COVID-19 Infection Related Bowel Perforation

Abstract

During an ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel virus, new discoveries about its complications and treatment are made every day. Bowel perforation is another rarely reported complication due to the virus itself leading to ischemia or can be due to the treatment with antiviral drugs that reduces the integrity of epithelial barriers. This makes the bowel more prone to perforation even in patients with no prior history of bowel disease. We report a case of bowel perforation in a 72-year-old male patient with severe COVID-19 infection.

Ileal perforation involvement in Wegener granulomatosis comorbid with COVID-19 infection: A case report and review of the literature

“…[42] Local inflammatory responses caused by viral replication in GI cells may play an important role in intestinal perforation. [43] There have been case reports of patients with GPA and COVID-19 receiving immunosuppressant therapy, [44,45] but immunosuppressive and steroid hormone therapy treatments increase GI perforation risk and may mask the typical abdominal signs of sepsis, leading to missed diagnoses. [41,43,44] It has been suggested, but not yet conclusively demonstrated, that COVID-19 may be a predisposing factor for intestinal perforation in patients with ANCA-positive GPA.…”

“…[43] There have been case reports of patients with GPA and COVID-19 receiving immunosuppressant therapy, [44,45] but immunosuppressive and steroid hormone therapy treatments increase GI perforation risk and may mask the typical abdominal signs of sepsis, leading to missed diagnoses. [41,43,44] It has been suggested, but not yet conclusively demonstrated, that COVID-19 may be a predisposing factor for intestinal perforation in patients with ANCA-positive GPA. [46,47] The clinical course observed in our patient, who developed coronary pneumonia followed by sudden intestinal perforation a couple of months after he was admitted with GPA, is consistent with a possible COVID-19-induced vulnerability to GPA-associated intestinal perforation.…”