Purpose To report imaging findings at computed tomography angiography (CTA) and venography (CTV) of the abdomen and pelvis in evaluation of hemorrhagic and thrombotic lesions in hospitalized patients with COVID-19. Methods In this retrospective observational study, patients admitted to a single tertiary care center from April 1 to July 20, 2020, who tested positive for SARS-CoV-2 and developed acute abdominal pain or decreasing hemoglobin levels over the course of hospitalization were included. Abdominal CTA/CTV imaging studies performed in these patients were reviewed, and acute hemorrhagic or thromboembolic findings were recorded. Results A total of 40 patients (mean age, 59.7 years; 20 men, 20 women) were evaluated. Twenty-five patients (62.5%) required intensive care unit (ICU) admission and 15 patients (37.5%) were treated in the medical ward. Hemorrhagic complications were detected in 19 patients (47.5%), the most common was intramuscular hematoma diagnosed in 17 patients; It involved the iliopsoas compartment unilaterally in 10 patients, bilaterally in 2 patients and the rectus sheath in 5 cases. Pelvic extraperitoneal hemorrhage was found in 3 patients, and mesenteric hematoma in one patient. Thromboembolic events were diagnosed in 8 patients (20%) including; arterial thrombosis (n = 2), venous thrombosis (n = 2), splenic infarct (n = 1), bowel ischemia (n = 1) and multiple sites of thromboembolism (n = 2). Conclusion Our study highlights that both hemorrhagic and thromboembolic complications can be seen in hospitalized patients with COVID-19. It is important that radiologists maintain a high index of suspicion for early diagnosis of these complications.

Background In December 2019, a large outbreak of a novel coronavirus infection occurred in Wuhan, China. The pneumonic disease caused by this virus is called coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO). As case numbers have increased worldwide, gastro-intestinal symptoms like diarrhea, constipation, abdominal pain, and vomiting have been increased, these symptoms associated with positive laboratory results including abnormal liver function tests, renal function tests, and D-Dimer levels. Although there are multiple articles evaluated the imaging findings in HRCT of COVID-19 patients that helped in understanding the disease course and potential complications in the chest, yet there are—to our knowledge—limited data about the abdominal imaging findings of the course and potential abdominal complications of COVID-19 notably in the intensive care units (ICU). Results Forty-one sonographic examinations were done for 30 confirmed COVID-intensive care patients presented with abdominal symptoms. Of the 30 patients, 26 were males (86.66%), and 4 were females (13.3%), the average age of the patients was 57.7 years old. The most common sonographic observation was hepatomegaly (n, 23/41, 56%) and biliary system disease (n, 17/41, 41.4%); the imaging findings were correlated with the clinical and laboratory data. CT examination when indicated (in our study to assess hematomas for active extravasation and to assess bowel obstruction and its level). Conclusion Abdominal sonographic imaging was often performed for inpatients with COVID-19. Hepatobiliary dysfunction as well as nephropathy was the most common imaging findings.

Management of severe coronavirus disease 2019 requires advanced respiratory support modalities including invasive mechanical ventilation (IMV), continuous positive airway pressure (C-PAP), and non-invasive ventilation ((NIV). IMV leads to either subtle forms of lung injury (pulmonary edema, lung cysts) or more severe form of lung injury manifested as subcutaneous emphysema, pneumomediastinum, and pneumothorax (herein collectively termed barotrauma). We have described two cases showing the two end of spectrum of ventilator associated lung injury (VALI).

Background Corona virus disease 2019 (COVID-19) pandemic—as declared by the World Health Organization—is a major threatening public health problem. At the time of writing, more than 60,000,000 patients and more than 1,500,000 deaths were recorded worldwide. Besides the classical chest symptoms, gastrointestinal tract-related symptoms were noted, like diarrhea, abdominal distention, and hematochezia, adding more difficulties in the diagnosis of the disease. Although there are many publications evaluated, the thoracic imaging signs and complications of COVID-19, there are few articles—to the best of our knowledge—that evaluated the gastrointestinal tract imaging features and complications related to COVID-19. Results In this retrospective study, positive COVID-19 patients who underwent diagnostic computed tomography (CT) for abdominal complaints along a 3-month duration in a large isolation hospital were evaluated. Strict infection control measures were taken during the CT examinations. The data were reviewed on picture archiving and communications systems with clinical data and laboratory result correlation. Thirty patients (30%) showed gastrointestinal (GI) findings, and 70 patients showed unremarkable or non-related GI findings. The 30 patients were classified into four groups: the ischemic group including 10 patients (10/30: 33.33%), the bleeding group included six patients (6/30: 20%), the inflammatory group included nine patients (9/30: 30%), and fluid-filled bowel group included five patients (5/30: 16.6%). Conclusions COVID-19 should be evaluated as a systemic disease with extra pulmonary highlights. GI imaging should be considered for COVID-19 patients with related suspicious symptoms. Ischemic GI complications were the most common GI findings.

Background Since late 2019, COVID-19 infection has quickly spread substantially in all countries, forcing the appropriation of noteworthy lockdown and social separating measures. It has been considered as a pandemic by the World Health Organization. Positive pressure ventilation is a non-physiological and invasive intervention that can be lifesaving in COVID-19 patients. Similar to any other interventions, it can cause its own danger and complications as it can prompt ventilator-induced lung injury and barotrauma. The aim of the work was to identify the incidence of invasive mechanical ventilation complication in COVID-19 pneumonias, and to describe patient characteristics and patterns of barotrauma in COVID-19 patients. Results This retrospective study included 103 patients with COVID-19 pneumonia, 76 males and 27 females are on invasive mechanical ventilation. Their mean age was 56.6, ranged from 21 to 85 years old. Barotraumas event type in the studied patients, (NB: one or multiple barotrauma events occurring on the same day were considered as single event (95/103 patients-92.23%), while separate multiple events (8/103 patients-7.77%) were recorded when occurring separated by at least 24 h). Single barotrauma events were subdivided into: one event (67/95 patients—70.53%), & multiple events (28/95 patients—29.47%). The mean interval between invasive mechanical ventilation and developing barotraumas was 3–7 days included 41 patients (39.98%). We revealed a strong prevalence of COVID-19 IMV complication with worsening prognosis and subsequent higher death rates in elderly smoker or obese males, as well as those suffering from ARDS. Past medical history (hypertension, DM, chronic renal or cardiac disease) or surgical history of CABG was more liable for these types of complications. Conclusion Patients with COVID-19 pneumonia were more liable to the higher incidence of barotraumas with presence of predisposition and high risk factors. In general, an outstanding bad prognostic outcome and a significantly high mortality rate prevailed in COVID-19 patients associated with mechanically ventilated patients.