• SARS-CoV-2
• inflammation
• mesenteric ischemia
• mesenteric venous thrombosis
• splanchnic circulation
• thrombosis

• COVID-19
• mesenteric ischaemia
• thromboembolism

• Aged
• Female
• Humans
• Male
• Middle Aged
• COVID-19/complications
• COVID-19/mortality
• Mesenteric Ischemia/etiology
• SARS-CoV-2

• Autopsy
• COVID-19
• Coronary Artery
• Heart
• SARS-CoV-2

• Child
• Humans
• Aortitis/pathology
• COVID-19/complications
• Plasma Cells/pathology
• SARS-CoV-2
• Death, Sudden, Cardiac/etiology
• Disease Progression

• endovascular
• percutaneous thrombectomy
• protection from embolization

• Arterial thromboembolism
• COVID-19
• Vasculitis
• Venous thromboembolism

• mesenteric ischemia
• covid-19
• sars-cov-2
• isquemia mesentérica

• Humans
• COVID-19/complications
• SARS-CoV-2
• Mesenteric Ischemia/etiology

• COVID-19
• antiplatelet therapy
• arterial thrombosis
• aspirin

• COVID-19
• Cholecystitis
• GI surgery
• Mesenteric ischemia
• Pancreatitis

• Humans
• Anticoagulants/therapeutic use
• COVID-19/complications
• Disease Progression
• SARS-CoV-2
• Thrombosis/etiology
• Venous Thromboembolism/diagnosis
• Venous Thromboembolism/epidemiology
• Venous Thromboembolism/etiology

• aortic arch
• ascending aorta
• deep hypothermic circulatory arrest
• surgical strategies
• thrombus

• Bowel
• COVID-19
• Intestinal Obstruction
• Resection

• COVID-19
• abdominal surgery
• acute abdomen
• mesenteric ischemia
• mortality

• Adult
• Humans
• Male
• Middle Aged
• Female
• Mesenteric Ischemia/epidemiology
• Mesenteric Ischemia/diagnosis
• COVID-19/complications
• Acute Disease
• Laparotomy
• Digestive System Surgical Procedures/adverse effects
• Ischemia/diagnosis
• Ischemia/etiology
• Ischemia/surgery

• COVID-19
• Edema
• Gastrointestinal symptoms
• Imaging
• SARS-CoV-2

• the research about Chongqing Key technology and application demonstration of medical imaging depth intelligent diagnostic platform
• Study on Intelligent assisted diagnostic model of vascular cognitive dysfunction based on MRI imaging groupology

• COVID-19
• SARS-CoV-2
• gastrointestinal symptom
• microbiome
• nutrition

Venous thrombosis has been widely described in the setting of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; however, arterial thrombosis has rarely been reported. This study aims to assess the incidence, risk factors, interventions, and outcomes of acute aortoiliac arterial thrombosis in patients with active SARS-CoV-2 infections.

We present seven SARS-CoV-2-positive patients from our institution who acutely developed thrombi in the aortoiliac arterial system (7/2020-1/2021). A systematic review of the literature on aortoiliac arterial thrombosis in patients with SARS-CoV-2 infections in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was also performed. The available data from all reported cases in the literature and at our institution were analyzed.

Thirty published articles and journal correspondences, including 52 patients, were reviewed and analyzed in addition to our institution's 7 cases. In total, 59 SARS-CoV-2-positive patients were found to have acute aortoiliac thrombosis. The abdominal aorta was the most frequent location for the development of a thrombus. Baseline demographics and medical comorbidities were not significantly different between the symptomatic and asymptomatic cohorts. Seventy-one percent of patients were symptomatic (lower limb ischemia: 75.0%, renal infarction: 20.0%, stroke: 12.5%, mesenteric ischemia: 10.0%). All patients with thrombus involving the ascending aorta, aortic bifurcation, or iliac artery developed thromboembolic or ischemic complications. All patients received systemic anticoagulation. Fifty-three percent of all patients were managed medically. Ninety-four percent of the asymptomatic patients were managed medically. One asymptomatic patient underwent endovascular aspiration of a mobile thrombus. Three (23.1%) deaths occurred in the asymptomatic cohort from hypoxic respiratory failure. Fourteen (36.8%) deaths occurred in the symptomatic cohort. The in-hospital mortality rate was 33.3% overall and 43.8% for patients with thrombi involving more than one aortoiliac segment.

