Objective: To describe the clinical characteristics and outcomes of patients with coronavirus disease 2019(COVID-19) who developed bowel perforation.
Materials and methods: This case series was conducted in Emergency Department of AORN Sant'Anna and S. Sebastiano located in Caserta. All patients resulted positive to SARS-Cov-2 in nasopharyngeal swabs whith a positive laboratory test for SARS-CoV-2 from real time reverse transcription polymerase chain reaction(RT-PCR) as well as bowel perforation which was identified by abdominal CT, from September 2020 to December 2020.
Results: A total of five patients were identified with Bowel perforation occurred despite all patients being on anticoagulation. All patients were Italian, predominantly male(four patients) with an average age of 60 years and the most common comorbidity was hypertension, diabetes and obesity.
Discussion: Bowel perforation in COVID-19 is clinically significant with high morbidity and mortality. In our series 40% of patients who were diagnosed of bowel perforation died. Average time to death after bowel perforation diagnosis was 6 days.
Conclusion: We describe a case series of COVID-19 patients who developed bowel perforation.
Key words: Covid-19, Bowel perforation.
I pazienti affetti da infezione da SARS-COV2 possono sviluppare complicanze fra cui la perforazione intestinale che presenta un elevato rischio di mortalità. Alcuni studi hanno evidenziato che elevati livelli sierici di lattati sono un fattore che aumenta il rischio di perforazione e di mortalità. Da un punto di visto fisiopatologico molti aspetti non sono ancora ben chiari. Rilievi autoptici hanno evidenziato lo sviluppo di un processo infiammatorio a carico dell’endotelio dei vasi mesenteriali con conseguente danno ipossico e perforativo dell’intestino. Inoltre i pazienti trattati con inibitori dell’interleuchina 6 hanno mostrato un elevato rischio di perforazione intestinale.