Páramo-Zunzunegui J, Ortega-Fernández I, Calvo-Espino P, Diego-Hernández C, Ariza-Ibarra I, Otazu-Canals L, Danés-Grases J E, Menchero-Sánchez A
Department of General and Digestive Surgery, University Hospital of Móstoles, Madrid, Spain.
Department of Histopathology, University Hospital of Móstoles, Madrid, Spain.
Ann R Coll Surg Engl. 2020 Sep;102(7):e176-e179. doi: 10.1308/rcsann.2020.0166. Epub 2020 Aug 17.
Spain has been one of the most affected countries by the COVID-19 outbreak. After the high impact of the pandemic, a wide clinical spectrum of late complications associated with COVID-19 are being observed. We report a case of a severe colitis in a post-treatment and recovered COVID-19 patient. A 64-year-woman with a one-month hospital admission for severe bilateral pneumonia associated with COVID-19 and 10 days after discharge presented with diarrhoea and abdominal pain. Severe -associated colitis is diagnosed according to clinical features and CT findings. An urgent pancolectomy was performed due to her bad response to conservative treatment. Later evolution slowly improved to recovery. -associated colitis is one of the most common hospital-acquired infections. Significant patient-related risk factors for infection are antibiotic exposure, older age, and hospitalisation. Initial therapeutic recommendations in our country included administration broad-spectrum antibiotics to all patients with bilateral pneumonia associated with SARS-CoV-2. These antibiotics are strongly associated with infection. Our patient developed a serious complication of due to the use of broad-spectrum antibiotics. The appearance of late digestive symptoms in patients diagnosed and treated for COVID-19 should alert clinicians to the possibility of infection. The updated criteria for severe colitis and severe infection should be considered to ensure an early effective treatment for the complication.
西班牙是受新冠疫情影响最严重的国家之一。在疫情造成巨大冲击之后,人们观察到了一系列与新冠病毒相关的后期并发症。我们报告了一例新冠病毒感染治疗后康复患者出现严重结肠炎的病例。一名64岁女性因与新冠病毒相关的严重双侧肺炎住院一个月,出院10天后出现腹泻和腹痛。根据临床特征和CT检查结果诊断为严重相关性结肠炎。由于她对保守治疗反应不佳,遂进行了紧急全结肠切除术。后来病情逐渐好转并康复。相关性结肠炎是最常见的医院获得性感染之一。与感染相关的重要患者风险因素包括抗生素暴露、年龄较大和住院治疗。我国最初的治疗建议包括对所有患有与严重急性呼吸综合征冠状病毒2相关的双侧肺炎的患者使用广谱抗生素。这些抗生素与感染密切相关。我们的患者因使用广谱抗生素而出现了严重的并发症。新冠病毒感染确诊和治疗后的患者出现晚期消化系统症状应提醒临床医生注意感染的可能性。应考虑更新后的严重结肠炎和严重感染标准,以确保对该并发症进行早期有效治疗。