Abdominal Pain: A Real Challenge in Novel COVID-19 Infection

Autor: Andrea Vercelli, Pau Mateo Ramos, Davide Bastoni, Erika Poggiali, Andrea Magnacavallo
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: European Journal of Case Reports in Internal Medicine (2020)
European Journal of Case Reports in Internal Medicine
Popis: COVID-19 (coronavirus disease 19) is an infectious disease caused by coronavirus 2019-nCoV. Since its detection in China at the end of 2019, the novel coronavirus has rapidly spread throughout the world and has caused an international public health emergency. The most common manifestation is flu-like symptoms. Mild infections usually improve within a few days, but COVID-19 can cause severe pneumonia with acute respiratory distress syndrome and death. Gastrointestinal symptoms are less common but possible and more difficult to recognize as part of a COVID-19 syndrome. In line with the current opinion of the WHO, we strongly believe that preventive measures and early diagnosis of COVID-19 are crucial to interrupt virus spread and avoid local outbreaks. We report the cases of COVID-19 patients admitted to our Emergency Department who complained of gastrointestinal symptoms at admission. LEARNING POINTS The novel COVID-19 infection is a severe public health problem which is causing an increasing number of deaths worldwide. Although uncommon, there may be a relationship between gastrointestinal symptoms and COVID-19, as reported in recent studies. Early detection and isolation of patients with COVID-19 infection is the only way to control and limit the global spread of this virus. Keywords: COVID-19 infection, abdominal pain, diarrhoea, gastrointestinal symptoms INTRODUCTION The coronaviruses are a large family of viruses that can cause respiratory infections ranging from mild symptoms to severe pneumonia. 2019-nCoV is a new type of coronavirus which was first identified in China. Since its detection in humans at the end of 2019, it has rapidly spread worldwide causing respiratory infections of various degrees of severity. The most common symptoms, which develop within 2–14 days of exposure, are dry cough, fever and fatigue[1, 2]. Mild infections may be self-limiting in few days, but in some cases the respiratory symptoms can develop into acute respiratory distress syndrome (ARDS) with a high risk of death from multiorgan failure. Nasopharyngeal and oropharyngeal swabs can be used to confirm the presence of 2019-nCoV. A CT scan of the chest is the gold standard for diagnosis and assessment of lung involvement. Ground-glass opacity and crazy-craving patterning are the most common radiological signs of COVID-19 pneumonia. CT is commonly used to evaluate lung damage during recovery[3]. Recently, we investigated the role of lung US in the early detection of COVID-19 pneumonia and showed a strong correlation between lung US and CT scans in all investigated patients[4]. No specific treatment or vaccines against COVID-19 are currently available. COVID-19 patients can be treated with antivirals but there is no clear evidence of benefit [5]. The most important way to fight this viral infection is to detect COVID-19 early, isolate cases, trace contacts and deliver the correct information to the general public [6]. Gastrointestinal involvement, such as abdominal pain, nausea, vomiting and diarrhoea, has been recently reported in the literature[7]. Diarrhoea occurs secondary to the interaction between ACE2, highly expressed in the human small intestine, and 2019-nCoV cell entry receptor ACE2. Recent studies show that 2019-nCoV RNA has been detected in stool samples, confirming faecal–oral transmission. According to the literature, the incidence of diarrhoea could be underestimated[8]. In the current case report, we consider COVID-19 infection in the differential diagnosis of gastrointestinal symptoms in 10 patients who referred to our Emergency Department in February 2020, at the beginning of the spread of COVID-19 in Italy.
Databáze: OpenAIRE
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