The presence of thrombi in the aortoiliac arterial system appears to be a poor prognostic indicator for patients with active SARS-CoV-2 infections. Medical management of patients with asymptomatic aortoiliac thrombi may be considered. The presence of thrombi involving the ascending aorta, aortic bifurcation, or iliac artery may warrant consideration for operative intervention due to the risk for thromboembolic or ischemic complications. Further study is needed to fully delineate the risk factors, optimal treatment, and outcomes of arterial thrombosis in the setting of SARS-CoV-2 infection.

Introduction: Chronic mesenteric ischemia is a rare entity with non-specific symptomatology; combined with rare etiologies, it could lead to unwarranted surgical indication. Case report: We report the case of an 85-year-old woman, with a history of hypertension, persistent thrombocytosis, atherosclerosis, and recent minor COVID-19 infection, presenting to the hospital with postprandial abdominal pain and nonspecific clinical examination findings; upon abdominal CT, superior mesenteric artery circumferential thrombosis was revealed. A bone marrow biopsy was performed due to suspected essential thrombocythemia, confirming the diagnosis. An endovascular approach was chosen as therapy option and a stent was placed in the occluded area. Dual antiplatelet and cytoreductive therapies were initiated after the intervention. Clinical course was excellent, with no residual stenosis 1 month after stenting. Conclusions: The therapeutic strategy in elderly patients with exacerbated chronic mesenteric ischemia requires an interdisciplinary approach in solving both the exacerbation and the underlying conditions in order to prevent further thrombotic events. Although the patient presented a thrombotic state, other specific risk factors such as COVID-19 related-coagulopathy and essential thrombocythemia should be considered.

• COVID-19
• Mesenteric ischemia
• Small bowel ischemia

• Abdomen
• COVID-19/complications
• Humans
• Ischemia/complications
• Mesenteric Ischemia/diagnostic imaging
• Tomography, X-Ray Computed/methods

The new coronavirus (COVID-19) infection, first detected in Wuhan, China in 2019 has become a pandemic that has spread to nearly every country in the world. Through October 11, 2021, more than 23 billion confirmed cases and 4.8 million fatalities were reported globally. The bulk of individuals afflicted in India during the first wave were elderly persons. The second wave, however, resulted in more severe diseases and mortality in even younger age groups due to mutations in the wild virus. Symptoms may range from being asymptomatic to fatal acute respiratory distress syndrome (ARDS). In addition to respiratory symptoms, patients may present with gastrointestinal symptoms such as stomach pain, vomiting, loose stools, or mesenteric vein thrombosis. The frequency of patients presenting with thromboembolic symptoms has recently increased. According to certain studies, the prevalence of venous thromboembolism among hospitalized patients ranges from 9 to 25%. It was also shown that the incidence is significantly greater among critically sick patients, with a prevalence of 21–31%. Although the exact origin of thromboembolism is unknown, it is considered to be produced by several altered pathways that manifest as pulmonary embolism, myocardial infarction, stroke, limb gangrene, and acute mesenteric ischemia. Acute mesenteric ischemia (AMI) is becoming an increasingly prevalent cause of acute surgical abdomen in both intensive care unit (ICU) and emergency room (ER) patients. Mesenteric ischemia should be evaluated in situations with unexplained stomach discomfort. In suspected situations, appropriate imaging techniques and early intervention, either non-surgical or surgical, are necessary to avert mortality. The purpose of this article is to look at the data on acute mesenteric ischemia in people infected with COVID-19.

• COVID-19
• CT abdomen and pelvis
• Mesenteric ischemia
• Renal infarct
• Thromboembolism

• COVID-19
• SARS-CoV-2
• coronavirus disease 2019
• hypoxemia
• hypoxia
• nursing
• pathophysiology

• Covid-19
• SARS-CoV-2
• VITT
• thrombosis

The novel 2019 coronavirus disease (COVID-19), which is caused by infection with the severe acute respiratory syndrome coronavirus 2, has spread rapidly around the world and has caused many deaths. COVID-19 involves a systemic hypercoagulable state and arterial/venous thrombosis which induces unfavorable prognosis. Herein, we present a first case in East Asia where an acute superior mesenteric artery (SMA) occlusion associated with COVID-19 pneumonia was successfully treated by surgical intervention.

