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Bowel Ischemia in COVID-19: A Systematic Review
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  • Suyog Patel,
  • Charmy Parikh,
  • Deepak Verma,
  • Ramaswamy Sundararajan ,
  • Upasana Agrawal,
  • Niharika Bheemisetty ,
  • Radhika Akku,
  • Diana Sánchez Velazco,
  • Madeeha Subhan Waleed
Suyog Patel
Department of Medicine, B.J. Medical College, Ahmedabad, India
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Charmy Parikh
Pramukh Swami Medical College, India
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Deepak Verma
Department of Medicine, Janaki Medical College, Nepal
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Ramaswamy Sundararajan
JSS Medical College, Mysore, India ( JSS Academy of Higher Education and Research)
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Upasana Agrawal
Kasturba Medical College, Manipal, India
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Niharika Bheemisetty
Department of Pediatrics, KS multi-speciality hospital,Telangana
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Radhika Akku
Mediciti Institute of Medical Sciences, India
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Diana Sánchez Velazco
Department of Medicine, Cayetano Heredia Peruvian University, Perú
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Madeeha Subhan Waleed
Department of Medicine,Ayub Medical College,Pakistan
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Abstract

Abstract: Background: Gastrointestinal complications of this COVID-19 have been reported over the last year. One such manifestation is bowel ischemia. This study thus aims to provide a more holistic review of our current understanding of COVID-19 induced bowel ischemia. Method and Results: A meticulous search was performed using different keywords in PubMed, EMBASE, and Google Scholar. Fifty-two articles were included in our study after applying inclusion and exclusion criteria and performing the qualitative assessment of the studies. A total of 25,702 patients were included in our study after the completion of the qualitative assessment. Discussion: COVID-19 commonly presents in the GIT as diarrhea, vomiting, and nausea. The mechanism of bowel ischemia is associated with the formation of emboli which is related to COVID-19’s high affinity for angiotensin-converting enzyme-2 on enterocytes, affecting the superior mesenteric vessels. Clinically, patients presented with abdominal pain and vomiting. CT angiography of the abdomen and pelvis showed acute mesenteric ischemia. Management was usually initiated with gastric decompression, fluid resuscitation, and hemodynamic support. Surgical intervention was also sought. Conclusion: Mesenteric ischemia presenting in patients with COVID-19 has to be considered when symptoms of severe abdominal pain are present. More research and guidelines are required to be able to triage patients with COVID-19 to suspect mesenteric ischemia and to help in diagnosis and management.
06 Aug 2021Submitted to International Journal of Clinical Practice
07 Aug 2021Submission Checks Completed
07 Aug 2021Assigned to Editor
16 Aug 2021Reviewer(s) Assigned
02 Sep 2021Review(s) Completed, Editorial Evaluation Pending
03 Sep 2021Editorial Decision: Revise Major
27 Sep 20211st Revision Received
28 Sep 2021Submission Checks Completed
28 Sep 2021Assigned to Editor
28 Sep 2021Review(s) Completed, Editorial Evaluation Pending
01 Oct 2021Editorial Decision: Accept
10 Oct 2021Published in International Journal of Clinical Practice. 10.1111/ijcp.14930