A histopathological view at the long-term effects of COVID-19 on the gastrointestinal system in children: a single center experience

Background. Subacute and chronic long-term effects of coronavirus disease 2019 (COVID-19) in different organ systems have been studied in post-COVID patients recently. COVID-19 may cause gastrointestinal (GI) system findings due to the presence of its receptor, angiotensin converting enzyme t...

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Main Authors: Semih Sandal, Özlem Tanas, Şefika Karabulut, Muzaffer Çaydere, Sema Hücümenoğlu
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2023-06-01
Series:The Turkish Journal of Pediatrics
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Online Access:https://turkjpediatr.org/article/view/48
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author Semih Sandal
Özlem Tanas
Şefika Karabulut
Muzaffer Çaydere
Sema Hücümenoğlu
author_facet Semih Sandal
Özlem Tanas
Şefika Karabulut
Muzaffer Çaydere
Sema Hücümenoğlu
author_sort Semih Sandal
collection DOAJ
description Background. Subacute and chronic long-term effects of coronavirus disease 2019 (COVID-19) in different organ systems have been studied in post-COVID patients recently. COVID-19 may cause gastrointestinal (GI) system findings due to the presence of its receptor, angiotensin converting enzyme type 2 (ACE2), which is extensively expressed in the GI tract. In this study, we aimed to evaluate the post-infectious histopathological alterations of COVID-19 in pediatric patients who had GI symptoms. Methods. Fifty-six specimens of upper endoscopic biopsies (including esophagus, stomach, bulbus and duodenum) obtained from seven patients and 12 specimens of lower endoscopic biopsies obtained from one patient who had GI symptoms after having COVID-19 (proven by polymerase chain reaction [PCR]) were evaluated as the study group. Forty specimens from five patients presenting with similar complaints but without COVID-19 were selected as the control group. All biopsy materials were immunohistochemically stained with the anti-SARS-CoV-2S1 antibody. Results. In all biopsies of the study group, anti-SARS-CoV-2S1 antibody was detected with moderate cytoplasmic positivity in epithelial cells and inflammatory cells in the lamina propria. No staining was observed in the control group. Epithelial damage, thrombus, or no other specific findings were detected in the GI tract biopsies of any of the patients. Conclusions. The virus antigen was detected immunohistochemically in the stomach and duodenum, but not in the esophagus, even months after infection and causes gastritis and duodenitis. No specific histopathological finding was observed from non-COVID-19 gastritis/duodenitis. Therefore, the post-COVID-19 GI system involvement should be kept in mind in patients presenting with dyspeptic symptoms even if several months have passed.
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spelling doaj-art-a86755d48a36494a9ef3cfdd2acf6f872025-08-20T02:00:55ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212023-06-0165310.24953/turkjped.2022.1039A histopathological view at the long-term effects of COVID-19 on the gastrointestinal system in children: a single center experienceSemih Sandal0Özlem Tanas1Şefika Karabulut2Muzaffer Çaydere3Sema Hücümenoğlu4Department of Pediatric Gastroenterology, Ankara Training and Research Hospital, Ankara.Department of Pathology, Ankara Training and Research Hospital, Ankara.Department of Medical Microbiology-Virology, Gülhane Institute of Health Science, Ankara, Türkiye.Department of Pathology, Ankara Training and Research Hospital, Ankara.Department of Pathology, Ankara Training and Research Hospital, Ankara. Background. Subacute and chronic long-term effects of coronavirus disease 2019 (COVID-19) in different organ systems have been studied in post-COVID patients recently. COVID-19 may cause gastrointestinal (GI) system findings due to the presence of its receptor, angiotensin converting enzyme type 2 (ACE2), which is extensively expressed in the GI tract. In this study, we aimed to evaluate the post-infectious histopathological alterations of COVID-19 in pediatric patients who had GI symptoms. Methods. Fifty-six specimens of upper endoscopic biopsies (including esophagus, stomach, bulbus and duodenum) obtained from seven patients and 12 specimens of lower endoscopic biopsies obtained from one patient who had GI symptoms after having COVID-19 (proven by polymerase chain reaction [PCR]) were evaluated as the study group. Forty specimens from five patients presenting with similar complaints but without COVID-19 were selected as the control group. All biopsy materials were immunohistochemically stained with the anti-SARS-CoV-2S1 antibody. Results. In all biopsies of the study group, anti-SARS-CoV-2S1 antibody was detected with moderate cytoplasmic positivity in epithelial cells and inflammatory cells in the lamina propria. No staining was observed in the control group. Epithelial damage, thrombus, or no other specific findings were detected in the GI tract biopsies of any of the patients. Conclusions. The virus antigen was detected immunohistochemically in the stomach and duodenum, but not in the esophagus, even months after infection and causes gastritis and duodenitis. No specific histopathological finding was observed from non-COVID-19 gastritis/duodenitis. Therefore, the post-COVID-19 GI system involvement should be kept in mind in patients presenting with dyspeptic symptoms even if several months have passed. https://turkjpediatr.org/article/view/48COVID-19biopsychildendoscopygastrointestinalimmunohistochemistry
spellingShingle Semih Sandal
Özlem Tanas
Şefika Karabulut
Muzaffer Çaydere
Sema Hücümenoğlu
A histopathological view at the long-term effects of COVID-19 on the gastrointestinal system in children: a single center experience
The Turkish Journal of Pediatrics
COVID-19
biopsy
child
endoscopy
gastrointestinal
immunohistochemistry
title A histopathological view at the long-term effects of COVID-19 on the gastrointestinal system in children: a single center experience
title_full A histopathological view at the long-term effects of COVID-19 on the gastrointestinal system in children: a single center experience
title_fullStr A histopathological view at the long-term effects of COVID-19 on the gastrointestinal system in children: a single center experience
title_full_unstemmed A histopathological view at the long-term effects of COVID-19 on the gastrointestinal system in children: a single center experience
title_short A histopathological view at the long-term effects of COVID-19 on the gastrointestinal system in children: a single center experience
title_sort histopathological view at the long term effects of covid 19 on the gastrointestinal system in children a single center experience
topic COVID-19
biopsy
child
endoscopy
gastrointestinal
immunohistochemistry
url https://turkjpediatr.org/article/view/48
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