Abdominal gastrointestinal imaging findings on computed tomography in patients with COVID-19 and correlation with clinical outcomes

Horvat, Natally; Pinto, Paulo Roberto Margutti; Araújo-Filho, José de Arimateia Batista; Santos, João Manoel Miranda Magalhães; Dias, Adriano Basso; Miranda, J. E. C. de; Oliveira, Camila Vilela de; Barbosa, Camila Silva; Morais, Teresa Christine Pereira; Assunção-Jr, Antonildes N; Nomura, César Higa; Viana, Públio César Cavalcante

doi:10.1016/j.ejro.2021.100326

Cited by 21 publications

(32 citation statements)

References 23 publications

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“…Along with ischemic complications, CT scan can also depict hemorrhagic complications such as hematomas or hemorrhagic transformation of bowel ischemia[ 21 ]. Besides its diagnostic role, abdominal imaging has also demonstrated prognostic value upon detection of ischemic gastrointestinal complications in COVID-19, which has been shown to be associated with higher mortality[ 32 , 33 ]. The most frequent findings on abdominal imaging in COVID-19 are summarized in Figure 1 .…”

Section: Discussionmentioning

confidence: 99%

Abdominal imaging in COVID-19

Balaban¹,

Baston²,

Jinga³

2021

WJR

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Initially thought of as a respiratory infection, coronavirus disease-2019 (COVID-19) is now recognized as a complex disease with a wide clinical spectrum, including digestive involvement. While several studies have evaluated chest imaging findings in COVID-19, few papers have looked at the abdominal imaging features of these patients. Liver, biliary, pancreas and bowel involvement have been reported in COVID-19 infected patients. In this review, we aim to summarize currently available data related to abdominal imaging techniques in COVID-19, in accordance with relevant clinical and laboratory workup of these patients. Underlying mechanisms, indications and imaging findings related to COVID-19 are discussed based on published data. Also, practice points for clinicians are highlighted in order to adequately recognize digestive-related injuries of severe acute respiratory syndrome coronavirus 2 infection. While there’s been a steady accumulation of data with respect to abdominal imaging findings in COVID-19, currently available recommendations are based on limited research. There is a wide spectrum of abdominal imaging findings in COVID-19, which includes hepato-biliary, pancreatic and luminal pathology.

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Section: Discussionmentioning

confidence: 99%

Abdominal imaging in COVID-19

Balaban¹,

Baston²,

Jinga³

2021

WJR

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“…Finally, Horvat et al found the presence of intestinal findings on CT in hospitalized COVID-19 patients positively correlated with a higher risk of worse clinical outcome including death or assisted ventilation (64).…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 98%

“…The most common and consistently reported imaging manifestations of COVID-19 affecting the bowel include mural thickening, non-specific ileus, fluid-filled colon, and pneumatosis intestinalis. Portal vein gas and pneumoperitoneum are less commonly seen (61,64). In a retrospective review of 141 COVID-19 patients in the ICU, 56% had clinically or radiologically diagnosed ileus, 2% had Ogilvie-like syndrome, 4% had bowel ischemia (3% small bowel, 1% small and large bowel and 1% cecal), 11% had GI bleeding and 4% had Clostridium difficile colitis (60).…”

Section: Bowel Imaging Patterns Of Covid-19mentioning

confidence: 99%

“…In a retrospective review of 141 COVID-19 patients in the ICU, 56% had clinically or radiologically diagnosed ileus, 2% had Ogilvie-like syndrome, 4% had bowel ischemia (3% small bowel, 1% small and large bowel and 1% cecal), 11% had GI bleeding and 4% had Clostridium difficile colitis (60). Out of 81 hospitalized COVID-19 patients who underwent abdominal CT, 24% had intestinal findings of which colorectal thickening (5%), small bowel thickening (12%), and ileus (18%) were the most common, while pneumatosis (1%) and perforation (1%) were relatively rare (64).…”

Section: Bowel Imaging Patterns Of Covid-19mentioning

confidence: 99%

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Review of COVID-19, part 1: Abdominal manifestations in adults and multisystem inflammatory syndrome in children

et al. 2021

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Another retrospective study included 81 COVID-19 patients with abdominal CT, and 45 (55%) had positive abdominopelvic findings. The most common abdominal imaging features were intestinal imaging findings (24%), including colorectal (5%) and small bowel thickening (12%), intestinal distension (18%), pneumatosis (1%), and intestinal perforation (1%)[ 79 ]. Morparia et al [ 80 ] reported abdominal imaging findings in critically ill children admitted with multisystem inflammatory syndrome associated with COVID-19.…”

Section: Abdominal Imaging Findings In Covid-19 Patientsmentioning

confidence: 99%

COVID-19 and the digestive system: A comprehensive review

Wang¹,

Yue²,

Cai³

et al. 2021

WJCC

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The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is spreading at an alarming rate, and it has created an unprecedented health emergency threatening tens of millions of people worldwide. Previous studies have indicated that SARS-CoV-2 ribonucleic acid could be detected in the feces of patients even after smear-negative respiratory samples. However, demonstration of confirmed fecal-oral transmission has been difficult. Clinical studies have shown an incidence rate of gastrointestinal (GI) symptoms ranging from 2% to 79.1% in patients with COVID-19. They may precede or accompany respiratory symptoms. The most common GI symptoms included nausea, diarrhea, and abdominal pain. In addition, some patients also had liver injury, pancreatic damage, and even acute mesenteric ischemia/thrombosis. Although the incidence rates reported in different centers were quite different, the digestive system was the clinical component of the COVID-19 section. Studies have shown that angiotensin-converting enzyme 2, the receptor of SARS-CoV-2, was not only expressed in the lungs, but also in the upper esophagus, small intestine, liver, and colon. The possible mechanism of GI symptoms in COVID-19 patients may include direct viral invasion into target cells, dysregulation of angiotensin-converting enzyme 2, immune-mediated tissue injury, and gut dysbiosis caused by microbiota. Additionally, numerous experiences, guidelines, recommendations, and position statements were published or released by different organizations and societies worldwide to optimize the management practice of outpatients, inpatients, and endoscopy in the era of COVID-19. In this review, based on our previous work and relevant literature, we mainly discuss potential fecal-oral transmission, GI manifestations, abdominal imaging findings, relevant pathophysiological mechanisms, and infection control and prevention measures in the time of COVID-19.

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Abdominal gastrointestinal imaging findings on computed tomography in patients with COVID-19 and correlation with clinical outcomes

Cited by 21 publications

References 23 publications

Abdominal imaging in COVID-19

Abdominal imaging in COVID-19

Review of COVID-19, part 1: Abdominal manifestations in adults and multisystem inflammatory syndrome in children

COVID-19 and the digestive system: A comprehensive review

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