Association Between SARS-CoV-2 Infection and Acute Ischemic Colitis

Area of Science:

• Gastroenterology
• Infectious Diseases
• Pathology

Background:

• COVID-19 is a global pandemic with diverse clinical manifestations.
• Ischemic colitis is a rare but serious gastrointestinal complication.
• A subset of hospitalized COVID-19 patients exhibit endoscopic features suggestive of ischemic colitis.

Purpose of the Study:

• To investigate the clinical presentation, treatment, and outcomes of ischemic colitis in COVID-19 patients.
• To detail the colonoscopic and histological findings in these patients.
• To understand the temporal relationship between COVID-19 infection and gastrointestinal symptoms.

Main Methods:

• A prospective study involving 12 patients with suspected ischemic colitis associated with COVID-19 across four centers.
• Diagnosis confirmed via colonoscopy and biopsy.
• Electronic medical records were searched for relevant data.
• A 12-month follow-up was conducted via phone interviews.

Main Results:

• The study included 12 patients (3 males, 9 females; age 33-76).
• Abdominal pain and hematochezia occurred within 2 weeks (average 5.5 days) post-COVID-19.
• The descending colon was most affected (83.33%).
• Colonoscopy showed diffuse mucosal inflammation; biopsy revealed crypt atrophy and interstitial bleeding.
• All cases were self-limiting with no chronic sequelae at 12 months.

Conclusions:

• SARS-CoV-2 infection can induce transient acute colon ischemia.
• Symptoms manifest within two weeks of infection and are typically self-limiting.
• COVID-19-associated ischemic colitis does not appear to lead to chronic gastrointestinal issues.