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Severe colon ischemia in patients with severe coronavirus-19 (COVID-19)

Ana Almeida Vargas1, Víctor Valentí2, Carlos Sánchez Justicia2

  • 1Cirugía General, Clínica Universidad de Navarra.

Revista Espanola De Enfermedades Digestivas
|September 21, 2020
PubMed

Insights

COVID-19 can cause severe coagulopathy, leading to colonic ischemia. This study highlights three fatal cases in elderly males linked to SARS-CoV-2 and disseminated intravascular coagulation.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Hematology

Background:

  • COVID-19 is recognized for its association with hypercoagulable states.
  • Disseminated intravascular coagulation (DIC) is a serious complication that can arise from severe infections like SARS-CoV-2.

Observation:

  • Three male patients (76, 68, and 56 years old) with COVID-19 presented with respiratory distress.
  • Clinical symptoms included rectal bleeding, abdominal distension, and signs of peritoneal irritation.

Findings:

  • Colonic ischemia was diagnosed via endoscopy and computed tomography angiography.
  • Markedly elevated D-dimer levels (2,170–7,360 ng/ml) were observed in all patients.
  • One patient with cecal perforation underwent surgery.

Implications:

  • These cases underscore the severe gastrointestinal complications, specifically colonic ischemia, that can occur in COVID-19 patients due to hypercoagulability and DIC.
  • The high mortality rate in these cases emphasizes the critical need for early recognition and management of coagulopathy in SARS-CoV-2 infection.
  • Further research is warranted to explore preventative and therapeutic strategies for COVID-19-associated coagulopathy and its visceral manifestations.

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