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Gastrointestinal Pathology in Samples From Coronavirus Disease 2019 (COVID-19)-Positive Patients.
Arch Pathol Lab Med. 2021 09 01; 145(9):1062-1068.AP

Abstract

CONTEXT.—

Although primarily considered a respiratory illness, coronavirus disease 2019 (COVID-19) can cause gastrointestinal manifestations.

OBJECTIVE.—

To evaluate histopathology and in situ hybridization for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in gastrointestinal samples from patients with recent and remote COVID-19.

DESIGN.—

Patients with positive SARS-CoV-2 nasopharyngeal tests and a gastrointestinal tissue specimen were included. SARS-CoV-2 in situ hybridization (ISH) was performed on each sample. A subset had SARS-CoV-2 next-generation sequencing (NGS) performed.

RESULTS.—

Twenty-five patients met inclusion criteria. Five had positive SARS-CoV-2 nasopharyngeal tests within 7 days of their gastrointestinal procedure. Two were ulcerative colitis patients on steroid therapy who lacked typical COVID-19 symptoms. Their colectomies showed severe ulcerative colitis; one demonstrated SARS-CoV-2 by NGS but a negative ISH. Another had an ischemic colon resected as a complication of the COVID-19 course; however, both ISH and NGS were negative. A fourth had a normal-appearing terminal ileum but positive ISH and NGS. The fifth patient had ileal ulcers with SARS-CoV-2 negativity by both modalities. The remaining 20 patients had positive nasopharyngeal tests an average of 53 days prior to procedure. None of their samples demonstrated SARS-CoV-2 ISH positivity, but one was positive on NGS despite a negative nasopharyngeal test.

CONCLUSIONS.—

Gastrointestinal findings from SARS-CoV-2-infected patients ranged from normal with virus detected by ISH and NGS to bowel ischemia secondary to systemic viral effects without evidence of virus in the tissue. No distinct histologic finding was identified in those with gastrointestinal tissue specimens demonstrating SARS-CoV-2 positivity in this cohort.

Authors+Show Affiliations

From the Department of Pathology, University of Michigan, Ann Arbor (Westerhoff, Hrycaj, Chan, Pantanowitz, Choi, Greenson, Lamps).The Department of Pathology, The Ohio State University Wexner Medical Center, Columbus (Jones, Tu).From the Department of Pathology, University of Michigan, Ann Arbor (Westerhoff, Hrycaj, Chan, Pantanowitz, Choi, Greenson, Lamps).From the Department of Pathology, University of Michigan, Ann Arbor (Westerhoff, Hrycaj, Chan, Pantanowitz, Choi, Greenson, Lamps).From the Department of Pathology, University of Michigan, Ann Arbor (Westerhoff, Hrycaj, Chan, Pantanowitz, Choi, Greenson, Lamps).The Department of Pathology, The Ohio State University Wexner Medical Center, Columbus (Jones, Tu).From the Department of Pathology, University of Michigan, Ann Arbor (Westerhoff, Hrycaj, Chan, Pantanowitz, Choi, Greenson, Lamps).From the Department of Pathology, University of Michigan, Ann Arbor (Westerhoff, Hrycaj, Chan, Pantanowitz, Choi, Greenson, Lamps).From the Department of Pathology, University of Michigan, Ann Arbor (Westerhoff, Hrycaj, Chan, Pantanowitz, Choi, Greenson, Lamps).

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33961007

Citation

Westerhoff, Maria, et al. "Gastrointestinal Pathology in Samples From Coronavirus Disease 2019 (COVID-19)-Positive Patients." Archives of Pathology & Laboratory Medicine, vol. 145, no. 9, 2021, pp. 1062-1068.
Westerhoff M, Jones D, Hrycaj SM, et al. Gastrointestinal Pathology in Samples From Coronavirus Disease 2019 (COVID-19)-Positive Patients. Arch Pathol Lab Med. 2021;145(9):1062-1068.
Westerhoff, M., Jones, D., Hrycaj, S. M., Chan, M. P., Pantanowitz, L., Tu, H., Choi, K., Greenson, J., & Lamps, L. (2021). Gastrointestinal Pathology in Samples From Coronavirus Disease 2019 (COVID-19)-Positive Patients. Archives of Pathology & Laboratory Medicine, 145(9), 1062-1068. https://doi.org/10.5858/arpa.2021-0137-SA
Westerhoff M, et al. Gastrointestinal Pathology in Samples From Coronavirus Disease 2019 (COVID-19)-Positive Patients. Arch Pathol Lab Med. 2021 09 1;145(9):1062-1068. PubMed PMID: 33961007.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gastrointestinal Pathology in Samples From Coronavirus Disease 2019 (COVID-19)-Positive Patients. AU - Westerhoff,Maria, AU - Jones,Dan, AU - Hrycaj,Steven M, AU - Chan,May P, AU - Pantanowitz,Liron, AU - Tu,Huolin, AU - Choi,Karen, AU - Greenson,Joel, AU - Lamps,Laura, PY - 2021/05/03/accepted PY - 2021/5/8/pubmed PY - 2021/9/24/medline PY - 2021/5/7/entrez SP - 1062 EP - 1068 JF - Archives of pathology & laboratory medicine JO - Arch Pathol Lab Med VL - 145 IS - 9 N2 - CONTEXT.—: Although primarily considered a respiratory illness, coronavirus disease 2019 (COVID-19) can cause gastrointestinal manifestations. OBJECTIVE.—: To evaluate histopathology and in situ hybridization for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in gastrointestinal samples from patients with recent and remote COVID-19. DESIGN.—: Patients with positive SARS-CoV-2 nasopharyngeal tests and a gastrointestinal tissue specimen were included. SARS-CoV-2 in situ hybridization (ISH) was performed on each sample. A subset had SARS-CoV-2 next-generation sequencing (NGS) performed. RESULTS.—: Twenty-five patients met inclusion criteria. Five had positive SARS-CoV-2 nasopharyngeal tests within 7 days of their gastrointestinal procedure. Two were ulcerative colitis patients on steroid therapy who lacked typical COVID-19 symptoms. Their colectomies showed severe ulcerative colitis; one demonstrated SARS-CoV-2 by NGS but a negative ISH. Another had an ischemic colon resected as a complication of the COVID-19 course; however, both ISH and NGS were negative. A fourth had a normal-appearing terminal ileum but positive ISH and NGS. The fifth patient had ileal ulcers with SARS-CoV-2 negativity by both modalities. The remaining 20 patients had positive nasopharyngeal tests an average of 53 days prior to procedure. None of their samples demonstrated SARS-CoV-2 ISH positivity, but one was positive on NGS despite a negative nasopharyngeal test. CONCLUSIONS.—: Gastrointestinal findings from SARS-CoV-2-infected patients ranged from normal with virus detected by ISH and NGS to bowel ischemia secondary to systemic viral effects without evidence of virus in the tissue. No distinct histologic finding was identified in those with gastrointestinal tissue specimens demonstrating SARS-CoV-2 positivity in this cohort. SN - 1543-2165 UR - https://www.unboundmedicine.com/medline/citation/33961007/Gastrointestinal_Pathology_in_Samples_From_Coronavirus_Disease_2019__COVID_19__Positive_Patients_ L2 - https://meridian.allenpress.com/aplm/article-lookup/doi/10.5858/arpa.2021-0137-SA DB - PRIME DP - Unbound Medicine ER -