Background: Coronavirus 2019 (COVID-19) is a systemic disease associated with severe gastrointestinal complications including life-threatening mesenteric ischemia. We sought to review and summarize the currently available literature on the presentation, management, and outcomes of mesenteric ischemia in patients with COVID-19.Patients and Methods: The PubMed database was searched to identify studies published between January 2020 and January 2021 that reported one or more adult (>= 18 years) patients with COVID-19 who developed mesenteric ischemia during hospitalization. The demographic characteristics, clinical and imaging findings, management, and outcomes of patients from each study were extracted and summarized.Results: A total of 35 articles reporting on 61 patients with COVID-19 with mesenteric ischemia met the eligibility and were included in our study. The mean age was 60 (+/- 15.9) years, and 53 of patients were male. Imaging findings of these patients included mesenteric arterial or venous thromboembolism, followed by signs of mesenteric ischemia. Sixty-seven percent of patients were taken to the operating room for an exploratory laparotomy and bowel resection and 21 were managed conservatively. The terminal ileum was the most commonly involved area of necrosis (26). The mortality rate of patients with COVID-19 with mesenteric ischemia was 33, and the most common cause of death was multiorgan failure or refractory septic shock. Twenty-seven percent of patients managed operatively died during the post-operative period.Conclusions: Mesenteric ischemia in patients with COVID-19 is a devastating complication associated with a high rate of morbidity and mortality. Further efforts should focus on developing strategies for early recognition and management.
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