Abstract
Objectiveswe describe Coronavirus Disease (COVID-19) patients also manifesting gastro-intestinal symptoms. Methodsfive women, between the ages of 32 and 82 years old, were admitted for acute abdomen, and received a nasopharyngeal swab for COVID-19 screening, lab test analysis, and contrast thoraco-abdominal CT-scan. All presented leukocytosis, different localizations of visceral vessels thrombosis and ischemia, and COVID-19. Resultsemergency laparotomy was accepted by all but 1, who died after 5 days. Postoperatively, 1 died of multi-organ failure, 3 were discharged home after 14, 8 and 10 days respectively, under anti-platelet and anticoagulation treatment. Conclusionsin COVID-19 patients with acute abdomen, abdominal contrast CT-scans should be systematically extended to the thorax to detect visceral COVID-19 initial pulmonary signs. Emergency laparotomy and visceral arteries thrombectomy could be necessary.
Highlights
IntroductionGastrointestinal involvement in COVID-19 occurs in up to 39% of patients
Gastrointestinal involvement in COVID-19 occurs in up to 39% of patients. 1The positive staining of angiotensin I converting enzyme 2 (ACE2, the viral host receptor) is expressed in gastrointestinal epithelial cells present in the stool of patients tested positive for the RNA of SARS-COV-2 (Severe Acute Respiratory Syndrome-Coronavirus-2, the virus responsible for COVID-19)
We describe our experience with patients manifesting bowel ischemia, and found affected by COVID-19: being positive for the reverse transcription polymerase chain reaction from nasopharyngeal swab
Summary
Gastrointestinal involvement in COVID-19 occurs in up to 39% of patients. 1. The positive staining of angiotensin I converting enzyme 2 (ACE2, the viral host receptor) is expressed in gastrointestinal epithelial cells present in the stool of patients tested positive for the RNA of SARS-COV-2 (Severe Acute Respiratory Syndrome-Coronavirus-2, the virus responsible for COVID-19). In patients with pulmonary symptoms, the beta-coronavirus responsible for COVID-19 disease can cause gastrointestinal infection possibly evolving in hemorrhagic colitis or bowel ischemia.[2,3] four recent studies have highlighted a coexisting hypercoagulable state that can lead to mesenteric arterial thromboses. In patients with pulmonary symptoms, the beta-coronavirus responsible for COVID-19 disease can cause gastrointestinal infection possibly evolving in hemorrhagic colitis or bowel ischemia.[2,3] four recent studies have highlighted a coexisting hypercoagulable state that can lead to mesenteric arterial thromboses. 4–7
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