Extrapulmonary manifestations of COVID-19: Radiologic and clinical overview

Behzad, Shima; Aghaghazvini, Leila; Radmard, Amir Reza; Gholamrezanezhad, Ali

doi:10.1016/j.clinimag.2020.05.013

Cited by 241 publications

(282 citation statements)

References 60 publications

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“…Moreover, the extrapulmonary findings of COVID-19 have been reported recently in many literatures, causing complications in the brain, gastrointestinal tract, heart and kidneys 29 , 30 . In this era, a unique advantage of whole-body PET/CT over competing for imaging modalities is the potential for detection of additional incidental metabolically active lesions throughout the rest of the body in a single acquisition.…”

Section: Discussionmentioning

confidence: 90%

Coronavirus Disease 2019 (COVID-19) in Molecular Imaging: A Systematic Review of Incidental Detection of SARS-CoV-2 Pneumonia on PET Studies

Rafiee

Keshavarz

Katal

et al. 2021

Seminars in Nuclear Medicine

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Purpose There have been several reports of the incidental detection of SARS-CoV-2 pneumonia on Positron Emission Tomography/Computed Tomography (PET/CT) studies, which represent the potential role of molecular imaging in detection and management of coronavirus disease 2019 (COVID-19). Here, we systematically review the value of PET/CT in this setting. Materials and Methods We conducted a systematic search on June 23, 2020, for PET studies with findings suggestive of COVID-19. Web of Science, PubMed, Scopus, EMBASE, and Google Scholar databases were used. Patients with at least one PET/CT imaging evaluation were included in the study. Results Fifty-two patients in 30 publications with a mean age of 60 ± 12.74 (age range; 27-87) were included in this study, of which 28(53.8%) were male, and 19(36.5%) were female. PET/CT was performed with 18 F-FDG for 49(94.2%), 18 F-choline for 2(3.8%), and 68 Ga-PSMA for 1 (1.9%) patients. The mean SUV max of pulmonary lesions with 18 F-FDG uptake was 4.9 ± 2.3. Moreover, 39(75%) cases had an underlying malignancy, including 18 different type of primary cancers and 6(11.5%) patients with metastatic disease. The most common pulmonary findings in PET/CT were bilateral hypermetabolic GGOs 39(75%), consolidation 18(34.6%), and interlobular thickening 4(7.6%). In addition, mediastinal 14(27%) and hilar 10(19.2%) lymph node involvement with increased metabolic activity were frequently identified. Conclusion Early diagnosis of SARS-CoV-2 pneumonia is not only crucial for both appropriate patient management but also helps to ensure appropriate post-exposure precautions are implemented for the department and hospital staff and those who have been in contact with the patient.

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Section: Discussionmentioning

confidence: 90%

Coronavirus Disease 2019 (COVID-19) in Molecular Imaging: A Systematic Review of Incidental Detection of SARS-CoV-2 Pneumonia on PET Studies

Rafiee

Keshavarz

Katal

et al. 2021

Seminars in Nuclear Medicine

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“…CT scan of his abdomen showed mild stranding surrounding mildly distended fluid-filled ascending colon and few small surrounding mesenteric lymph nodes were identified, as well as incidental, patchy ground-glass opacities with reverse halo appearance in the visualized lung bases. SARS-CoV-2 PCR was subsequently positive [3] .…”

Section: Discussionmentioning

confidence: 99%

“…They are reported in approximately 3%-50% of patients with SARS-CoV-2 pulmonary infection. It is important to note that these symptoms might be the only presenting findings in some patients [3] , [4] , [5] , [6] , [7] .…”

Section: Discussionmentioning

confidence: 99%

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SARS-CoV-2 infection presenting as colitis with chest and abdomen CT findings

Khader¹,

Bishawi²,

Kambal³

et al. 2020

Radiology Case Reports

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Most of reported symptoms of SARS-CoV-2 infection are related to the respiratory system. Extra pulmonary manifestations of this novel virus infection are being increasingly reported in the literature, with increased attention on the gastrointestinal symptoms which might be the only presenting symptoms in some patients. These GI symptoms are nonspecific and little reported cases in the literature of confirmed gastrointestinal manifestations of SARS-CoV-2 infection by imaging. Colitis related to SARS-CoV-2 is even less reported in the literature. We present a case of SARS-CoV-2 infection of a 40-year-old lady who presented with GI manifestations and features of colitis of the caecum and ascending colon on CT scan. The patient did not have respiratory symptoms but had incidental lung changes in the visualized lung bases. These features were completely resolved as evident clinically and on follow-up CT scan after only 2 weeks, with only supportive care for SARS-CoV-2 infection. GI symptoms, in general, are very common presenting complain for many patients visiting the emergency department; hence, early recognition and high index of clinical suspicion for SARS-CoV-2 infection with the presence of supporting laboratory and imaging findings are to be considered for early protective measures to be undertaken to help in reducing the spread of this virus; in particular, in the middle of global pandemic of this virus and the fact that GI symptoms could be the only presenting symptoms without any respiratory symptoms. More studies and further invasive investigations in patients with features of colitis in imaging are needed to further understand the pathogenesis and its relation to SARS-CoV-2 infection

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“…As principais consequências desse vírus ocorrem sobre o sistema respiratório e, em sua maioria, são de caráter leve incluindo febre, tosse e dispneia, ou constituem-se repercussões assintomáticas. No entanto, o que tem chamado a atenção são as formas graves de como essa doença afeta os seres humanos, em especial pelo desenvolvimento de complicações sobre o trato respiratório, mas também com comprometimento de outros aparelhos do organismo (STRABELLI & UIP, 2020;BEHZAD et al, 2020;DOCKERY et al, 2020). A situação de agravamento ocorre com a progressão do quadro infeccioso inicial e surgimento de edema agudo nos pulmões, sendo necessária internação hospitalar em Unidade de Terapia Intensiva (UTI).…”

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