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\begin{document}

\title{Bowel Ischemia in COVID-19: A Systematic Review}



\author[1]{Suyog Patel}%
\author[2]{Charmy Parikh}%
\author[3]{Deepak  Verma}%
\author[4]{Ramaswamy  Sundararajan }%
\author[5]{Upasana Agrawal}%
\author[6]{Niharika Bheemisetty }%
\author[7]{Radhika Akku}%
\author[8]{Diana  Sánchez Velazco}%
\author[9]{Madeeha Subhan Waleed}%
\affil[1]{Department of Medicine, B.J. Medical College, Ahmedabad, India}%
\affil[2]{Pramukh Swami Medical College, India}%
\affil[3]{Department of Medicine, Janaki Medical College, Nepal}%
\affil[4]{JSS Medical College, Mysore, India ( JSS Academy of Higher Education and Research)}%
\affil[5]{Kasturba Medical College, Manipal, India}%
\affil[6]{Department of Pediatrics, KS multi-speciality hospital,Telangana }%
\affil[7]{Mediciti Institute of Medical Sciences, India }%
\affil[8]{Department of Medicine, Cayetano Heredia Peruvian University, Perú}%
\affil[9]{Department of Medicine,Ayub Medical College,Pakistan}%


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  \date{May 27, 2024}


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\begin{abstract}
Abstract: Background: Gastrointestinal complications of this COVID-19
have been reported over the last year. One such manifestation is bowel
ischemia. This study thus aims to provide a more holistic review of our
current understanding of COVID-19 induced bowel ischemia. Method and
Results: A meticulous search was performed using different keywords in
PubMed, EMBASE, and Google Scholar. Fifty-two articles were included in
our study after applying inclusion and exclusion criteria and performing
the qualitative assessment of the studies. A total of 25,702 patients
were included in our study after the completion of the qualitative
assessment. Discussion: COVID-19 commonly presents in the GIT as
diarrhea, vomiting, and nausea. The mechanism of bowel ischemia is
associated with the formation of emboli which is related to COVID-19's
high affinity for angiotensin-converting enzyme-2 on enterocytes,
affecting the superior mesenteric vessels. Clinically, patients
presented with abdominal pain and vomiting. CT angiography of the
abdomen and pelvis showed acute mesenteric ischemia. Management was
usually initiated with gastric decompression, fluid resuscitation, and
hemodynamic support. Surgical intervention was also sought. Conclusion:
Mesenteric ischemia presenting in patients with COVID-19 has to be
considered when symptoms of severe abdominal pain are present. More
research and guidelines are required to be able to triage patients with
COVID-19 to suspect mesenteric ischemia and to help in diagnosis and
management.%
\end{abstract}%



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