A 70-year-old man presented to his local physician with a 3-day history of cough and diarrhea. A real-time reverse transcriptase-polymerase chain reaction test showed positive for COVID-19, and he was admitted to the source hospital with the diagnosis of moderate COVID-19 pneumonia. Eight days later, acute onset of severe abdominal pain appeared with worsening respiratory condition. Contrast CT showed that bilateral lower lobe/middle lobe and lingula ground glass opacification with distribution suggestive of COVID-19 pneumonia and right renal infarction. In addition, it demonstrated SMA occlusion with intestinal ischemia suggesting extensive necrosis from the jejunum to the transverse colon. The patient underwent an emergency exploratory laparotomy with implementing institutional COVID-19 precaution guideline. Upon exploration, the intestine from jejunum at 100 cm from Treitz ligament to middle of transverse colon appeared necrotic. Necrotic bowel resection was performed with constructing jejunostomy and transverse colon mucous fistula. We performed second surgery to close the jejunostomy and transverse colon mucous fistula with end-to-end anastomosis on postoperative day 22. The postoperative course was uneventful and he moved to another hospital for rehabilitation to improve activities of daily living (ADLs) on postoperative day 45. As of 6 months after the surgery, his ADLs have completely improved and he has returned to social life without any intravenous nutritional supports.

Intensive treatment including surgical procedures allowed the patient with SMA occlusion in COVID-19 pneumonia to return to social life with completely independent ADLs. Although treatment for COVID-19 involves many challenges, including securing medical resources and controlling the spread of infection, when severe abdominal pain occurs in patients with COVID-19, physicians should consider SMA occlusion and treat promptly for life-saving from this deadly combination.

• COVID-19
• SARS-CoV-2
• Superior mesenteric artery occlusion

• COVID-19
• SARS-CoV-2
• acute mesenteric ischemia
• cytokines
• endothelitis
• hypercoagulability
• thromboemboembolism

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in a global health emergency. In addition to common respiratory symptoms, some patients with COVID-19 infections may experience a range of extra-pulmonary manifestations, such as digestive system involvement. Patients with COVID-19 have been reported to suffer from acute mesenteric ischemia (AMI) that is associated with disease-related severity and mortality. However, in the context of COVID-19, the exact cause of AMI has yet to be clearly defined. This review provides a comprehensive overview of the available data and elucidates the possible underlying mechanisms linking COVID-19 to AMI, in addition to highlighting therapeutic approaches for clinicians. Finally, given the severe global impact of COVID-19, we emphasize the importance of coordinated vaccination programs.

• Acute mesenteric ischemia
• COVID-19
• Gastrointestinal disorders
• SARS-CoV-2
• Therapy

The Covid 19 pandemia since the first reported case in 2019 had a direct socioeconomic impact related to morbi-mortality and indirect in response to protection and isolation strategies. To our knowledge thrombo-embolic complications can be a mode of revelation complicating the management.

We present an exceptional case of a patient with a history of Covid 19,admitted 21 days later for disturbed consciousness, in whom an ischemic occipital stroke ,intestinal and colonic ishemia had been objectified. Our objective through this presentation is to remind the thrombo-embolic particularity of Covid 19, to take the viral attack as a serious antecedent in the periods following theinfection and to put the point on the primordial place of early rehabilitation in patients with stroke.

We discuss through this report the recommendations of anticoagulation in Covid 19 patients and the place of early rehabilitation in patients with stroke. We also report a new case among the rare cases described in the literature that associates several thrombo-embolic manifestations secondary to Covid 19, in particular the neurological and digestive association.

•

Exceptional Clinical Presentation associating an occipital Stroke, a Superior and Inferior Mesenteric Thrombosis following Covid 19 Disease.

