Abstract
Novel coronavirus disease 2019 (COVID-19) as a potential health risk factor continues to spread worldwide. Although common symptoms include headache and respiratory symptoms, some studies have suggested that COVID-19 may cause coagulation disorders and thrombolytic events, disrupt blood flow to the visceral organs, and cause some complications such as mesenteric ischemia. The authors reported four cases of acute mesenteric ischemia associated with COVID-19 confirmed in patients hospitalized in Imam Reza Hospital (a COVID-19 referral center in Mashhad University of Medical Sciences, Mashhad, Iran). The authors described the pathological findings that may be associated with this infection. The authors collected clinical data, imaging, microscopic, and operative findings of four patients with severe COVID-19 infection and evidence of intestinal necrosis. These four cases of severe COVID-19 pneumonia simultaneously showed intestinal necrosis during the infection process, indicating a relationship between coronavirus and mesenteric vascular events. Physicians should be aware of thrombosis symptoms in the digestive system in patients with severe COVID-19.
Highlights
Novel coronavirus disease 2019 (COVID-19) as a potential health risk factor continues to spread worldwide
Numerous studies have suggested that there is a link between gastrointestinal symptoms that are seen in patients with COVID-19 and coagulation disorders such as excessive coagulation and intestinal necrosis [4]
We presented four cases infected with COVID-19 confirmed by reverse transcriptasepolymerase chain reaction (RT-PCR); they were referred to Imam Reza Hospital Complex, Mashhad, Iran, with abdominal discomforts; the laboratory tests, imaging, pathology, and operating findings suggested intestinal necrosis
Summary
Novel coronavirus disease 2019 (COVID-19) as a potential health risk factor continues to spread worldwide. The authors collected clinical data, imaging, microscopic, and operative findings of four patients with severe COVID-19 infection and evidence of intestinal necrosis. Intestinal necrosis is a late symptom of various disease processes, which eventually causes cell death as a result of reduced blood flow to the bowel These severe and deadly conditions are often caused by acute vascular occlusion and, less commonly, bowel obstruction infection or inflammation [5]. As a result, based on the findings, hypercoagulable state, blood stasis, and endothelial injury increase the risk of thrombosis in patients with COVID-19 [6] In this case series, we presented four cases infected with COVID-19 confirmed by reverse transcriptasepolymerase chain reaction (RT-PCR); they were referred to Imam Reza Hospital Complex, Mashhad, Iran, with abdominal discomforts; the laboratory tests, imaging, pathology, and operating findings suggested intestinal necrosis. The patient underwent an emergency laparotomy; during the operation, necrosis and perforation in three parts of the ileum with a length of 40 cm at a distance of 70 cm from the ileocecal valve were seen; after the operation, the patient’s condition became unstable that led to his death
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