1Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
2Department of Gastroenterology, Hamad Medical Corporation, Doha, Qatar.
Am J Trop Med Hyg. 2021 Jan;104(1):63-65. doi: 10.4269/ajtmh.20-1262.
Clinical manifestations and complications of SARS-CoV-2 are still emerging and variant. Gastrointestinal (GI) manifestations and complications are hugely under-recognized. The presence of angiotensin converting enzyme-2 receptors in the intestinal enterocytes, the receptors primarily involved in the pathogenesis of COVID-19 pneumonia, maybe the key factor contributing to the pathogenesis of GI manifestations. Ischemic colitis, although the most common ischemic pathology of the GI tract, is relatively rare, occurring as a result of colonic hypoperfusion. The innumerable causes of colonic ischemia are categorized into occlusive and nonocclusive pathologies. Here, we have discussed a case of severe COVID-19 pneumonia, developing ischemic colitis, as a rare GI complication. The cause of ischemia in COVID-19 pneumonia is multifactorial, including hypercoagulable state, coagulopathy leading to thromboembolic complications, and use of vasopressors in severely ill patients with hemodynamic compromise.
SARS-CoV-2 的临床表现和并发症仍在不断出现和变异。胃肠道（GI）表现和并发症被严重低估。肠上皮细胞中存在血管紧张素转换酶 2 受体，该受体主要参与 COVID-19 肺炎的发病机制，可能是导致胃肠道表现发病机制的关键因素。缺血性结肠炎虽然是胃肠道最常见的缺血性病理，但相对较少见，是由于结肠低灌注引起的。引起结肠缺血的无数原因可分为阻塞性和非阻塞性病理。在这里，我们讨论了一例严重 COVID-19 肺炎发展为缺血性结肠炎的罕见胃肠道并发症。COVID-19 肺炎引起的缺血的原因是多方面的，包括高凝状态、导致血栓栓塞并发症的凝血功能障碍，以及严重血流动力学不稳定的患者使用血管加压素。