• Anticoagulation
• Covid 19
• Mesenteric thrombosis
• Rehabilitation
• Stroke

• COVID-19
• abdomen
• chest
• computed tomography
• pandemic

• COVID-19
• bowel ischemia
• surgical management

• COVID-19/complications
• Female
• Humans
• Intestinal Diseases/surgery
• Intestinal Diseases/virology
• Ischemia/surgery
• Ischemia/virology
• Laparotomy
• Male
• Massachusetts
• Middle Aged
• SARS-CoV-2

• R01 HL119248 NHLBI NIH HHS

To correlate thromboembolic (TE) complications secondary to COVID-19 with the extent of the pulmonary parenchymal disease using CT severity scores and other comorbidities.

In total, 185 patients with COVID-19 and suspected thromboembolic complications were classified into two groups based on the presence or absence of thromboembolic complications. Thromboembolic complications were categorized based on location. Chest CT severity scoring system was used to assess the pulmonary parenchymal disease severity in all patients. Based into severity scores, patients were categorized into three groups (mild, moderate, and sever disease).

The final study cohort consisted of 171 patients (99 male and 72 female) after excluding 14 patients with non-diagnostic CT pulmonary angiography. The TE group included 53 patients with a mean age of 55.1 ± 7.1, while the non-TE group included 118 patients with a mean age of 52.9 ± 10.8. Patients with BMI > 30 kg/m² or having a history of smoking and HTN were found more frequently in the TE group (p < 0.05). Patients admitted to ICU were significantly higher in the TE group (p < 0.001). There was statistically significant difference (p = 0.002) in chest CT-SS between the TE group (22.8 ± 11.4) and non-TE group (17.6 ± 10.7). The percentage of severe parenchymal disease in the TE group was significantly higher compared to the non-TE group (p < 0.05). Severe parenchymal disease, BMI > 30 kg/m², smoking, and HTN had a higher and more significant odds ratio for developing TE complications.

The present data suggest that severe pulmonary parenchymal disease secondary to COVID-19 is associated with a higher incidence of thromboembolic complications.

• COVID-19
• Coronavirus
• Embolism
• Ischemia
• SARS-COV-2
• Thrombosis

• COVID-19
• NRP-1
• SARS-CoV-2
• TGF-β1
• fibrosis
• heart

• Bowel perforation
• COVID-19
• Mesenteric ischemia
• Mesenteric thrombosis

Objective: Coronavirus disease 19 is a well-established cause of rare arterial thrombosis. Nevertheless, the exact mechanism of arterial thrombosis remains to be elucidated. We herein report the case of a large floating thrombus of the aortic arch, its surgical management and histological analysis.

Case: A 65-year-old patient presented to the emergency department with a suspected stroke. He was non-smoker, but presented cardiovascular risk factors, namely hypertension, type 2 diabetes and hyperlipidaemia. A computed tomography of the aorta revealed a large floating thrombus of the aortic arch, at the base of the brachiocephalic trunk, suspected to be the etiology of stroke. Therapeutic anticoagulation was immediately started. The decision was made to perform an open aortic replacement surgery because of the symptomatic thromboembolic event with recent cerebral infarction and the potential harmfulness of the thrombus due to its size. A mobile thrombus was observed at the base of the brachiocephalic trunk by echocardiography. It was attached to a small area of the upper aortic wall and had an irregular surface. Histology revealed a platelet-rich thrombus lying on an aortic atherosclerotic plaque without pronounced inflammation. No plaque ulceration was present but endothelial cell desquamation was observed consistent with plaque erosion.

Conclusion: In our case, there was a thrombus lying on an atherosclerotic plaque with intact thick fibrous cap, but associated with a plaque erosion mechanism. The thrombus formation appeared more likely to relate to a very localized endothelial injury.

