iarjaccIARJACCIARJACC2709-1880https://doi.org/10.47310/iarjacc.2022.v03i02.71Institutionalized Mitochondrial Disorders Are at Risk of Dying from Unrecognized Sars-Cov-2 InfectionA limitation of the study is that a SARS-CoV-2 infection was not ruled out as the cause of gastro-enteritis leading to the initial admission. Because the events apparently took place after the start of the SARS-CoV-2 pandemic, it cannot be ruled out that the patient deteriorated because of an undiagnosed COVID-19 infection. Arguments for a SARS-CoV-2 infection are that the patient was institutionalized and manifested with gastro-enteritis. Institutionalized patients are at an increased risk of contracting and dying from a SARS-CoV-2 infection [2]. It is also known that SARS-CoV-2 infections can manifest itself not only in the lungs but also in extra-pulmonary sites, including the gastro-intestinal tract [3]. In patients with manifestations of COVID-19 with extra-pulmonary onset, the causative agent can be difficult to confirm. We should be told whether the patient was SARS-CoV-2 vaccinated at the time of the first deterioration.