Histological and immunohistochemical changes in patients with appendectomy and cholecystectomy in times of pandemic by sars-cov2.

Abstract

Covid-19 is characterized by predominantly respiratory symptoms, its clinicopathological features are well described, whereas, gastrointestinally they are not clearly demonstrated. The SARS-CoV-2 receptor, angiotensin-converting enzyme 2 (ACE2) is expressed in gastrointestinal epithelial cells, high levels of these proteins may explain the concomitant digestive symptoms. Purpose: To describe histopathologic changes in appendectomy and cholecystectomy specimens in Covid-19-positive CMDLT patients in 2021. Methods: Descriptive analytical study of a series of cases, the population was 98 patients, operated for acute appendicitis (n=37) and acute cholecystitis (n=61); of these patients only (n=6) were Covid-19 positive, being selected as a sample for the study in the Anatomic Pathology Service and compare them with two groups of control cases, a pandemic group and a pre-pandemic group, were (n=6) patients in each group with the same demographic characteristics as the sample. Results: The average age was 33 years, the distribution of males and females was equal, the histological findings were similar in the 3 study groups, corroborating that endothelial hyperplasia predominated in 100% of cases Covid-19 positive and 83% Covid-19 negative, compared to 2019 presenting in 17% of cases, also thrombosis in the year 2021 predominated with 83% Covid-19 positive and 67% Covid-19 negative, compared to 17% of 2019. Conclusion: histopathological changes are evidenced in postoperative patients in times of pandemic, represented in endothelial hyperplasia and thrombosis, while the immunohistochemical marking for ACE2 was similar in all groups analyzed, there were nonspecific gastrointestinal symptoms in 4 of the 6 patients, however, postoperative evolution was satisfactory in all.