TY - JOUR
T1 - Pneumatosis Intestinalis in the Setting of COVID-19
T2 - A Single Center Case Series From New York
AU - Miyara, Santiago J.
AU - Becker, Lance B.
AU - Guevara, Sara
AU - Kirsch, Claudia
AU - Metz, Christine N.
AU - Shoaib, Muhammad
AU - Grodstein, Elliot
AU - Nair, Vinay V.
AU - Jandovitz, Nicholas
AU - McCann-Molmenti, Alexia
AU - Hayashida, Kei
AU - Takegawa, Ryosuke
AU - Shinozaki, Koichiro
AU - Yagi, Tsukasa
AU - Aoki, Tomoaki
AU - Nishikimi, Mitsuaki
AU - Choudhary, Rishabh C.
AU - Cho, Young Min
AU - Zanos, Stavros
AU - Zafeiropoulos, Stefanos
AU - Hoffman, Hannah B.
AU - Watt, Stacey
AU - Lumermann, Claudio M.
AU - Aronsohn, Judith
AU - Shore-Lesserson, Linda
AU - Molmenti, Ernesto P.
N1 - Publisher Copyright:
© Copyright © 2021 Miyara, Becker, Guevara, Kirsch, Metz, Shoaib, Grodstein, Nair, Jandovitz, McCann-Molmenti, Hayashida, Takegawa, Shinozaki, Yagi, Aoki, Nishikimi, Choudhary, Cho, Zanos, Zafeiropoulos, Hoffman, Watt, Lumermann, Aronsohn, Shore-Lesserson and Molmenti.
PY - 2021/6/4
Y1 - 2021/6/4
N2 - 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.
AB - 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.
KW - COVID-19
KW - IL-6 inhibitor
KW - SARS-CoV-2
KW - ischemia-reperfusion injury
KW - mesenteric ischemia
KW - molecular targeted therapy
KW - pneumatosis intestinalis
KW - tocilizumab
UR - https://www.scopus.com/pages/publications/85108152242
U2 - 10.3389/fmed.2021.638075
DO - 10.3389/fmed.2021.638075
M3 - Article
AN - SCOPUS:85108152242
SN - 2296-858X
VL - 8
JO - Frontiers in Medicine
JF - Frontiers in Medicine
M1 - 638075
ER -