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COVID-19 brings blue skies
Isabel Garrido, Armando Peixoto, Guilherme Macedo
Centro Hospitalar e Universitário de São João
A 54-year-old male with hypertension, dyslipidemia, obesity and diastolic heart failure, was admitted for severe COVID-19 pneumonia. He started mechanical ventilation and venovenous extracorporeal membrane oxygenation. On the fifth day in the Intensive Care Unit, the patient had new-onset melena and hemoglobin of 7.8 g/dL. Esophagogastroduodenoscopy revealed the fundus and proximal body with large hemorrhagic ulceration, and the distal gastric corpus and antrum with a circumferential bluish appearance. The second part of the duodenum also presented mucosal ulceration. Abdominal computed tomography showed thickening of the gastric wall, with signs of submucosal edema. The histopathological examination was compatible with gastroduodenal ischemia.
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