• COVID-19
• aortic arch
• arterial thrombus
• endothelial dysfunction
• plaque erosion

For more than 2 years, health care systems have been floundering in a massive crisis of coronavirus disease 2019 (COVID-19) pandemic. While acute respiratory distress syndrome is the main complication in patients with COVID-19, as the pandemic continues, more data about the nonrespiratory effects of the coronavirus is obtained, including developing Coagulopathy-related manifestations, in the form of venous and arterial thromboembolism. Although arterial thrombosis a rare complication of this disease, it proves to be an effective factor in the mortality and morbidity of COVID-19 patients. The pathophysiology of thrombosis reveals a complex relation between hemostasis and immune system that can be disrupted by COVID-19. Thrombectomy, anticoagulant therapy, and thrombolysis are the main treatments in these patients. In addition, appropriate thromboprophylaxis treatment should be considered in COVID-19 patients. In this article, we have successfully reviewed the arterial thrombotic events in patients reported around the world, including the diagnostic and management method of choice.

• COVID-19
• GI
• immunohistochemistry
• microscopy
• pediatric
• surg path

• Abdominal imaging
• Computed tomography
• Gastrointestinal
• Radiology

• Bowel perforation
• COVID-19
• Isquemia mesentérica
• Mesenteric ischemia
• Mesenteric thrombosis
• Perforación intestinal
• Trombosis mesentérica

• Abdomen
• COVID-19
• Radiology
• SARS-CoV-2
• Small intestine

With the increasing recognition of gastrointestinal (GI) manifestation of coronavirus disease-19 (COVID-19), various abdominal imaging findings are increasingly being noted. We scoped the existing literature on the abdominal imaging findings in COVID-19.

A systematic literature search was performed on PubMed, Embase, Google scholar and World Health Organization COVID-19 database.

35 studies were included in the final descriptive synthesis. Among the studies reporting positive abdominal imaging findings in patients with COVID-19, majority described imaging abnormalities of the GI tract (16 studies), of which bowel wall thickening was most frequently reported. Other findings noted were abdominal imaging manifestations of bowel ischemia with thrombosis of the splanchnic vasculature, and imaging features suggestive of pancreatitis. Imaging findings suggestive of solid organ infarction were reported in nine studies. An association between imaging evidence of hepatic steatosis and COVID-19 was noted in three studies. Incidental lung base findings on abdominal imaging were noted in 18 studies, where patients presented with predominant GI symptoms. The most common finding was bilateral ground glass opacities (90.7%) with predominant multilobar (91.1%) and peripheral (64.4%) distribution.

This systematic review provides insight into the abdominal imaging findings in patients with COVID-19. Knowledge of these imaging manifestations will not only help in further research but also will aid in curtailing transmission of the SARS-CoV-2. Further prospective studies are needed to gain better insight into the pathophysiology of these imaging manifestations.

This review highlights the abdominal imaging findings in patients with COVID-19, to gain insight into the disease pathophysiology and gear the abdominal radiologist through the pandemic.

Coronavirus disease 2019 (COVID-19) virus has affected all the systems of the body, defying all impressions of it being a respiratory virus only.

To see the association of mesenteric ischemia with COVID-19.

After initial screening and filtering of the titles on PubMed and Google Scholar, 124 articles were selected. Articles were read in full, and the references were skimmed for relevance. Twenty-six articles (case reports and case series) were found to eligible for inclusion. References of these 26 articles were checked for any additional cases. Two more publications were found, and a total of 28 articles (22 case reports and 6 case series) have been included for review in this manuscript.

A total of 41 cases of acute mesenteric ischemia in COVID-19 patients have been reported in the literature since the outbreak of this pandemic. Most of them include patients with comorbidities.

In conclusion, based on this literature review and precise published knowledge regarding acute mesenteric ischemia in patients with COVID-19, it is essential to understand its relevance in all patients with gastrointestinal symptoms. The threshold for the diagnostic investigations should also be kept low for the timely diagnosis and management of this disorder.

• Mesenteric ischemia
• COVID-19
• SARS-CoV-2
• Influenza
• Severe acute respiratory syndrome
• Acute abdomen

• COVID-19/complications
• Cells/virology
• Elective Surgical Procedures
• Humans
• Internationality
• SARS-CoV-2/pathogenicity
• Vascular Diseases/etiology

• acute mesenteric ischemia (AMI)
• gut vitality
• image assessment
• intraoperative diagnostics
• optical coherence tomography (OCT)
• optical coherence tomography angiography (OCTA)

• 19-75-10096 Russian Science Foundation
• 0030-2021-0013 State task for IAP RAS

Cardiovascular involvement in SARS-CoV-2 infection has emerged as one of viral major clinical features during actual pandemic; limb arterial ischemic events, venous thrombosis, acute myocardial infection and stroke have occurred in patients.

