Scans of COVID-19 Patients Reveal What the Coronavirus Can Do to Your Bowel

Scans of the bodies of COVID-19 patients have revealed what the coronavirus can do to the bowel.

For the study, which is thought to mark the first time abdominal images of COVID-19 patients have been published in a scientific journal, researchers at Massachusetts General Hospital and Harvard Medical School looked at the scans of 412 people who were admitted to a care center between March 27 and April 10. The patients were sent for scans for a variety of reasons, including complaints of abdominal pain and abnormal liver test results.

The team hoped assessing the scans would shed light on how the virus affects parts of the body aside from the lungs.

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covid-19, bowel

A CT of the abdomen and pelvis in a 47-year-old man with abdominal tenderness. The scan shows signs of inadequate blood supply, gas cysts in the bowel wall, and thickened loop of small bowel in the pelvis.
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Of the total participants, 241 were men, 171 were women. Thirty-four percent of the participants had at least one gastrointestinal symptom, and 136 needed intensive care treatment. The patients were aged 57 on average, and ranged from 18 to 90 years old. Health care workers performed radiographs on 137 of the patients, ultrasounds on 44, CT scans on 42, and an MRI on one.

The findings published in the journal Radiology showed signs of bowel abnormalities and problems with bile flow were common in the patients' scans. Some 31 percent of the CT scans showed patients had problems with their bowel wall.

Patients were also found to have conditions including a thickened bowel wall, as well as gas cysts in the bowel wall and the vein which drains blood from the gastrointestinal tract and spleen to the liver. One patient had a perforated bowel. In 20 percent of ICU patients, there were signs of inadequate blood supply to the bowel.

Study co-author Dr. Rajesh Bhayana, abdominal imaging fellow in the Department of Radiology at Massachusetts General Hospital in Boston, commented in a statement: "We found bowel abnormalities on imaging in patients with COVID-19, more commonly in sicker patients who went to the ICU.

"Some findings were typical of bowel ischemia, or dying bowel, and in those who had surgery we saw small vessel clots beside areas of dead bowel.

Bhayana explained: "Patients in the ICU can have bowel ischemia for other reasons, but we know COVID-19 can lead to clotting and small vessel injury, so [the] bowel might also be affected by this."

More research is needed to clarify why COVID-19 patients encounter bowel problems, and in particular the role of blood clots in cell death in this part of the body, and to uncover whether the virus itself is responsible, the authors wrote.

The team considered why COVID-19 patients may have gut issues, and highlighted that the enzyme in our bodies which the coronavirus uses to infect us is expressed in cells in the intestines, in the arteries and veins, and the gastrointestinal tract as well as the lungs. They also pointed out that past research suggests the coronavirus could inflame the cells that line the inside of the blood vessels.

The most notable limitation of the study was that it included patients from one health care center, so the results might not be generalizable to a wider population, they said.

The study is the latest to explore how the coronavirus, which has infected over 4.1 million people according to Johns Hopkins University, can affect the digestive system. A study published in the journal Science last week, for instance, found that the coronavirus can infect and replicate in human intestine cells.

Since the pandemic started late last year, 286,669 people have died, and 1.4 million are known to have recovered. As the graph by Statista below shows, the U.S. has the most known cases in the world.

COVID-19 U.S. Statista chart
Countries with most COVID-19 cases.
Scans of COVID-19 Patients Reveal What the Coronavirus Can Do to Your Bowel | Health
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