TITLE:
Duodenal Endoscopic and Histopathologic Findings in a COVID-19 Patient: A Case Report and Literature Review
AUTHORS:
Vahatra Joëlle Razafimahefa, Jocia Fenomanana, Manoahasina Ranaliarinosy Rabarison, Soloniaina Hélio Razafimahefa, Tsitohery Francine Andriamampionona
KEYWORDS:
COVID-19, SARS-CoV-2, Histopathologic Findings, Duodenum, Endoscopy, Biopsy
JOURNAL NAME:
Open Journal of Pathology,
Vol.12 No.4,
September
23,
2022
ABSTRACT: Although COVID-19 clinical manifestations are mostly respiratory gastrointestinal manifestations may also be encountered in some instances. However, at the time of our writing, little is known about COVID-19, associated pathologic changes in the digestive system. We describe a case of COVID-19 disease with digestive manifestations that demonstrated specific pathologic changes in the gastrointestinal tract. Histological examination of endoscopic biopsy samples from duodenum was performed in combination with a review of the literature. According to our literature review, digestive histopathologic changes have been reported in 14 cases of COVID-19 patients. Pathological findings were generally nonspecific in all these cases and ranged from epithelial damage, lymphoplasmacytic and macrophages infiltrates, prominent endothelitis and ischemic enterocolitis. In our patient, histological features were more specific, characterized by several viral cytopathic effects associated with mucosal damage, numerous microthrombi and positive staining of ACE2 on various enterocytes. Histological analysis is not a practical option for the diagnosis of SARS-CoV-2 infections but could help to elucidate pathophysiology of the disease. Those changes may be specific in the GI tract and related clinical manifestations should not be overlooked. Furthermore, preventive measures for oral-fecal transmission should not be minimized.