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Impact of COVID-19 on inflammatory bowel disease practice and perspectives for the future

World Journal of Gastroenterology 2021年第33期27卷 5520-5535页

作者： Chiara Viganò Giacomo Mulinacci Andrea Palermo Donatella Barisani lorena pirola Maria Fichera Pietro Invernizzi Sara Massironi Division of Gastroenterology and Center for Autoimmune Liver Diseases Department of Medicine and SurgeryUniversity of Milano-BicoccaMonza 20900Italy European Reference Network on Hepatological Diseases San Gerardo HospitalMonza 20900Italy School of Medicine and Surgery University of Milano-BicoccaMonza 20900Italy

Coronavirus disease 2019(COVID-19)is an infectious disease caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2(SARS-CoV-2);since its first description in December 2019,it has rapidly spread to a global *** concerns have been raised concerning patients with inflammatory bowel diseases(IBD),which are chronic autoimmune inflammatory disorders of the gut that frequently require immunosuppressive and biological therapies to control their *** evidence has so far demonstrated that patients with IBD are not at increased risk of contracting severe acute respiratory syndrome coronavirus 2 *** for the general population,the identified risk factors for severe COVID-19 course among IBD patients have been established to be advanced age and the presence of *** with high-dose corticosteroids has also been associated with an increased risk of death in IBD patients with *** on COVID-19 is constantly evolving,with data growing at a rapid *** will guarantee better knowledge and stronger evidence to help physicians in the choice of the best therapeutic approach for each patient,concurrently controlling for the risk of IBD disease under treatment and the risk of COVID-19 adverse outcomes and balancing the ***,the impact of the enormous number of severe respiratory patients on healthcare systems and facilities has led to an unprecedented redeployment of healthcare resources,significantly impacting the care of patients with chronic *** this newly changed environment,the primary aim is to avoid harm whilst still providing adequate *** has been applied and is strongly encouraged for patients without the necessity of infusion therapy and whose conditions are *** severe acute respiratory syndrome coronavirus 2 pandemic has already revolutionized the management of patients with chronic immune-mediated diseases such as *** and indirect

关键词： Inflammatory bowel disease Ulcerative colitis Crohn disease COVID-19 SARS-CoV-2 Autoimmunity

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Acute mesenteric ischemia and small bowel imaging findings in COVID-19:A comprehensive review of the literature

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World Journal of Gastrointestinal Surgery 2021年第7期13卷 702-716页

作者： lorena pirola Andrea Palermo Giacomo Mulinacci Laura Ratti Maria Fichera Pietro Invernizzi Chiara Viganò Sara Massironi Division of Gastroenterology and Center for Autoimmune Liver Diseases Department of Medicine and SurgeryUniversity of Milano-BicoccaMonza 20900Italy European Reference Network on Hepatological Diseases San Gerardo HospitalMonza 20900Italy

BACKGROUND Coronavirus disease 2019(COVID-19),an infectious condition caused by severe acute respiratory syndrome coronavirus 2(SARS-Co V-2),has rapidly spread worldwide since its first description in Wuhan in December *** though respiratory manifestations are the most prevalent and responsible for disease morbidity and mortality,extrapulmonary involvement has progressively gained *** particular,gastrointestinal(GI)signs and symptoms,reported in up to two-thirds of patients with COVID-19,might represent the first and,in some cases,the only disease *** presence has been associated in some studies with an increased risk of a severe disease *** pathogenic mechanisms explaining GI tract involvement are either direct viral access to intestinal cells via angiotensin-converting enzyme 2 or indirect damage of the intestinal wall through mesenteric ischemia induced by the hypercoagulable state associated with COVID-19 *** not typical of SARS-Co V-2 infection,several small bowel manifestations have been described in infected patients who underwent any form of abdominal *** radiological findings were mainly reported in patients with abdominal symptoms,among which abdominal pain was the most *** To discuss small bowel radiological manifestations of SARS-Co V-2 infection in abdominal imaging *** Bibliographical searches were performed in Pub Med,using the following keywords:"COVID-19"AND"imaging"AND"gastrointestinal"OR"abdominal"OR"small bowel".RESULTS Of 62 patients with described radiologic small bowel alterations,mesenteric ischemia was diagnosed in 31 cases(50%),small bowel wall thickening in 10 cases(16%),pneumatosis in nine cases(15%),intussusception in eight cases(13%),pneumoperitoneum in two cases(3%)and paralytic ileus in two cases(3%).We also reported mesenteric adipose tissue hypertrophy and lymph nodes enlargement in a young *** So far it is difficult to establish whether

关键词： COVID-19 SARS-CoV-2 Radiology Small intestine Abdomen

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