Coronavirus Disease and Abdominal Pain: Mechanism, Diagnostic, and Treatment
DOI:
https://doi.org/10.3889/oamjms.2021.6168Keywords:
Abdominal pain, Coronavirus Disease, Gastrointestinal symptoms, Atypical manifestationAbstract
BACKGROUND: On March 11, 2020, the General Director of the World Health Organization has announced that according to the organization, the level of spread and severity of symptoms of coronavirus disease (COVID-19) is becoming alarming and because of that, it can be characterized as a pandemic. The assessment of the World Health Organization stimulated more urgent and belligerent actions from the governments as the number of case reports and studies on COVID-19 symptoms and treatment increased dramatically.
AIM: In this paper, the aim is to make a review of the studies and case reports/series that indicate that abdominal pain is one of the manifestations of COVID-19.
METHODS: A search was performed on two electronic databases: PubMed Central and Google Scholar, using the key words “COVID-19 and abdominal pain.” Case reports and case series in adults and children were included regardless of the language, region, or the publication date. The methods of synthesis and comparison were also used.
RESULTS: In general, it can be noted that the manifestation of the COVID-19 infection on the digestive tract and the consequences on the same are not fully examined.
CONCLUSION: The conclusion of the analyzed papers is that clinical practitioners in COVID-19 pandemic should carefully distinguish abdominal pain and other GI symptoms from COVID-19 manifestations and should exclude acute surgical condition.
Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Widyadharma PE, Sari NN, Pradnyaswari KE, Yuwana KT, Adikarya IP, Tertia C, et al. Pain as clinical manifestations of COVID-19 infection and its management in the pandemic era: A literature review. Egypt J Neurol Psychiatr Neurosurg. 2020;56(1):121. https://doi.org/10.1186/s41983-020-00258-0 PMid:33390724
Saeed U, Sellevoll HB, Young VS, Sandbaek G, Glomsaker T, Mala T. COVID-19 may present with acute abdominal pain. Br J Surg. 2020;107(7):e186-7. https://doi.org/10.1002/bjs.11674 PMid:32343396
Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, et al. Clinical characteristics of novel Coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J (Engl). 2020;133(9):1025-31. https://doi.org/10.1097/cm9.0000000000000744 PMid:32044814
Stokes EK, Zambrano LD, Anderson KN, Marder EP, Raz KM, Felix SE, et al. Coronavirus disease 2019 case surveillance- United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(24):759-65. https://doi.org/10.15585/mmwr.mm6924e2 PMid:32555134
Amaral LTW, Brito VM, Beraldo GL, Fonseca EK, Yokoo P, Talans A, Filho MO, et al. Abdominal symptoms as initial manifestation of COVID-19: A case series. Einstein (São Paulo). 2020;18:eRC5831. https://doi.org/10.31744/einstein_journal/2020rc5831 PMid:33084795
Zang J, Garrett S, Sun J. Gastrointestinal symptoms, pathophysiology and treatment in COVID-19. Genes Dis. 2020; doi: 10.1016/j.gendis.2020.08.013 [Epub ahead of print]. PMid:33521210
Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of Coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.
Ye Q, Wang B, Zhang T, Xu J, Shang S. The mechanism and treatment of gastrointestinal symptoms in patients with COVID-19. Am J Physiol Gastrointest Liver Physiol. 2020;319(2):G245-52. PMid:32639848
Perisetti A, Goyal H, Gajendran M, Boregowda U, Mann R, Sharma N. Prevalence, mechanisms, and implications of gastrointestinal symptoms in COVID-19. Front Med. 2020;7:588711. https://doi.org/10.3389/fmed.2020.588711 PMid:33195352
Ying M, Lu B, Pan J, Lu G, Zhou S, Wang D, et al. COVID-19 with acute cholecystitis: A case report. BMC Infect Dis. 2020;20(1):437. https://doi.org/10.1186/s12879-020-05164-7 PMid:32571224
Mattone E, Sofia M, Schembari E, Palumbo V, Bonaccorso R, Randazzo V, et al. Acute acalculous cholecystitis on a COVID- 19 patient: A case report. Ann Med Surg (Lond). 2020;58:73-5. https://doi.org/10.21203/rs.3.rs-42230/v1 PMid:32895611
Balaphas A, Gkoufa K, Meyer J, Peloso A, Bornand A, McKee TA, et al. COVID-19 can mimic acute cholecystitis and is associated with the presence of viral RNA in the gallbladder wall. J Hepatol. 2020;73(6):1566-8. https://doi.org/10.1016/j.jhep.2020.08.020 PMid:32890595
