Cytomegalovirus-Induced Gastrointestinal Bleeding and Pancreatitis Complicating Severe Covid-19 Pneumonia: a Paradigmatic Case.

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Giacomo Marchi
Alice Vianello
Ernesto Crisafulli
Alessio Maroccia
Stefano Francesco Crinò
Sara Pecori
Giulia A Zamboni
Fulvia Mazzaferri
Evelina Tacconelli
Domenico Girelli


cytomegalovirus, sars-cov-2


Key points:

  • COVID-19 is a novel pandemic disease whose pathophysiology and clinical description are still not completely defined.

  • Besides respiratory symptoms, gastrointestinal (GI) symptoms (especially including anorexia, diarrhea, and abdominal pain) represent the commonest clinical manifestations.

  • Emerging data point out that severe SARS-CoV-2 infection causes an immune dysregulation, which in turn may favor other infections.

  • Here we describe a patient with severe COVID-19 pneumonia who developed in the resolving phase abdominal pain associated to cytomegalovirus (CMV)-induced duodenitis with bleeding, and pancreatitis.

  • A high level of suspicion toward multiple infections, including CMV, should be maintained in COVID-19 patients with heterogeneous clinical manifestations.


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