Newly Diagnosed Crohn's Disease After SARS-CoV-2 Infection.

Abstract

Coronavirus disease 2019 (COVID-19) is known to induce gastrointestinal symptoms as well as respiratory symptoms. There have been instances where diarrhea persists after the acute phase of COVID-19, suggesting an extension of the disease's symptoms. It is not typical to recall the onset of inflammatory bowel disease (IBD) with such symptoms, much less with reports on Crohn's disease (CD). It is important to collect such cases in order to lead to appropriate diagnosis and treatment. This report presents a case of a young man in which diarrhea, initially manifesting during the acute phase of COVID-19, persisted for two months, ultimately leading to a CD diagnosis. At the onset of COVID-19, the patient had fever, abdominal pain, and diarrhea, but respiratory symptoms were not prominent. An ileocolonoscopy was performed to further investigate the cause of persistent diarrhea, leading to an appropriate diagnosis of CD. It is hypothesized that aberrations in the immune system triggered by severe acute respiratory syndrome coronavirus 2's impact on the intestinal tract might contribute to the onset of CD. The patient's condition gradually improved after the initiation of treatment with prednisolone. By the following treatment with azathioprine, the patient has maintained clinical remission. Clinicians should consider performing ileocolonoscopy for patients with persistent diarrhea after COVID-19, given the possibility of IBD. Gastrointestinal symptoms are relatively common with COVID-19. COVID-19 infection may trigger CD through immunological mechanisms. It is important to consider that cases of prolonged diarrhea after COVID-19 may include the induction of CD and to perform an ileocolonoscopy.