Gastrointestinal effects of an attempt to avoid contracting COVID‐19 by ‘disinfection’

• DOI: 10.1111/his.14137
• Publication Date: 2020-05-07T14:20:33Z
• Authors: Lukas Binder; Christoph Högenauer; Cord Langner
• Keywords: Foveolar cell

In April 2020 during the coronavirus disease 2019 (COVID-19) pandemic, a 41-year-old female presented to emergency department with recurrent vomiting and abdominal pain that had been ongoing for 2 days haematemesis present several hours. The past medical history was unremarkable, except bariatric gastric bypass surgery performed in 2016. During detailed inquiry, patient reported she intentionally taken 10 ml of ethanol-containing hand disinfectant orally each day period of> 3 weeks fear being infected severe acute respiratory syndrome (SARS-CoV-2). product obtained from regular pharmacy produced locally according World Health Organization standards disinfectant.1 An upper gastrointestinal endoscopy performed, showed superficial mucosal damage oesophagus (Figure 1A), slightly increased redness stomach, severely injured small-bowel mucosa extensive fibrinous exudates 2A). Biopsies corrosive injury squamous epithelium 'two-toned appearance' 1B). half appeared compact markedly eosinophilic condensed fading nuclei, whereas underlying intact only mild reactive changes. There intracellular oedema leading balloon cell formation. Active inflammation vacuolisation were focally at interface between necrosis mucosa, indicating beginning epithelial sloughing. pre-existing chronic inactive Helicobacter-negative gastritis atrophy complete intestinal metaplasia. Neutrophils clustered beneath within surface epithelium. subacute active erosions covered by fibrinopurulent debris 2B). stroma condensed, reduced numbers lymphocytes plasma cells. varying amounts, mainly restricted stroma. margins flattened nuclear crypts hyperplastic, number goblet cells crypt reduced. most cases, intake sanitisers is unintentional; however, incidence intentional ingestion rising American Association Poison Control Centre's National Data System.2 case first documented taking mouth over weeks, order prevent global pandemic virus. general, histological changes tract are poorly described,3 textbooks refer this as footnote. It well known degree varies amount exact nature ingested substance, concentration contact time. Our particularly interesting, it shows consequences repetitive sublethal ingestion. oesophageal are, on gross inspection, reminiscent oesophagitis, histology closely resembles 'sloughing oesophagitis' (oesophagitis dissecans superficialis), which has attributed debilitation medications injuring mucosa.4 character observed small bowel illustrated combination (superficial erosion) repair (crypt hyperplasia, loss, changes), so-called 'chronic erosions' occurring stomach. patient's symptoms subsided few after termination treatment. 1 week later disclosed normal mucosa. conclusion, chemicals an attempt avoid contracting COVID-19 'disinfection' leads oesophageal, small-intestine This treatment, even when considered governmental authorities, not no proven antiviral effect, but actually involves major health risks. authors declare conflict interest. L. Binder: endoscopy, wrote manuscript. C. Högenauer: reviewed Langner: histology,