Your browser doesn't support javascript.
Intestinal Abnormalities in Patients With SARS-CoV-2 Infection: Histopathologic Changes Reflect Mechanisms of Disease.
Yantiss, Rhonda K; Qin, LiHui; He, Bing; Crawford, Carl V; Seshan, Surya; Patel, Sanjay; Wahid, Nabeel; Jessurun, Jose.
  • Yantiss RK; Department of Pathology and Laboratory Medicine.
  • Qin L; Department of Pathology and Laboratory Medicine.
  • He B; Department of Pathology and Laboratory Medicine.
  • Crawford CV; Division of Gastroenterology and Hepatology, Weill Cornell Medicine.
  • Seshan S; Department of Pathology and Laboratory Medicine.
  • Patel S; Department of Pathology and Laboratory Medicine.
  • Wahid N; Department of Medicine, New York-Presbyterian Hospital, New York, NY.
  • Jessurun J; Department of Pathology and Laboratory Medicine.
Am J Surg Pathol ; 46(1): 89-96, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1254925
Semantic information from SemMedBD (by NLM)
1. Coronavirus Infections PROCESS_OF Patients
Subject
Coronavirus Infections
Predicate
PROCESS_OF
Object
Patients
2. Gastrointestinal Hemorrhage PROCESS_OF Patients
Subject
Gastrointestinal Hemorrhage
Predicate
PROCESS_OF
Object
Patients
3. Evaluation USES Endoscopy (procedure)
Subject
Evaluation
Predicate
USES
Object
Endoscopy (procedure)
4. Virus Diseases CAUSES Coronavirus Infections
Subject
Virus Diseases
Predicate
CAUSES
Object
Coronavirus Infections
5. Epithelium LOCATION_OF Virus
Subject
Epithelium
Predicate
LOCATION_OF
Object
Virus
6. Coronavirus Infections CAUSES Gastrointestinal symptom
Subject
Coronavirus Infections
Predicate
CAUSES
Object
Gastrointestinal symptom
7. cell injury COEXISTS_WITH Diarrhea
Subject
cell injury
Predicate
COEXISTS_WITH
Object
Diarrhea
8. Coronavirus Infections PROCESS_OF Patients
Subject
Coronavirus Infections
Predicate
PROCESS_OF
Object
Patients
9. Gastrointestinal Hemorrhage PROCESS_OF Patients
Subject
Gastrointestinal Hemorrhage
Predicate
PROCESS_OF
Object
Patients
10. Evaluation USES Endoscopy (procedure)
Subject
Evaluation
Predicate
USES
Object
Endoscopy (procedure)
11. Virus Diseases CAUSES Coronavirus Infections
Subject
Virus Diseases
Predicate
CAUSES
Object
Coronavirus Infections
12. Epithelium LOCATION_OF Virus
Subject
Epithelium
Predicate
LOCATION_OF
Object
Virus
13. Coronavirus Infections CAUSES Gastrointestinal symptom
Subject
Coronavirus Infections
Predicate
CAUSES
Object
Gastrointestinal symptom
14. cell injury COEXISTS_WITH Diarrhea
Subject
cell injury
Predicate
COEXISTS_WITH
Object
Diarrhea
ABSTRACT
Approximately 20% of patients with symptomatic syndrome-associated coronavirus-2 (SARS-CoV-2) infection have gastrointestinal bleeding and/or diarrhea. Most are managed without endoscopic evaluation because the risk of practitioner infection outweighs the value of biopsy analysis unless symptoms are life-threatening. As a result, much of what is known about the gastrointestinal manifestations of coronavirus disease-2019 (COVID-19) has been gleaned from surgical and autopsy cases that suffer from extensive ischemic injury and/or poor preservation. There are no detailed reports describing any other gastrointestinal effects of SARS-CoV-2 even though >3,000,000 people have died from COVID-19 worldwide. The purpose of this study is to report the intestinal findings related to SARS-CoV-2 infection by way of a small case series including one with evidence of direct viral cytopathic effect and 2 with secondary injury attributed to viral infection. Infection can be confirmed by immunohistochemical stains directed against SARS-CoV-2 spike protein, in situ hybridization for spike protein-encoding RNA, and ultrastructural visualization of viruses within the epithelium. It induces cytoplasmic blebs and tufted epithelial cells without inflammation and may not cause symptoms. In contrast, SARS-CoV-2 infection can cause gastrointestinal symptoms after the virus is no longer detected, reflecting systemic activation of cytokine and complement cascades rather than direct viral injury. Reversible mucosal ischemia features microvascular injury with hemorrhage, small vessel thrombosis, and platelet-rich thrombi. Systemic cytokine elaboration and dysbiosis likely explain epithelial cell injury that accompanies diarrheal symptoms. These observations are consistent with clinical and in vitro data and contribute to our understanding of the protean manifestations of COVID-19.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Intestinal Diseases / Intestines Type of study: Diagnostic study Limits: Adult / Aged / Humans / Male Language: English Journal: Am J Surg Pathol Year: 2022 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Intestinal Diseases / Intestines Type of study: Diagnostic study Limits: Adult / Aged / Humans / Male Language: English Journal: Am J Surg Pathol Year: 2022 Document Type: Article