PMC9978098_01
Clinical course of the 13-year-old patient with de novo ulcerative colitis post COVID-19. (A) Abdominal ultrasound depicting sigmoid colon. Wall thickening and loss of Haustra with mesenteric lymphadenopathy (dotted line) are shown. (B) Endoscopic image depicting sigmoid colon. Complete obliteration of vascular pattern with erosions are shown. (C) histology of ascending colon (left) and rectum (right): A crypt abscess in the ascending colon and crypt distortion in the rectum are shown. (D) Clinical course of the patient. COVID-19, coronavirus disease 2019; 5ASA, 5-aminosalicylate; PSL, Prednisolone; SASP, salazosulfapyridine.
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f1
Treestar). The gating strategies are outlined in  Supplementary Figures 1 - 3  using a patient sample from month 2.
Serum gut permeability markers. (A) Changes in serum zonulin. (B) Changes in serum lipopolysaccharide binding protein (LBP). Levels of both markers were compared to those patients with MIS-C as positive control (see reference for details on the clinical course) and patients with inflammatory bowel disease in remission as negative control. Note that the patient did not have elevated zonulin through the clinical course, but had elevated LBP, which was normalized by steroid therapy. They were measured by a zonulin (serum) ELISA kit (Immundiagnostik, Bensheim, Germany) and an LBP ELISA kit (Hycult Biotech, Wayne, PA, USA), respectively. 5ASA, 5-aminosalicylate; PSL, Prednisolone; UC, ulcerative colitis; CD, Crohn's disease; MIS-C, multisystem inflammatory syndrome in children.
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f2
Treestar). The gating strategies are outlined in  Supplementary Figures 1 - 3  using a patient sample from month 2.
Colorectal histological and peripheral immunophenotyping. (A) Rectal histology: Moderate to severe lymphocyte infiltration and equally composed of CD8+ and CD4+ lymphocytes are shown. (B) Changes in T cell subsets: activated T cells (HLA-DR+ CD38+), memory T cells (CD45RO+), and alpha4beta7+ memory T cells. Increases in activated and memory T cells, including alpha4beta7-expressing cells, particularly CD8+ T cells, are shown. The dashed lines indicate the median value of healthy children around the same age as the patient according to reference values. (C) Changes in T cell receptor repertoire during the active pre-treatment period. The expansion of Vbeta 4 and Vbeta 20 in memory CD8+ T cells and of Vbeta 2 and Vbeta 8 in memory CD4+ T cells were observed. A similar trend was observed in activated T cells. The gray bar indicates the control value of a healthy 11-year-old boy. See supplementary materials of panel design and gating strategy for peripheral T-cell subsets and T-cell receptor repertories.
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f3
Treestar). The gating strategies are outlined in  Supplementary Figures 1 - 3  using a patient sample from month 2.