Endoscopic Findings in Patients Infected With 2019 Novel Coronavirus in Lombardy, Italy

Abstract

Coronavirus disease 2019 (COVID-19) is a major worldwide threat caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), rapidly spreading to a global pandemic. As of May 11, 2020, 4,176,346 cases have been reported worldwide, 219,814 in Italy, and of them, 81,871 occurred in the Lombardy region.¹ Although the respiratory manifestations of COVID-19 have been widely described, the impact on the gastrointestinal (GI) system remains less clear. The reported prevalence of digestive symptoms ranges from 3% to 79%, depending on the setting,^2-5 but data on GI endoscopic and histologic findings in COVID-19 patients are lacking. Therefore, the aim of this study is to describe the GI endoscopic and histologic findings in COVID-19 patients.

Figure 1

Ulcerative endoscopic lesions with the characteristics of colon ischemia (A) and segmental colitis associated with diverticulosis (B), observed in 2 COVID-19 patients. Histopathologic findings in a case of colon ischemia are shown in (C) and (D); numerous vessels with the lumen obstructed by fibrinous thrombus are recognizable beneath the surface epithelium. ERG is a nuclear marker (brown) of endothelial cells of the vessels. CD31 is a cytoplasmic marker for both the endothelial cells of the vessels and the platelets.