CASE REPORT article
Front. Med.
Sec. Gastroenterology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1618638
This article is part of the Research TopicUnraveling the long-term effects of COVID-19View all 9 articles
Acute upper gastrointestinal mucosal lesions caused by COVID-19 infection: A case report
Provisionally accepted
- Shandong Second Medical University, Weifang, China
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Abstract:Background: COVID-19 enters human cells by binding its surface protein to angiotensin-converting enzyme 2 (ACE2) present in the host. ACE2 is expressed in various organ cells in the human body. Consequently, COVID-19 can invade gastrointestinal epithelial cells through ACE2, leading to the manifestation of gastrointestinal symptoms. However, the occurrence of gastrointestinal mucosal lesions and bleeding is rare. Case summary: A 34-year-old man with no previous medical history was hospitalized due to two weeks of nausea, hematemesis, and one week of fever. Gastroscopy showed widespread inflammation and necrotic tissue in the stomach, suggesting erosive hemorrhagic gastritis. Laboratory tests confirmed COVID-19 infection and blood hypercoagulability. After treatment, the patient was discharged. Follow-up gastroscopy showed mucosal lesion healing after recovery from COVID-19.Conclusion: The patient underwent endoscopy and pathological analysis. ACE2 immunohistochemistry was performed on the pathological tissues to investigate the cause of the lesions. After ruling out other possible factors, the final results indicated that the patient’s gastric mucosal lesion was caused by COVID-19 infection. This suggests that further research on COVID-19 should consider its gastrointestinal symptoms and diseases.
Keywords: COVID-19, COVID-19 pandemic, SARS-CoV-2 virus, ACE2, Digestive system infection, Acute upper gastrointestinal mucosal lesions
Received: 26 Apr 2025; Accepted: 22 Jul 2025.
Copyright: © 2025 Qi, Yan, Hu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lei Li, Shandong Second Medical University, Weifang, China
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