Abstract
The clinical features of corona virus disease 2019 (COVID-19) are variable, but the majority of patients experience mild flu-like symptoms. The cases of severe disease include complications such as progressive pneumonia, acute kidney injury, multi-organ failure, and even death. This paper explores the association between COVID-19 and its effect on multiple organ systems and how the subsequent treatment of this disease can itself lead to morbidity and mortality. We present a case which emphasizes the life threatening gastrointestinal complications associated with treatment of acute kidney injury (AKI) in a patient with COVID-19. We conclude that the patients whose treatment regimens utilize medical resins should be closely monitored for gastrointestinal complications so as to mitigate the known adverse effects associated with these drugs, such as colonic mucosal ulceration, perforation, or even death.
Highlights
Corona virus disease 2019 (COVID-19) associated with the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) virus was first described in late 2019 but has since disseminated across the globe leading to a worldwide pandemic
This paper explores the association between COVID-19 and its effect on multiple organ systems and how the subsequent treatment of this disease can lead to morbidity and mortality
We present a case that emphasizes the life-threatening gastrointestinal complications associated with the treatment of acute kidney injury (AKI) in a patient with COVID-19
Summary
Corona virus disease 2019 (COVID-19) associated with the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) virus was first described in late 2019 but has since disseminated across the globe leading to a worldwide pandemic. The patient’s white blood cell count was elevated, and he was placed on broad spectrum antibiotics His outside hospital course was complicated by AKI with increased creatinine and hyperkalemia for which he was given Kayexalate (sodium polystyrene sulfonate [SPS]). After nearly 2 weeks of hospitalization at the UMMC, the patient’s hemoglobin began to drop and there was clinical concern for a gastrointestinal bleed At this time, the patient did not have any abdominal pain but experienced one episode of non - bloody emesis for which a nasogastric tube was placed. The patient did not have any abdominal pain but experienced one episode of non - bloody emesis for which a nasogastric tube was placed He developed a distended abdomen and reported an episode of hematochezia, which prompted an abdominal X-ray that showed multiple dilated loops of small bowel with concern for pneumoperitoneum. Crystals with morphologic and tinctorial qualities consistent with Kayexalate and sevelamer were embedded within the fibrinopurulent exudate
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