Acute upper gastrointestinal mucosal lesions caused by COVID-19 infection: a case report

BackgroundCOVID-19 enters human cells by binding its surface protein to angiotensin-converting enzyme 2 (ACE2) present in the host. ACE2 is expressed in various organ cells in the human body. Consequently, SARS-CoV-2 can invade gastrointestinal epithelial cells through ACE2, leading to the manifesta...

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Main Authors: Ze Qi, Bing-Jie Yan, Ruo-Han Hu, Lei Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1618638/full
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author Ze Qi
Bing-Jie Yan
Ruo-Han Hu
Lei Li
author_facet Ze Qi
Bing-Jie Yan
Ruo-Han Hu
Lei Li
author_sort Ze Qi
collection DOAJ
description BackgroundCOVID-19 enters human cells by binding its surface protein to angiotensin-converting enzyme 2 (ACE2) present in the host. ACE2 is expressed in various organ cells in the human body. Consequently, SARS-CoV-2 can invade gastrointestinal epithelial cells through ACE2, leading to the manifestation of gastrointestinal symptoms. However, the occurrence of gastrointestinal mucosal lesions and bleeding is rare.Case summaryA 34-year-old man with no previous medical history was hospitalized due to two weeks of nausea, hematemesis, and one week of fever. Gastroscopy showed widespread inflammation and necrotic tissue in the stomach, suggesting erosive hemorrhagic gastritis. Laboratory tests confirmed COVID-19 infection and blood hypercoagulability. After treatment, the patient was discharged. Follow-up gastroscopy showed mucosal lesion healing after recovery from COVID-19.ConclusionThe patient underwent endoscopy and pathological analysis. ACE2 immunohistochemistry was performed on the pathological tissues to investigate the cause of the lesions. After ruling out other possible factors, the final results indicated that the patient’s gastric mucosal lesion was caused by COVID-19 infection. This suggests that further research on COVID-19 should consider its gastrointestinal symptoms and diseases.
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spelling doaj-art-59b1852592b04787b41debcee26a2ed12025-08-20T03:09:34ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.16186381618638Acute upper gastrointestinal mucosal lesions caused by COVID-19 infection: a case reportZe Qi0Bing-Jie Yan1Ruo-Han Hu2Lei Li3Department of Gastroenterology, Affiliated Hospital of Shandong Second Medical University, Weifang, ChinaDepartment of Gastroenterology, Affiliated Hospital of Shandong Second Medical University, Weifang, ChinaShandong Second Medical University, Weifang, ChinaDepartment of Gastroenterology, Affiliated Hospital of Shandong Second Medical University, Weifang, ChinaBackgroundCOVID-19 enters human cells by binding its surface protein to angiotensin-converting enzyme 2 (ACE2) present in the host. ACE2 is expressed in various organ cells in the human body. Consequently, SARS-CoV-2 can invade gastrointestinal epithelial cells through ACE2, leading to the manifestation of gastrointestinal symptoms. However, the occurrence of gastrointestinal mucosal lesions and bleeding is rare.Case summaryA 34-year-old man with no previous medical history was hospitalized due to two weeks of nausea, hematemesis, and one week of fever. Gastroscopy showed widespread inflammation and necrotic tissue in the stomach, suggesting erosive hemorrhagic gastritis. Laboratory tests confirmed COVID-19 infection and blood hypercoagulability. After treatment, the patient was discharged. Follow-up gastroscopy showed mucosal lesion healing after recovery from COVID-19.ConclusionThe patient underwent endoscopy and pathological analysis. ACE2 immunohistochemistry was performed on the pathological tissues to investigate the cause of the lesions. After ruling out other possible factors, the final results indicated that the patient’s gastric mucosal lesion was caused by COVID-19 infection. This suggests that further research on COVID-19 should consider its gastrointestinal symptoms and diseases.https://www.frontiersin.org/articles/10.3389/fmed.2025.1618638/fullCOVID-19COVID-19 pandemicSARS-CoV-2 virusACE2digestive system infectionacute upper gastrointestinal mucosal lesions
spellingShingle Ze Qi
Bing-Jie Yan
Ruo-Han Hu
Lei Li
Acute upper gastrointestinal mucosal lesions caused by COVID-19 infection: a case report
Frontiers in Medicine
COVID-19
COVID-19 pandemic
SARS-CoV-2 virus
ACE2
digestive system infection
acute upper gastrointestinal mucosal lesions
title Acute upper gastrointestinal mucosal lesions caused by COVID-19 infection: a case report
title_full Acute upper gastrointestinal mucosal lesions caused by COVID-19 infection: a case report
title_fullStr Acute upper gastrointestinal mucosal lesions caused by COVID-19 infection: a case report
title_full_unstemmed Acute upper gastrointestinal mucosal lesions caused by COVID-19 infection: a case report
title_short Acute upper gastrointestinal mucosal lesions caused by COVID-19 infection: a case report
title_sort acute upper gastrointestinal mucosal lesions caused by covid 19 infection a case report
topic COVID-19
COVID-19 pandemic
SARS-CoV-2 virus
ACE2
digestive system infection
acute upper gastrointestinal mucosal lesions
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1618638/full
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AT leili acuteuppergastrointestinalmucosallesionscausedbycovid19infectionacasereport