Evidence map›Paper›PMID 33204749›Full record

ArticleOpen forum infectious diseases2020

Occult Colonic Perforation in a Patient With Coronavirus Disease 2019 After Interleukin-6 Receptor Antagonist Therapy.

Kristin Schwab, Sepehr Hamidi, Augustine Chung, Raymond J Lim, Negar Khanlou, Daniel Hoesterey, Camelia Dumitras, Oladunni B Adeyiga, Michelle Phan-Tang, Tisha S Wang and 6 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Open forum infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.2field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 13 citations in OpenAlex.

  1. Article
  2. Review
  3. Large intestinal perforation secondary to COVID-19: A case report.International journal of surgery case reports · 2021
    Article
  4. Article
  5. Postoperative multiple perforations of the small bowel in a patient with COVID-19 - case report.Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 1 institution in 1 country.

Kristin SchwabDivision of Pulmonary and Critical Care, Department of Medicine at University of California, Los Angeles, California, USA.ORCID 0000-0003-0288-7568
Sepehr HamidiDepartment of Pathology and Laboratory Medicine at University of California, Los Angeles, California, USA.
Augustine ChungDivision of Pulmonary and Critical Care, Department of Medicine at University of California, Los Angeles, California, USA.
Raymond J LimDepartment of Molecular and Medical Pharmacology at University of California, Los Angeles, California, USA.
Negar KhanlouDepartment of Pathology and Laboratory Medicine at University of California, Los Angeles, California, USA.
Daniel HoestereyDepartment of Medicine at University of California, Los Angeles, California, USA.
Camelia DumitrasDivision of Pulmonary and Critical Care, Department of Medicine at University of California, Los Angeles, California, USA.
Oladunni B AdeyigaDivision of Infectious Diseases, Department of Medicine at University of California, Los Angeles, California, USA.
Michelle Phan-TangDepartment of Pathology and Laboratory Medicine at University of California, Los Angeles, California, USA.
Tisha S WangDivision of Pulmonary and Critical Care, Department of Medicine at University of California, Los Angeles, California, USA.
Rajan SaggarDivision of Pulmonary and Critical Care, Department of Medicine at University of California, Los Angeles, California, USA.
Jeffrey GoldsteinDepartment of Pathology and Laboratory Medicine at University of California, Los Angeles, California, USA.
John A BelperioDivision of Pulmonary and Critical Care, Department of Medicine at University of California, Los Angeles, California, USA.
Steven M DubinettDivision of Pulmonary and Critical Care, Department of Medicine at University of California, Los Angeles, California, USA.
Jocelyn T KimDivision of Infectious Diseases, Department of Medicine at University of California, Los Angeles, California, USA.
Ramin Salehi-RadDivision of Pulmonary and Critical Care, Department of Medicine at University of California, Los Angeles, California, USA.
University of California, Los Angeles · US

Funding

UCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1M
The Effect of Nanoparticle Encapsulated Resveratrol on Treatment of PeriodontitisKL2TR001882 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Elizabeta Nemeth · 2016 to 2026
$13.1M
The Effect of Natural Killer Cell-Based Therapy on the HIV ReservoirK08AI155232 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KIM, JOCELYN T · 2020 to 2024
$1.0M
NCATS NIH HHS KL2 TR001882NCATS NIH HHS UL1 TR001881NIAID NIH HHS K08 AI155232
6 · The paper itself

Abstract

backgroundInterleukin-6 blockade (IL-6) has become a focus of therapeutic investigation for the coronavirus disease 2019 (COVID-19).

methodsWe report a case of a 34-year-old with COVID-19 pneumonia receiving an IL-6 receptor antagonist (IL-6Ra) who developed spontaneous colonic perforation. This perforation occurred despite a benign abdominal exam and in the absence of other known risk factors associated with colonic perforation.

resultsExamination of the colon by electron microscopy revealed numerous intact severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virions abutting the microvilli of the colonic mucosa. Multiplex immunofluorescent staining revealed the presence of the SARS-CoV-2 spike protein on the brush borders of colonic enterocytes that expressed angiotensin-converting enzyme 2. However, no viral particles were observed within the enterocytes to suggest direct viral injury as the cause of colonic perforation.

conclusionsThese data and absence of known risk factors for spontaneous colonic perforation implicate IL-6Ra therapy as the potential mediator of colonic injury in this case. Furthermore, this report provides the first in situ visual evidence of the virus in the colon of a patient presenting with colonic perforation adding to growing evidence that intact infectious virus can be present in the stool.

Indexed as

coronaviruselectron microscopyinterleukin-6 receptorsintestinal perforation

Identifiers

PMID33204749
PMCPMC7543619
OpenAlexW3086798633

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.