What is it about?
COVID-19 was first seen as a lung disease, but the virus can also affect the gut. Faecal calprotectin, a stool marker of intestinal inflammation, is raised in COVID-19 patients with gastrointestinal symptoms, and bowel abnormalities are often seen on scans even without symptoms. We measured faecal calprotectin in 25 consecutive patients hospitalized for COVID-19 pneumonia who had no gut symptoms and no history of inflammatory bowel disease. Surprisingly, 21 of them had elevated values. Calprotectin levels were strongly correlated with D-dimer, a blood marker of clotting, and two patients later developed bowel perforation.
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Why is it important?
These pilot findings suggest that intestinal damage in COVID-19 may be driven by blood clots in small vessels and the resulting lack of oxygen to the bowel wall, rather than only by direct viral injury. This hypothesis could change the understanding of COVID-19 gut disease and encourage attention to intestinal complications even in patients without abdominal symptoms.
Perspectives
Early in the pandemic we were learning about COVID-19 day by day. This small study, led by Mauro Giuffre with gastroenterology colleagues in Trieste, was one of those early observations that helped show COVID-19 as a systemic, thrombotic disease, not just a pneumonia.
Professor Stefano Di Bella
Universita degli Studi di Trieste
Read the Original
This page is a summary of: COVID-19-Induced Thrombosis in Patients without Gastrointestinal Symptoms and Elevated Fecal Calprotectin: Hypothesis Regarding Mechanism of Intestinal Damage Associated with COVID-19, Tropical Medicine and Infectious Disease, September 2020, MDPI AG,
DOI: 10.3390/tropicalmed5030147.
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