Pseudomembranous Colitis in a Coronavirus Disease 19 positive patient : not a simple issue

Abstract Since its emergence, Coronavirus Disease (Covid-19) rapidly spread worldwide and was responsible for a global pandemic. Although it was initially considered a respiratory disease, recent studies have evidenced that Covid-19 had serious systemic adverse effects involving major organs, including those of the digestive system. Histological lesions associated with these manifestations have rarely been reported. We, herein, present a singular case of pseudomembranous colitis (PMC), proven histologically, in a 73-year-old Covid-19 positive female patient. We aim to study the clinico-pathological characteristics of this association. A 73-year-old Covid positive patient was intubated and put on intravenous antibiotherapy after the deterioration of her respiratory function. Ten days after admission, the patient presented abdominal distension and melena. An abdominal tomography scan showed a left mesenteric infarction related to a thrombosis at the origin of the left mesenteric artery. A left hemicolectomy was performed in emergency. Macroscopic examination of the hemicolectomy specimen showed an edematous colonic mucosa, with multiple ulcerations covered by a whitish necrotic coating reminiscent of false membranes. Histological examination confirmed the diagnosis of PMC. The patient presented a septic shock and died six days after the operation. The PMC could have resulted from the use of antibiotics. However, the direct involvement of Covid-19 in the occurrence of this PMC cannot be excluded. Further studies are needed to evaluate the direct correlation between Covid-19 and PMC.