Colonic and Rectum Infarction in the Covid19 Pandemic: A Case Series from an Uncommon Event
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Keywords

Colon and Rectum
Infarction
Covid19

Categories

How to Cite

Sarkardeh, M. ., Dalili , A. ., Etesamyzade, P. ., Shamshirian, A. ., Sadrzadeh, Z. ., Kooshki, J. ., Khoshdast, M. ., & Rezapanah, A. . (2022). Colonic and Rectum Infarction in the Covid19 Pandemic: A Case Series from an Uncommon Event. Iranian Red Crescent Medical Journal, 24(6). Retrieved from https://www.ircmj.org/index.php/IRCMJ/article/view/1945

Abstract

Background: By the end of May 2021, 170 million cases and 3.54 million death from Covid-19 infection have been reported. The high affinity of virus particles to ACE-2 receptors in different body organs can cause varied clinical manifestations and complications. Ischemic colitis and necrosis are some rare complications of Covid-19 infection with high morbidity and mortality resulting from colonic hypoperfusion. Different underlying mechanisms for ischemic colitis in Covid-19 patients have been described, including hypercoagulable state, inflammatory responses, microthrombosis, and non-occlusive intestinal ischemia due to shock, hypoxemia, and low cardiac output.

Case Presentation: here, we presented three patients with ischemic colitis and one rectal necrosis as a rare presentation of gastrointestinal complication of SARS-CoV-2 infection. All of our patients presented with abdominal pain and tenderness and received a standard regimen of antibiotics, anticoagulation, and ventilation support.

Conclusion: Ischemic colitis is one of these rare but with high mortality manifestations, which presents with non-specific signs and symptoms. Hence, ischemic colitis should be kept in mind in patients with Covid-19 infection and abdominal pain, which necessitates further evaluations.

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References

Sehhat S, Talebzadeh H, Hakamifard A, Melali H, Shabib S, Rahmati A, et al. Acute mesenteric ischemia in a patient with COVID-19: a case report. Arch Iran Med. 2020;23(9):639-43. doi: 10.34172/aim.2020.77. [PubMed: 32979913].

Almeida Vargas A, Valentí V, Sánchez Justicia C, Martínez Regueira F, Marti-Cruchaga P, Lujan J, et al. Severe colon ischemia in patients with severe coronavirus-19

(COVID-19). Rev Esp Enferm Dig. 2020;112(10):784-7. doi: 10.17235/reed.2020.7329/2020. [PubMed: 32954769].

Chan KH, Lim SL, Damati A, Maruboyina SP, Bondili L, Hanoud AA, et al. Coronavirus disease 2019 (COVID-19) and ischemic colitis: an under-recognized complication. Am J Emerg Med. 2020;38(12):1-5. doi: 10.1016/j.ajem.2020.05.072. [PubMed: 32499176].

Singhania N, Bansal S, Nimmatoori DP, Ejaz AA, McCullough PA, Singhania G. Current overview on hypercoagulability in COVID-19. Am J Cardiovasc Drugs. 2020;20(5):393-403. doi: 10.1007/s40256-020-00431-z. [PubMed: 32748336].

Fan BE. COVID-19-associated thromboembolic events causing acute mesenteric ischemia. Acad Radiol. 2020;27(12):1788-9. doi: 10.1016/j.acra.2020.09.005. [PubMed: 33011045].

McGonagle D, Bridgewood C, Ramanan AV, Meaney JF, Watad A. COVID-19 vasculitis, and novel vasculitis mimics. Lancet Rheumatol. 2021;3(3):224-33. doi: 10.1016/S2665-9913(20)30420-3. [PubMed: 33521655].

Feuerstadt P, Brandt LJ. Update on colon ischemia: recent insights and advances. Curr Gastroenterol Rep. 2015;17(12):1-9. doi: 10.1007/s11894-015-0469-6. [PubMed: 26446556].

Paul T, Joy AR, Alsoub HARS, Parambil JV. Case report: ischemic colitis in severe COVID-19 pneumonia: an unforeseen gastrointestinal complication. Am J Trop Med Hyg. 2021;104(1):63-5. doi: 10.4269/ajtmh.20-1262. [PubMed: 33146121].

Brandt LJ, Feuerstadt P, Longstreth GF, Boley SJ. ACG clinical guideline: epidemiology, risk factors, patterns of presentation, diagnosis, and management of colon ischemia (CI). Am J Gastroenterol. 2015;110(1):18-44. doi: 10.1038/ajg.2014.395. [PubMed: 25559486].

Patel S, Parikh C, Verma D, Sundararajan R, Agrawal U, Bheemisetty N, et al. Bowel ischemia in COVID‐19: A systematic review. Int J Clin Pract. 2021;75(12):1-11. doi: 10.1111/ijcp.14930. [PubMed: 34605117].

Sarkardeh M, Dalili A, Tayyebi Meibodi N, Izanlu M, Davari-Sani SJ, Moghaddamzade S, et al. Intestinal Infarction in COVID-19 Pandemic: A Case Series. Iran J Pathol. 2022;17(1):85-90. doi: 10.30699/IJP.2021.525280.2600. [PubMed: 35096093].

Bhayana R, Som A, Li MD, Carey DE, Anderson MA, Blake MA, et al. Abdominal imaging findings in COVID-19: preliminary observations. Radiology. 2020;297(1):207-15. doi: 10.1148/radiol.2020201908. [PubMed: 32391742].

Escher R, Breakey N, Lämmle B. Severe COVID-19 infection associated with endothelial activation. Thromb Res. 2020;190:1-2. doi: 10.1016/j.thromres.2020.04.014. [PubMed: 32305740].

Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology. 2020;158(6):1831-3. doi: 10.1053/j.gastro.2020.02.055. [PubMed: 32142773].

Oldenburg WA, Lau LL, Rodenberg TJ, Edmonds HJ, Burger CD. Acute mesenteric ischemia: a clinical review. Arch Intern Med. 2004;164(10):1054-62. doi: 10.1001/archinte.164.10.1054. [PubMed: 15159262].