Trop Med Infect Dis . COVID-19-Induced Thrombosis in Patients without Gastrointestinal Symptoms and Elevated Fecal Calprotectin: Hypothesis Regarding Mechanism of Intestinal Damage Associated with COVID-19

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Trop Med Infect Dis


. 2020 Sep 16;5(3):E147.
doi: 10.3390/tropicalmed5030147.
COVID-19-Induced Thrombosis in Patients without Gastrointestinal Symptoms and Elevated Fecal Calprotectin: Hypothesis Regarding Mechanism of Intestinal Damage Associated with COVID-19


Mauro Giuffr? ^{1 2} , Stefano Di Bella ¹ , Gianluca Sambataro ³ , Verena Zerbato ⁴ , Marco Cavallaro ⁵ , Alessandro Agostino Occhipinti ⁶ , Andrea Palermo ⁷ , Anna Crescenti ⁸ , Fabio Monica ⁹ , Roberto Luzzati ¹ , Lory Saveria Croc? ^{1 2}



Affiliations

• PMID: 32947803
• DOI: 10.3390/tropicalmed5030147

Abstract

Background: Patients with coronavirus infectious disease 2019 (COVID-19) and gastrointestinal symptoms showed increased values of fecal calprotectin (FC). Additionally, bowel abnormalities were a common finding during abdominal imaging of individuals with COVID-19 despite being asymptomatic. The current pilot study aims at evaluating FC concentrations in patients without gastrointestinal symptoms.
Methods: we enrolled 25 consecutive inpatients with COVID-19 pneumonia, who were admitted without gastrointestinal symptoms and a previous history of inflammatory bowel disease.
Results: At admission, 21 patients showed increased FC with median values of 116 (87.5; 243.5) mg/kg despite absent gastrointestinal symptoms. We found a strong positive correlation between FC and D-Dimer (r = 0.745, p < 0.0001). Two patients developed bowel perforation.
Conclusion: our findings may change the current understanding of COVID-19 intestinal-related disease pathogenesis, shedding new light on the potential role of thrombosis and the consequent hypoxic intestinal damage.

Keywords: COVID-19; D-Dimer; SARS-CoV-2; bowel perforation; fecal calprotectin; ischemia; thrombosis.