SARS-CoV-2 identified by transmission electron microscopy in lymphoproliferative and ischaemic intestinal lesions of COVID-19 patients with acute abdominal pain: two case reports

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• dc.contributor.author Martin-Cardona, Albert
• dc.contributor.author Lloreta, Josep, 1958-
• dc.contributor.author Albero-González, Raquel
• dc.contributor.author Paraira Beser, Marta
• dc.contributor.author Andújar Murcia, Xavier
• dc.contributor.author Ruiz-Ramirez, Pablo
• dc.contributor.author Tur-Martínez, Jaume
• dc.contributor.author Ferrer, Carme
• dc.contributor.author Marcos Izquierdo, José Angel de
• dc.contributor.author Pérez-Madrigal, Anna
• dc.contributor.author Goiburú González, Laura
• dc.contributor.author Espinós Perez, Jorge
• dc.contributor.author Esteve, Maria
• dc.date.accessioned 2022-03-21T11:54:56Z
• dc.date.available 2022-03-21T11:54:56Z
• dc.date.issued 2021
• dc.description.abstract Background: SARS-CoV-2 may produce intestinal symptoms that are generally mild, with a small percentage of patients developing more severe symptoms. The involvement of SARS-CoV-2 in the physiopathology of bowel damage is poorly known. Transmission electron microscopy (TEM) is a useful tool that provides an understanding of SARS-CoV-2 invasiveness, replication and dissemination in body cells but information outside the respiratory tract is very limited. We report two cases of severe intestinal complications (intestinal lymphoma and ischaemic colitis) in which the presence of SARS-CoV-2 in intestinal tissue was confirmed by TEM. These are the first two cases reported in the literature of persistence of SARS-CoV-2 demonstrated by TEM in intestinal tissue after COVID 19 recovery and SARS-CoV-2 nasopharyngeal clearance. Case presentation: During the first pandemic peak (1st March-30th April 2020) 932 patients were admitted in Hospital Universitari Mútua Terrassa due to COVID-19, 41 (4.4%) required cross-sectional imaging techniques to assess severe abdominal pain and six of them (0.64%) required surgical resection. SARS-CoV-2 in bowel tissue was demonstrated by TEM in two of these patients. The first case presented as an ileocaecal inflammatory mass which turned to be a B-cell lymphoma. Viral particles were found in the cytoplasm of endothelial cells of damaged mucosa. In situ hybridization was negative in tumour cells, thus ruling out an oncogenic role for the virus. SARS-CoV-2 remained in intestinal tissue 6 months after nasopharyngeal clearance, suggesting latent infection. The second patient had a severe ischaemic colitis with perforation and SARS-CoV-2 was also identified in endothelial cells. Conclusions: Severe intestinal complications associated with COVID-19 are uncommon. SARS-CoV-2 was identified by TEM in two cases, suggesting a causal role in bowel damage.
• dc.format.mimetype application/pdf
• dc.identifier.citation Martin-Cardona A, Lloreta Trull J, Alberto-González R, Paraira Beser M, Andújar X, Ruiz-Ramirez P et al. SARS-CoV-2 identified by transmission electron microscopy in lymphoproliferative and ischaemic intestinal lesions of COVID-19 patients with acute abdominal pain: two case reports. BMC Gastroenterol. 2021 Aug 26;21(1):334. DOI: 10.1186/s12876-021-01905-3
• dc.identifier.doi http://dx.doi.org/10.1186/s12876-021-01905-3
• dc.identifier.issn 1471-230X
• dc.identifier.uri http://hdl.handle.net/10230/52742
• dc.language.iso eng
• dc.publisher BioMed Central
• dc.rights © Albert Martin-Cardona et al. 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.other COVID-19 (Malaltia)
• dc.subject.other Intestins -- Malalties
• dc.subject.other Limfomes
• dc.subject.other Colitis
• dc.title SARS-CoV-2 identified by transmission electron microscopy in lymphoproliferative and ischaemic intestinal lesions of COVID-19 patients with acute abdominal pain: two case reports
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion