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Occult Colonic Perforation in a Patient With Coronavirus Disease 2019 After Interleukin-6 Receptor Antagonist Therapy.
Schwab, Kristin; Hamidi, Sepehr; Chung, Augustine; Lim, Raymond J; Khanlou, Negar; Hoesterey, Daniel; Dumitras, Camelia; Adeyiga, Oladunni B; Phan-Tang, Michelle; Wang, Tisha S; Saggar, Rajan; Goldstein, Jeffrey; Belperio, John A; Dubinett, Steven M; Kim, Jocelyn T; Salehi-Rad, Ramin.
Afiliación
  • Schwab K; Division of Pulmonary and Critical Care, Department of Medicine at University of California, Los Angeles, California, USA.
  • Hamidi S; Department of Pathology and Laboratory Medicine at University of California, Los Angeles, California, USA.
  • Chung A; Division of Pulmonary and Critical Care, Department of Medicine at University of California, Los Angeles, California, USA.
  • Lim RJ; Department of Molecular and Medical Pharmacology at University of California, Los Angeles, California, USA.
  • Khanlou N; Department of Pathology and Laboratory Medicine at University of California, Los Angeles, California, USA.
  • Hoesterey D; Department of Medicine at University of California, Los Angeles, California, USA.
  • Dumitras C; Division of Pulmonary and Critical Care, Department of Medicine at University of California, Los Angeles, California, USA.
  • Adeyiga OB; Division of Infectious Diseases, Department of Medicine at University of California, Los Angeles, California, USA.
  • Phan-Tang M; Department of Pathology and Laboratory Medicine at University of California, Los Angeles, California, USA.
  • Wang TS; Division of Pulmonary and Critical Care, Department of Medicine at University of California, Los Angeles, California, USA.
  • Saggar R; Division of Pulmonary and Critical Care, Department of Medicine at University of California, Los Angeles, California, USA.
  • Goldstein J; Department of Pathology and Laboratory Medicine at University of California, Los Angeles, California, USA.
  • Belperio JA; Division of Pulmonary and Critical Care, Department of Medicine at University of California, Los Angeles, California, USA.
  • Dubinett SM; Division of Pulmonary and Critical Care, Department of Medicine at University of California, Los Angeles, California, USA.
  • Kim JT; Department of Pathology and Laboratory Medicine at University of California, Los Angeles, California, USA.
  • Salehi-Rad R; Department of Molecular and Medical Pharmacology at University of California, Los Angeles, California, USA.
Open Forum Infect Dis ; 7(11): ofaa424, 2020 Nov.
Article en En | MEDLINE | ID: mdl-33204749
BACKGROUND: Interleukin-6 blockade (IL-6) has become a focus of therapeutic investigation for the coronavirus disease 2019 (COVID-19). METHODS: We report a case of a 34-year-old with COVID-19 pneumonia receiving an IL-6 receptor antagonist (IL-6Ra) who developed spontaneous colonic perforation. This perforation occurred despite a benign abdominal exam and in the absence of other known risk factors associated with colonic perforation. RESULTS: Examination of the colon by electron microscopy revealed numerous intact severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virions abutting the microvilli of the colonic mucosa. Multiplex immunofluorescent staining revealed the presence of the SARS-CoV-2 spike protein on the brush borders of colonic enterocytes that expressed angiotensin-converting enzyme 2. However, no viral particles were observed within the enterocytes to suggest direct viral injury as the cause of colonic perforation. CONCLUSIONS: These data and absence of known risk factors for spontaneous colonic perforation implicate IL-6Ra therapy as the potential mediator of colonic injury in this case. Furthermore, this report provides the first in situ visual evidence of the virus in the colon of a patient presenting with colonic perforation adding to growing evidence that intact infectious virus can be present in the stool.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Open Forum Infect Dis Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Open Forum Infect Dis Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos