tetano
Editor, Senior Moderator
Int J Clin Exp Pathol
. 2021 Nov 15;14(11):1069-1079.
eCollection 2021.
Vascular thrombosis and vasculitis in the gastrointestinal tract are associated with poor prognosis in patients with COVID-19
Min Cui[SUP] 1 2 [/SUP], Qiang Wang[SUP] 3 [/SUP], Alison W Xin[SUP] 4 [/SUP], Danian Che[SUP] 2 [/SUP], Zhengbin Lu[SUP] 3 [/SUP], Lan Zhou[SUP] 1 2 [/SUP], Wei Xin[SUP] 1 2 [/SUP]
Affiliations
Abstract
Aim: To report pathologic findings in the gastrointestinal (GI) tract of coronavirus disease 2019 (COVID-19) patients.
Material and methods: we evaluated clinical and GI tract histologic findings in six COVID-19 patients that presented with GI symptoms like diarrhea, and abdominal pain. This study includes surgical resection specimens from five patients and two sets of biopsy specimens from one patient.
Results: Idiopathic inflammatory bowel disease was considered in three of six cases based on clinical, radiologic, and endoscopic presentation. Histologically, the enteric mucosa had a spectrum of histologic changes, including active enteritis, chronic active enteritis, and transmural necrosis. Extensive thrombi in vessels and/or vasculitis were identified in three out of the six cases. The presence of extensive vascular thrombi is associated with poor prognosis, and the three patients deceased in a short period of time (ranges from 7-67 days, median 14 days) after admission for GI symptoms. Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) RNA was detected in bowel tissue of one case. The other three patients recovered and were discharged and free of GI symptoms (follow-up period ranges from 235 days to 270 days, median 237 days).
Conclusion: COVID-19 associated enteritis may mimic Crohn's disease clinically, radiologically and endoscopically, and these two entities can be differentiated by pathologic findings. COVID-19 patients with GI symptoms may warrant a workup to evaluate for pathologic changes, as the presence of vasculitis and microthrombi may predict poor clinical outcome.
Keywords: COVID-19; Thrombosis; gastrointestinal tract; vasculitis.
. 2021 Nov 15;14(11):1069-1079.
eCollection 2021.
Vascular thrombosis and vasculitis in the gastrointestinal tract are associated with poor prognosis in patients with COVID-19
Min Cui[SUP] 1 2 [/SUP], Qiang Wang[SUP] 3 [/SUP], Alison W Xin[SUP] 4 [/SUP], Danian Che[SUP] 2 [/SUP], Zhengbin Lu[SUP] 3 [/SUP], Lan Zhou[SUP] 1 2 [/SUP], Wei Xin[SUP] 1 2 [/SUP]
Affiliations
- PMID: 34900075
- PMCID: PMC8661070
Abstract
Aim: To report pathologic findings in the gastrointestinal (GI) tract of coronavirus disease 2019 (COVID-19) patients.
Material and methods: we evaluated clinical and GI tract histologic findings in six COVID-19 patients that presented with GI symptoms like diarrhea, and abdominal pain. This study includes surgical resection specimens from five patients and two sets of biopsy specimens from one patient.
Results: Idiopathic inflammatory bowel disease was considered in three of six cases based on clinical, radiologic, and endoscopic presentation. Histologically, the enteric mucosa had a spectrum of histologic changes, including active enteritis, chronic active enteritis, and transmural necrosis. Extensive thrombi in vessels and/or vasculitis were identified in three out of the six cases. The presence of extensive vascular thrombi is associated with poor prognosis, and the three patients deceased in a short period of time (ranges from 7-67 days, median 14 days) after admission for GI symptoms. Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) RNA was detected in bowel tissue of one case. The other three patients recovered and were discharged and free of GI symptoms (follow-up period ranges from 235 days to 270 days, median 237 days).
Conclusion: COVID-19 associated enteritis may mimic Crohn's disease clinically, radiologically and endoscopically, and these two entities can be differentiated by pathologic findings. COVID-19 patients with GI symptoms may warrant a workup to evaluate for pathologic changes, as the presence of vasculitis and microthrombi may predict poor clinical outcome.
Keywords: COVID-19; Thrombosis; gastrointestinal tract; vasculitis.