Pneumatosis Intestinalis in the Setting of COVID-19: A Single Center Case Series From New York

Autor: Santiago J. Miyara, Lance B. Becker, Sara Guevara, Claudia Kirsch, Christine N. Metz, Muhammad Shoaib, Elliot Grodstein, Vinay V. Nair, Nicholas Jandovitz, Alexia McCann-Molmenti, Kei Hayashida, Ryosuke Takegawa, Koichiro Shinozaki, Tsukasa Yagi, Tomoaki Aoki, Mitsuaki Nishikimi, Rishabh C. Choudhary, Young Min Cho, Stavros Zanos, Stefanos Zafeiropoulos, Hannah B. Hoffman, Stacey Watt, Claudio M. Lumermann, Judith Aronsohn, Linda Shore-Lesserson, Ernesto P. Molmenti
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Frontiers in Medicine, Vol 8 (2021)
Druh dokumentu: article
ISSN: 2296-858X
DOI: 10.3389/fmed.2021.638075
Popis: This case series reviews four critically ill patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [coronavirus disease 2019 (COVID-19)] suffering from pneumatosis intestinalis (PI) during their hospital admission. All patients received the biological agent tocilizumab (TCZ), an interleukin (IL)-6 antagonist, as an experimental treatment for COVID-19 before developing PI. COVID-19 and TCZ have been independently linked to PI risk, yet the cause of this relationship is unknown and under speculation. PI is a rare condition, defined as the presence of gas in the intestinal wall, and although its pathogenesis is poorly understood, intestinal ischemia is one of its causative agents. Based on COVID-19's association with vasculopathic and ischemic insults, and IL-6's protective role in intestinal epithelial ischemia–reperfusion injury, an adverse synergistic association of COVID-19 and TCZ can be proposed in the setting of PI. To our knowledge, this is the first published, single center, case series of pneumatosis intestinalis in COVID-19 patients who received tocilizumab therapy.
Databáze: Directory of Open Access Journals