Acute Mesenteric Ischemia in COVID-19 Patients.
COVID-19
SARS-CoV-2
acute mesenteric ischemia
cytokines
endothelitis
hypercoagulability
thromboemboembolism
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
30 Dec 2021
30 Dec 2021
Historique:
received:
09
12
2021
revised:
19
12
2021
accepted:
27
12
2021
entrez:
11
1
2022
pubmed:
12
1
2022
medline:
12
1
2022
Statut:
epublish
Résumé
Acute mesenteric ischemia is a rare but extremely severe complication of SARS-CoV-2 infection. The present review aims to document the clinical, laboratory, and imaging findings, management, and outcomes of acute intestinal ischemia in COVID-19 patients. A comprehensive search was performed on PubMed and Web of Science with the terms "COVID-19" and "bowel ischemia" OR "intestinal ischemia" OR "mesenteric ischemia" OR "mesenteric thrombosis". After duplication removal, a total of 36 articles were included, reporting data on a total of 89 patients, 63 being hospitalized at the moment of onset. Elevated D-dimers, leukocytosis, and C reactive protein (CRP) were present in most reported cases, and a contrast-enhanced CT exam confirms the vascular thromboembolism and offers important information about the bowel viability. There are distinct features of bowel ischemia in non-hospitalized vs. hospitalized COVID-19 patients, suggesting different pathological pathways. In ICU patients, the most frequently affected was the large bowel alone (56%) or in association with the small bowel (24%), with microvascular thrombosis. Surgery was necessary in 95.4% of cases. In the non-hospitalized group, the small bowel was involved in 80%, with splanchnic veins or arteries thromboembolism, and a favorable response to conservative anticoagulant therapy was reported in 38.4%. Mortality was 54.4% in the hospitalized group and 21.7% in the non-hospitalized group (
Identifiants
pubmed: 35011941
pii: jcm11010200
doi: 10.3390/jcm11010200
pmc: PMC8745985
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
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