SARS-CoV-2 identified by transmission electron microscopy in lymphoproliferative and ischaemic intestinal lesions of COVID-19 patients with acute abdominal pain : two case reports
Martin Cardona, Albert (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Lloreta Trull, Josep (Hospital del Mar (Barcelona, Catalunya))
Albero González, Raquel (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Paraira Beser, Marta (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Andújar, Xavier (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Ruiz-Ramirez, Pablo (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Tur-Martínez, Jaume (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Ferrer, Carme (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
De Marcos Izquierdo, José Angel (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Pérez-Madrigal, Anna (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Goiburú González, Laura (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Espinós Perez, Jorge (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Esteve, Maria (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Universitat Autònoma de Barcelona

Data:	2021
Resum:	SARS-CoV-2 may produce intestinal symptoms that are generally mild, with a small percentage of patients developing more severe symptoms. The involvement of SARS-CoV-2 in the physiopathology of bowel damage is poorly known. Transmission electron microscopy (TEM) is a useful tool that provides an understanding of SARS-CoV-2 invasiveness, replication and dissemination in body cells but information outside the respiratory tract is very limited. We report two cases of severe intestinal complications (intestinal lymphoma and ischaemic colitis) in which the presence of SARS-CoV-2 in intestinal tissue was confirmed by TEM. These are the first two cases reported in the literature of persistence of SARS-CoV-2 demonstrated by TEM in intestinal tissue after COVID 19 recovery and SARS-CoV-2 nasopharyngeal clearance. During the first pandemic peak (1st March-30th April 2020) 932 patients were admitted in Hospital Universitari Mútua Terrassa due to COVID-19, 41 (4. 4%) required cross-sectional imaging techniques to assess severe abdominal pain and six of them (0. 64%) required surgical resection. SARS-CoV-2 in bowel tissue was demonstrated by TEM in two of these patients. The first case presented as an ileocaecal inflammatory mass which turned to be a B-cell lymphoma. Viral particles were found in the cytoplasm of endothelial cells of damaged mucosa. In situ hybridization was negative in tumour cells, thus ruling out an oncogenic role for the virus. SARS-CoV-2 remained in intestinal tissue 6 months after nasopharyngeal clearance, suggesting latent infection. The second patient had a severe ischaemic colitis with perforation and SARS-CoV-2 was also identified in endothelial cells. Severe intestinal complications associated with COVID-19 are uncommon. SARS-CoV-2 was identified by TEM in two cases, suggesting a causal role in bowel damage.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; altres ; Versió publicada
Matèria:	SARS-CoV-2 ; COVID-19 ; Intestinal lymphoma ; Ischaemic colitis ; Transmission electron microscopy ; Case report
Publicat a:	BMC Gastroenterology, Vol. 21 (august 2021) , ISSN 1471-230X

DOI: 10.1186/s12876-021-01905-3
PMID: 34445965

10 p, 3.8 MB

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