Maryam Sarkardeh; Alireza Rezapanah; Aida Ayati Afin; Ali Shamshirian; Zahra Sadrzadeh; Javad Koushki; Amin Dalili
Volume 24, Issue 12 , 2022
Abstract
Background: Coronavirus disease 2019 (COVID-19) involves multiple organs, including the gastrointestinal tract. It also causes frequent thromboembolic events because of its thrombogenicity. This study reports a COVID-19 case of extensive bowel necrosis despite using warfarin.
Case Presentation: A 52-year-old ...
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Background: Coronavirus disease 2019 (COVID-19) involves multiple organs, including the gastrointestinal tract. It also causes frequent thromboembolic events because of its thrombogenicity. This study reports a COVID-19 case of extensive bowel necrosis despite using warfarin.
Case Presentation: A 52-year-old homeless addict male was brought via Emergency Medical Services with a chief complaint of abdominal pain for two days and loss of consciousness since the day before. He had a history of cough and dyspnea for seven days and had been using warfarin after mitral valve replacement three years earlier. On admission, he had low oxygen saturation, tachycardia, and fever. Because of his respiratory signs and symptoms, a chest CT scan was performed, and evidence of COVID-19 infection was detected. He had nausea, and on abdominal examination, there was generalized tenderness, rebound tenderness, and guarding. Following physical examination and abnormal laboratory test results, he underwent an emergent laparotomy. Extensive necrosis made surgical intervention impossible, and he died shortly after the surgery.
Conclusion: COVID-19-associated coagulopathy raises many challenges nowadays, and according to the present case, even using anticoagulants may not prevent it.
Maryam Sarkardeh; Amin Dalili; Poorya Etesamyzade; Ali Shamshirian; Zahra Sadrzadeh; Javad Kooshki; Maryam Khoshdast; Alireza Rezapanah
Volume 24, Issue 6 , 2022
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 ...
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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.
