Successful recovery of COVID-19-associated recurrent diarrhea and gastrointestinal hemorrhage using convalescent plasma
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CASE REPORT
Open Access
Successful recovery of COVID-19-associated recurrent diarrhea and gastrointestinal hemorrhage using convalescent plasma Li-Bo Zhang1,2†, Rong-Rong Pang1,2†, Qing-Hua Qiao3,4†, Zhi-Hua Wang4,5,6†, Xin-Yi Xia1,4,6* , Chang-Jun Wang6,7* and Xiao-Li Xu6,8*
Abstract Background: Gastrointestinal symptoms are not rare among coronavirus disease 2019 (COVID-19) patients, but there have been no reports regarding convalescent plasma therapy for the recovery of gastrointestinal problems in COVID-19 patients. Case presentation: We present two cases of patients with COVID-19-associated recurrent diarrhea and positive fecal occult blood who successfully recovered after a one-time convalescent plasma administration. Conclusion: When COVID-19 patients develop recurrent or refractory gastrointestinal symptoms and fail to respond to the available treatment, alternative therapy with convalescent plasma administration may be considered. Keywords: Coronavirus disease 2019 (COVID-19), Convalescent plasma, SARS-CoV-2 virus, Gastrointestinal symptoms
Background Coronavirus disease 2019 (COVID-19) is an emerging disease caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and it has spread throughout the world [1]. In terms of clinical presentation of the new coronavirus infection, the main clinical presentation is acute febrile illness with pulmonary manifestations [2]. However, recent studies have reported the detection of the SARS-CoV-2 virus in feces [3–5], and endoscopic examination revealed COVID-19associated ulcers and bleeding in gastrointestinal tissues in some patients [6]. In autopsy studies, the beaded * Correspondence: [email protected]; [email protected]; [email protected] † Li-Bo Zhang, Rong-Rong Pang, Qing-Hua Qiao and Zhi-Hua Wang contributed equally to this work. 1 COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, the First School of Clinical Medicine, Southern Medical University, Nanjing 210002, Jiangsu, China 6 Joint Expert Group for COVID-19, Wuhan Huoshenshan Hospital, Wuhan 430100, Hubei, China Full list of author information is available at the end of the article
intestine may be a more intuitive finding [7]. Accumulated evidence supports SARS-CoV-2 being transmitted through the gastrointestinal tract and targeting the gastrointestinal tract through angiotensin-converting enzyme 2 (ACE2) [8]. In fact, gastrointestinal symptoms are not rare in COVID-19 patients. In previous reports, 2–10% of patients with COVID-19 had gastrointestinal symptoms, such as diarrhea, vomiting and nausea [9–13]. Gastrointestinal bleeding was also found in SARS-CoV-2 infected patients [6, 14]. To date, there is no effective antiviral therapy for COVID-19. The main treatments are supportive care in the forms of supplementary oxygen therapy and extracorporeal membrane oxygenation. Convalescent plasma (CP) has been used as a last resort to treat many infectious diseases. Expectedly, CP infusion was suggested for th
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