Famularo G, Spada PL. COVID-19-related cholecystitis. Clin Res Hepatol Gastroenterol. 2021;45(2):101635. PMid:33588314
Walpole SC, McHugh R, Samuel J, Schmid ML. COVID-19 presenting as severe, persistent abdominal pain and causing late respiratory compromise in a 33-year-old man. BMJ Case Rep. 2020;13(6):e236030. https://doi.org/10.1136/ bcr-2020-236030 PMid:32546557
Ahmed AO, Mohamed SF, Saleha AO, Al-Shokria SD, Ahmedb K, Mohamed MF. Acute abdomen-like-presentation associated with SARS-CoV-2 infection. IDCases. 2020;21:e00895. https://doi.org/10.1016/j.idcr.2020.e00895 PMid:32691004
Ahmed AO, Badawi M, Ahmed K, Mohamed MFH. Case report: COVID-19 masquerading as an acute surgical abdomen. Am J Trop Med Hyg. 2020;103(2):841-3. https://doi.org/10.4269/ajtmh.20-0559 PMid:32524962
Abdalhadi A, Alkhatib M, Mismar AY, Awouda W, Albarqouni L. Can COVID-19 present like appendicitis? IDCases. 2020;21:e00860. https://doi.org/10.1016/j.idcr.2020.e00860 PMid:32523872
Pazgan-Simon M, Rorat M, Buczyńska I, Zińczuk A, Simon K. Gastrointestinal symptoms as the first, atypical indication of severe acute respiratory syndrome Coronavirus 2 infection. Pol Arch Intern Med. 2020;130(4):338-9. https://doi.org/10.20452/pamw.15278 PMid:32250094
Voutsinas N, Toussie D, Jacobi A, Bernheim A, Chung M. Incidental CT findings in the lungs in COVID-19 patients presenting with abdominal pain. Clin Imaging. 2020;67:1-4. https://doi.org/10.1016/j.clinimag.2020.05.021 PMid:32492557
Mahan K, Kabrhel C, Goldsmith AJ. Abdominal pain in a patient with COVID-19 infection: A case of multiple thromboemboli. Am J Emerg Med. 2020;38(10):2245.e3-5. https://doi.org/10.1016/j.ajem.2020.05.054 PMid:32513452
Gérald G, Frandon JA, Vendrell JF. COVID-19 patients presenting with afebrile acute abdominal pain. Clin Med. 2020;20(3):e4-6. https://doi.org/10.7861/clinmed.2020-0150 PMid:32341078
Purayil N, Sirajudeen J, Naushad VA, Mathew J. COVID-19 presenting as acute abdominal pain: A case report. Cureus. 2020;12(8):e9659. https://doi.org/10.7759/cureus.9659 PMid:32923256
Altermanini M, Habib MB, Elzouki AN. A challenging case of COVID-19 infection presented with isolated acute abdominal pain: A case report and literature review. SAGE Open Med Case Rep. 2020;9:1-5. https://doi.org/10.1177/2050313x20983211 PMid:33633860
Gora-Gebka M, Liberek A, Bako W, Szarszewski A, Kamińska B, Korzon M. Acute acalculous cholecystitis of viral etiology-a rare condition in children? J Pediatr Surg. 2008;43(1):e25-7. https://doi.org/10.1016/j.jpedsurg.2007.10.073 PMid:18206441
Strehle EM, De Alwis Y, Saleem M. Epstein-Barr virus-associated acute cholecystitis in a teenager. Ultrasound. 2014;22(2):123-5. https://doi.org/10.1177/1742271x13513223 PMid:27433206
Poddighe D, Sazonov V. Acute acalculous cholecystitis in children. World J Gastroenterol. 2018;24(43):4870-9. https://doi.org/10.3748/wjg.v24.i43.4870 PMid:30487697
Langenohl R, Young S, Couperus K. Acute acalculous cholecystitis from infection with Epstein-Barr virus in a previously healthy child: A case report. Clin Pract Cases Emerg Med. 2020;4(3):393-6. https://doi.org/10.5811/cpcem.2020.4.46301 PMid:32926694
Harwood R, Partridge R, Minford J, Almond S. Paediatric abdominal pain in the time of COVID-19: A new diagnostic dilemma. J Surg Case Rep. 2020;2020:rjaa337. https://doi.org/10.1093/jscr/rjaa337 PMid:32994918
Tullie L, Ford K, Bisharat M, Watson T, Thakkar H, Mullassery D, et al. Gastrointestinal features in children with COVID-19: An observation of varied presentation in eight children. Lancet Child Adolesc Health. 2020;4(7):e19-20. https://doi.org/10.1016/s2352-4642(20)30165-6 PMid:32442420
Saleh R, Rahimi H, Javadi N, Amini S, Saeidi S, Pourmoghaddas, Z. Abdominal signs and symptoms of COVID- 19 in children. Arch Pediatr Infect Dis. 2021;9(1):e107259. https://doi.org/10.5812/pedinfect.107259
Falch C, Vicente D, Häberle H, Kirschniak A, Müller S, Nissan A, et al. Treatment of acute abdominal pain in the emergency room: A systematic review of the literature. Eur J Pain. 2014;18(7):902- 13. https://doi.org/10.1002/j.1532-2149.2014.00456.x PMid:24449533
Hijaz NM, Friesen CA. Managing acute abdominal pain in pediatric patients: Current perspectives. Pediatric Health Med Ther. 2017;29(8):83-91. https://doi.org/10.2147/phmt.s120156 PMid:29388612
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2021 Aleksandra Bozhinovska (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0)
