Moheb MEL, Naar L, Christensen MA, et al. - Critically ill patients with COVID-19–induced acute respiratory distress syndrome (ARDS) vs comparably ill patients with non–COVID-19 ARDS were assessed for the incidence of gastrointestinal complications using propensity score analysis. Researchers identified in total of 486 patients with ARDS, who met eligibility criteria; these comprised 242 patients with COVID-19 ARDS who were admitted to 1 of 13 (preexistent and surge) intensive care units (ICUs) of the Massachusetts General Hospital between March 13, 2020, and May 7, 2020, and 244 patients with non–COVID-19 ARDS admitted between 2018 and 2019. Propensity score matching was done of 92 with COVID-19 and ARDS to 92 patients with non–COVID-19 ARDS. Per findings, critically ill patients with COVID-19 had a higher rate of gastrointestinal complications, including mesenteric ischemia, compared with propensity score–matched patients without COVID-19. This suggests that COVID-19 had different phenotype to conventional ARDS. Involvement of abdominal organs could be explained by the high expression of angiotensin-converting enzyme 2 receptors along the epithelial lining of the gut that act as host-cell receptors for SARS-CoV-2. The disproportionately high rate of ileus and ischemic bowel disease may also be explained with higher opioid requirements and COVID-19–induced coagulopathy.