RESUMO
Apart from the mechanisms reported by Fernandes et al, the thromboembolic pathogenesis should also be taken into account in patients with severe COVID-19 and prophylaxis with low molecular weight heparin should be implemented.
Assuntos
COVID-19/complicações , Pancreatopatias/virologia , Tromboembolia/virologia , COVID-19/diagnóstico , COVID-19/fisiopatologia , Humanos , Pancreatopatias/diagnóstico , Pancreatopatias/fisiopatologia , Tromboembolia/diagnóstico , Tromboembolia/fisiopatologiaRESUMO
Mönkemüller et al. brilliantly describe the pathogenesis of SARS-CoV-2 (COVID-19) in the gastrointestinal tract. Their findings highlight the local and systemic inflammatory response generated by the coronavirus. After having the opportunity to observe three cases of severe colonic ischemia and elevation of D-dimer levels in patients with COVID-19 and severe acute respiratory distress syndrome (SARS) due to SARS-CoV-2, we would like to highlight the thromboembolic complications in COVID-19, which are related to those reported by Mönkemüller and which have been mentioned by other authors.
Assuntos
Infecções por Coronavirus , Trato Gastrointestinal , Pandemias , Pneumonia Viral , Tromboembolia Venosa , Autopsia , Betacoronavirus , COVID-19 , Humanos , SARS-CoV-2RESUMO
COVID-19 is associated with severe coagulopathy. We present three cases of colonic ischemia that can be attributed to the hypercoagulable state related with SARS-CoV2 and disseminated intravascular coagulation. Three males aged 76, 68 and 56 with respiratory distress presented episodes of rectal bleeding, abdominal distension and signs of peritoneal irritation. Endoscopy (case 1) and computed tomography angiography revealed colonic ischemia. One patient (case 2) in which a computed tomography (CT) scan showed perforation of the gangrenous cecum underwent surgery. D-dimer levels were markedly increased (2,170, 2,100 and 7,360 ng/ml) in all three patients. All three patients died shortly after diagnosis.