Acute Mesenteric Ischemia during the COVID-19 Pandemic – An Observational Study

Abstract Background and Purpose: COVID-19 infection has been associated with arterial and venous thrombosis, including acute mesenteric ischemia (AMI). Information on AMI during the COVID-19 pandemic is very limited; coagulopathy related to the gastrointestinal system manifests as AMI, a severe complication due to its high morbidity and poorer outcomes. This project aimed to study the clinical profile and outcomes of patients with AMI during the COVID-19 pandemic and compare them with a similar group of patients with AMI prepandemic. Methodology: All patients admitted with AMI between March and December 2020 and March and December 2019 were included. Data were collected from electronic hospital records. Results: Twenty-six patients during the pandemic and 15 in the prepandemic era were admitted with AMI, indicating a 73.3% increase in admissions during the pandemic. Baseline characteristics, coagulation parameters, and overall mortality were similar between both the groups. Venous ischemia rates were 53.8% when compared to 40% in the prepandemic era. Prothrombotic rates were 11.5% when compared to 26.6% during the prepandemic era. During the pandemic, bowel resection rates were 93% (14/15), and backout rates were 7% (1/15) when compared to 60% (6/10) and 40% (4/10), respectively, during the prepandemic era. Conclusions: More AMI was seen during the COVID-19 pandemic, with lower rates of preexisting hypercoagulable states. However, rates of nonoperative management and small bowel resection were higher, with fewer backouts. Deranged coagulation was associated with a higher mortality.