Author: Miyara, Santiago J.; Becker, Lance B.; Guevara, Sara; Kirsch, Claudia; Metz, Christine N.; Shoaib, Muhammad; Grodstein, Elliot; Nair, Vinay V.; Jandovitz, Nicholas; McCann-Molmenti, Alexia; Hayashida, Kei; Takegawa, Ryosuke; Shinozaki, Koichiro; Yagi, Tsukasa; Aoki, Tomoaki; Nishikimi, Mitsuaki; Choudhary, Rishabh C.; Cho, Young Min; Zanos, Stavros; Zafeiropoulos, Stefanos; Hoffman, Hannah B.; Watt, Stacey; Lumermann, Claudio M.; Aronsohn, Judith; Shore-Lesserson, Linda; Molmenti, Ernesto P.
Title: Pneumatosis Intestinalis in the Setting of COVID-19: A Single Center Case Series From New York Cord-id: pqdq4oj6 Document date: 2021_6_4
ID: pqdq4oj6
Snippet: This case series reviews four critically ill patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [coronavirus disease 2019 (COVID-19)] suffering from pneumatosis intestinalis (PI) during their hospital admission. All patients received the biological agent tocilizumab (TCZ), an interleukin (IL)-6 antagonist, as an experimental treatment for COVID-19 before developing PI. COVID-19 and TCZ have been independently linked to PI risk, yet the cause of this relationship
Document: This case series reviews four critically ill patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [coronavirus disease 2019 (COVID-19)] suffering from pneumatosis intestinalis (PI) during their hospital admission. All patients received the biological agent tocilizumab (TCZ), an interleukin (IL)-6 antagonist, as an experimental treatment for COVID-19 before developing PI. COVID-19 and TCZ have been independently linked to PI risk, yet the cause of this relationship is unknown and under speculation. PI is a rare condition, defined as the presence of gas in the intestinal wall, and although its pathogenesis is poorly understood, intestinal ischemia is one of its causative agents. Based on COVID-19's association with vasculopathic and ischemic insults, and IL-6's protective role in intestinal epithelial ischemia–reperfusion injury, an adverse synergistic association of COVID-19 and TCZ can be proposed in the setting of PI. To our knowledge, this is the first published, single center, case series of pneumatosis intestinalis in COVID-19 patients who received tocilizumab therapy.
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