18. Lodigiani C et al., 2020. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res 191: 914.
    [Google Scholar]
  19. Bhayana R et al., 2020. Abdominal imaging findings in COVID-19: preliminary observations. Radiology 297: E207E215.
    [Google Scholar]
  20. Escher R, Breakey N, Lammle B, 2020. Severe COVID-19 infection associated with endothelial activation. Thromb Res 190: 62.
    [Google Scholar]
  21. Oldenburg WA, Lau LL, Rodenberg TJ, Edmonds HJ, Burger CD, 2004. Acute mesenteric ischemia: a clinical review. Arch Intern Med 164: 10541062.
    [Google Scholar]
  22. Mikkelsen E, Andersson KE, Pedersen OL, 1979. Effects of digoxin on isolated human mesenteric vessels. Acta Pharmacol Toxicol (Copenh) 45: 2531.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.20-1262
Loading
  • Received : 26 Sep 2020
  • Accepted : 26 Oct 2020
  • Published online : 03 Nov 2020
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error