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COVID-19-associated multiple colonic perforations in a 6-month-old infant: a rare case report

Ali Manafi Anari1, Ladan Teymoorzadeh1, Ramez Nasiri2

  • 1Department of Pediatrics, School of Medicine, Hazrat-e Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran.

BMC Pediatrics
|July 10, 2025
PubMed

Insights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may cause intestinal perforation in infants. This rare gastrointestinal complication requires prompt surgical intervention for affected infants.

Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases
  • Surgical Neonatology

Background:

  • COVID-19 typically presents as a respiratory illness.
  • Gastrointestinal complications like colitis and perforation are rare in infants but documented in adults.
  • Infant presentations of COVID-19 with severe GI issues are exceptionally uncommon.

Purpose of the Study:

  • To report a rare case of intestinal perforation in an infant due to COVID-19.
  • To highlight the potential link between SARS-CoV-2 and severe gastrointestinal injury in neonates.
  • To emphasize the need for early surgical management in such critical cases.

Main Methods:

  • Case report of a 6-month-old infant with sepsis and subsequent COVID-19 diagnosis.
  • Clinical presentation included lethargy, poor feeding, vomiting, and abdominal distension.
  • Diagnostic workup involved imaging and laboratory tests, leading to emergency laparotomy and colectomy.

Main Results:

  • The infant tested positive for COVID-19.
  • Intraoperative findings revealed perforations in the transverse and descending colon.
  • Histopathological examination provided evidence linking SARS-CoV-2 to the intestinal injury.

Conclusions:

  • SARS-CoV-2 may cause ischemic or inflammatory bowel injury leading to intestinal perforation in infants.
  • Early surgical intervention is crucial for infants with COVID-19-associated intestinal perforation.
  • Further research is necessary to elucidate the exact pathophysiology and establish causality.
Abstract

Keywords:
COVID-19ColectomyColonic perforationInfantPediatric surgerySARS-CoV-2

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