Spontaneous abdominal bleeding associated with SARS-CoV-2 infection: causality or coincidence? Abdominal bleeding and SARS-CoV-2

Spontaneous abdominal bleeding associated with SARS-CoV-2 infection: causality or coincidence?

Abdominal bleeding and SARS-CoV-2

Authors

  • Bruno Sposato Pneumology Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy; Experimental Medicine and Systems, “PhD program" Department of Systems Medicine University of Rome “Tor Vergata”
  • Leonardo Croci UOC Malattie Infettive, Ospedale Misericordia di Grosseto
  • Maurizio Di Tomassi UOC Pneumologia, Ospedale Misericordia di Grosseto
  • Camilla Puttini UOC Malattie Infettive, Ospedale Misericordia di Grosseto
  • Carmela Olivieri UOC Pneumologia, Ospedale Misericordia di Grosseto
  • Mario Alessandri UOC Malattie Infettive, Ospedale Misericordia di Grosseto
  • Maria Cristina Ronchi UOC Pneumologia, Ospedale Misericordia di Grosseto
  • Elisa Donati UOC Malattie Infettive, Ospedale Misericordia di Grosseto
  • Alessio Garcea UOC Pneumologia, Ospedale Misericordia di Grosseto
  • Angelica Brazzi UOC Malattie Infettive, Ospedale Misericordia di Grosseto
  • Maria Giovanna Migliorini UOC Pneumologia, Ospedale Misericordia di Grosseto
  • Silvia Chigiotti UOC Malattie Infettive, Ospedale Misericordia di Grosseto
  • Nikolaos Nikiforakis UOC Pneumologia, Ospedale Misericordia di Grosseto
  • Tiziana Carli UOC Malattie Infettive, Ospedale Misericordia di Grosseto
  • Elena Canneti UOC Pneumologia, Ospedale Misericordia di Grosseto
  • Francesco Strambio UOC Malattie Infettive, Ospedale Misericordia di Grosseto
  • Cristina Cellini UOC Malattie Infettive, Ospedale Misericordia di Grosseto
  • Claudia Nardangeli Pneumology Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Maria Pia Allegri UOC Malattie Infettive, Ospedale Misericordia di Grosseto
  • Francesco Bianchi Pneumology Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Claudio Bettini Pneumology Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy; Cardiothoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
  • Marco Perruzza Pneumology Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Nicola Lanzarone Pneumology Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Lucia Valentini Pneumology Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Paolo Orselli Pneumology Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Marco Solari Cardiology Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Salvatore Cardaci Infectious Disease Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Marco Nofri Infectious Disease Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Giorgia Angeli Infectious Disease Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Francesca Mangani Infectious Disease Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Elio Aloia Infectious Disease Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Alessandro Lanari Infectious Disease Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Marta Corridi Intensive Care Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Genni Spargi Intensive Care Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Antonio Perrella Pneumology Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy
  • Cesira Nencioni Infectious Disease Department, USL SUDEST, Toscana, Misericordia Hospital, Grosseto, Italy

Keywords:

COVID-19; SARS-CoV-2, bleeding, abdominal, pneumonia

Abstract

Authors present 6 cases of abdominal bleeding associated with COVID-19, representing 1.35% of all hospitalized COVID-19 patients and hypothesize that there could be, although not very frequently, a relationship between SARS-CoV2 and bleeding. They excluded a side effect of the low molecular weight heparin therapy that all patients underwent during the course of the disease or other possible causes. Alterations of the coagulation state or a weakness of the vascular wall due toa presumed endotheliitis SARS-CoV-2 infection induced, are hypothesized by the authors. Investigation and follow-up for possible hemorrhagic problems in patients with COVID-19 is recommended. In particular, clinicians should be vigilant about retroperitoneal hemorrhage in COVID-19 patients. In addition to the fact that these patients are being treated with anticoagulants, anemia and abdominal pain are the signs that should lead us to suspect this type of haemorrhage. More studies are needed to understand if COVID-19 can be directly associated with bleeding. (www.actabiomedica.it)

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Published

12-05-2021

Issue

Section

CASE REPORTS - SPECIAL COVID19

How to Cite

1.
Sposato B, Croci L, Di Tomassi M, et al. Spontaneous abdominal bleeding associated with SARS-CoV-2 infection: causality or coincidence? Abdominal bleeding and SARS-CoV-2. Acta Biomed. 2021;92(2):e2021199. doi:10.23750/abm.v92i2.10142