Acute aortic conditions have also been described, followed by interesting observations on cases, hypothesis, raised since the emergence of the pandemics.

a review of cases in literature of aortic pathology in patients with clinically suspected/microbiologically confirmed COVID-19 infection has been carried out to analyze anagraphic data, clinical presentation, treatment options and outcome.

Seventeen cases have been included. Mean age of patients was 58.6 ± 15.2 years, with a male to female ratio of 12:15 (70.5% vs. 29.5%). Comorbidities were reported in 11 cases (64.7%), but in 5 cases (29.4%) no previous pathology was signaled in history. Hypertension was the most frequently reported comorbidity, in 8 cases, (47%), followed by renal pathology (17.6%), coronary artery disease (17.6%), previous aortic surgery (11.7%) and arrhythmia (11.7%); but also cerebrovascular disease, diabetes, autoimmune conditions, previous neoplasia and arrhythmia were reported once each. Fever and thoracic pain were the most frequently reported findings at presentation (8 cases, 47% each), followed by respiratory symptoms (6, 35.2%), low lymphocyte count (17.6%), features related to aneurysm rupture, ischemic stroke, abdominal pain and acute renal insufficiency. Reported aortic pathology included: type A aortic dissection (11 cases; 64.7%); new pathology of previous aortic graft (2 cases, 11.7%); 2 aortitis, 1 associated with type A aortic dissection; 1 thoraco-abdominal aortic aneurysm, 1 ruptured aortic aneurysm and 1 aortic embolizing thrombosis. Open surgery was carried out in 10 cases (58.8%), endovascular treatment in 3 (17.6%). Three patients (17.6%) died before surgery. Exitus was reported in 4 cases, with a total mortality of 23.5%.

Acute aortic events have occurred during pandemic in patients with clinically suspected/microbiologically confirmed COVID-19 infection. Confounding clinical features at presentation, the importance of anamnestic details (as previous vascular graft implant), the observed surgical and postoperatory challenges may suggest the need to consider the implications of the possible link between acute aortic events and SARS-CoV-2 infection, in order to promptly correctly diagnose the patient and respond to specific needs.

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Aorta/pathology
• Aorta/surgery
• Aortic Diseases/mortality
• Aortic Diseases/pathology
• Aortic Diseases/therapy
• COVID-19/diagnosis
• COVID-19/mortality
• COVID-19/therapy
• Comorbidity
• Female
• Humans
• Male
• Middle Aged
• Prognosis
• Risk Assessment
• Risk Factors
• Time Factors

• Anemia, Sickle Cell/complications
• Anemia, Sickle Cell/physiopathology
• Anticoagulants/therapeutic use
• Apoptosis
• Bone Marrow Transplantation/adverse effects
• COVID-19/complications
• COVID-19/epidemiology
• Endothelial Cells/pathology
• Endothelial Cells/virology
• Endothelium, Vascular/virology
• Glucuronidase/antagonists & inhibitors
• Graft vs Host Disease/etiology
• Graft vs Host Disease/physiopathology
• Heparin/therapeutic use
• Hepatic Veno-Occlusive Disease/etiology
• Hepatic Veno-Occlusive Disease/physiopathology
• Humans
• Idiopathic Interstitial Pneumonias/etiology
• Idiopathic Interstitial Pneumonias/physiopathology
• Interleukin-6/physiology
• Multiple Organ Failure/etiology
• Multiple Organ Failure/physiopathology
• Organ Specificity
• Pandemics
• Polydeoxyribonucleotides/therapeutic use
• SARS-CoV-2/isolation & purification
• SARS-CoV-2/pathogenicity
• Stem Cell Transplantation/adverse effects
• Thrombophilia/drug therapy
• Thrombophilia/etiology
• Thrombotic Microangiopathies/etiology
• Thrombotic Microangiopathies/physiopathology
• Vasculitis/drug therapy
• Vasculitis/etiology
• Vasculitis/virology
• Viral Tropism

• #20575 to CC-S AIRC
• AIRC