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Trop Med Infect Dis . COVID-19-Induced Thrombosis in Patients without Gastrointestinal Symptoms and Elevated Fecal Calprotectin: Hypothesis Regardin

tetano

Editor, Senior Moderator
Trop Med Infect Dis


. 2020 Sep 16;5(3):E147.
doi: 10.3390/tropicalmed5030147.
COVID-19-Induced Thrombosis in Patients without Gastrointestinal Symptoms and Elevated Fecal Calprotectin: Hypothesis Regarding Mechanism of Intestinal Damage Associated with COVID-19


Mauro Giuffr?[SUP] 1 2 [/SUP], Stefano Di Bella[SUP] 1 [/SUP], Gianluca Sambataro[SUP] 3 [/SUP], Verena Zerbato[SUP] 4 [/SUP], Marco Cavallaro[SUP] 5 [/SUP], Alessandro Agostino Occhipinti[SUP] 6 [/SUP], Andrea Palermo[SUP] 7 [/SUP], Anna Crescenti[SUP] 8 [/SUP], Fabio Monica[SUP] 9 [/SUP], Roberto Luzzati[SUP] 1 [/SUP], Lory Saveria Croc?[SUP] 1 2 [/SUP]



Affiliations

Abstract

Background: Patients with coronavirus infectious disease 2019 (COVID-19) and gastrointestinal symptoms showed increased values of fecal calprotectin (FC). Additionally, bowel abnormalities were a common finding during abdominal imaging of individuals with COVID-19 despite being asymptomatic. The current pilot study aims at evaluating FC concentrations in patients without gastrointestinal symptoms.
Methods: we enrolled 25 consecutive inpatients with COVID-19 pneumonia, who were admitted without gastrointestinal symptoms and a previous history of inflammatory bowel disease.
Results: At admission, 21 patients showed increased FC with median values of 116 (87.5; 243.5) mg/kg despite absent gastrointestinal symptoms. We found a strong positive correlation between FC and D-Dimer (r = 0.745, p < 0.0001). Two patients developed bowel perforation.
Conclusion: our findings may change the current understanding of COVID-19 intestinal-related disease pathogenesis, shedding new light on the potential role of thrombosis and the consequent hypoxic intestinal damage.

Keywords: COVID-19; D-Dimer; SARS-CoV-2; bowel perforation; fecal calprotectin; ischemia; thrombosis.
 
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