Radiological findings of COVID-19-related thromboembolic complications

Abstract

Background The ongoing global pandemic of coronavirus disease 2019 (COVID-19) may cause, in addition to lung disease, a wide spectrum of non-respiratory complications. Among these are thromboembolic complications. The theories that explain the mechanism of thromboembolic complications of COVID-19 are accumulating rapidly, and in addition to the role of imaging for assessment of COVID-19 pneumonia, CT may be useful for identification of these complications, such as pulmonary embolism, ischaemic stroke, mesenteric ischaemia, and acro-ischaemia. Results Thromboembolic manifestations were diagnosed in 10% of our patients (124 patients out of the total 1245 COVID-19 patients); 56 patients (45.2%) presented with pulmonary embolism, 32 patients (25.8%) presented with cerebrovascular manifestations, 17 patients (13.7%) presented with limb affection, and 19 patients (15.3%) presented with gastrointestinal thromboembolic complications. Most of our patients had significant comorbidities; diabetes was found in 72 patients (58%), dyslipidemia in 72 patients (58%), smoking in 71 patients (57.3%), hypertension in 63 patients (50.8%), and morbid obesity in 40 patients (32.2%). Thromboembolic events were diagnosed on admission in 41 patients (33.1%), during the first week in 61 patients (49.2%), and after the first week in 22 patients (17.7%). Conclusions The incidence of thromboembolic complications in COVID-19 patients is relatively high resulting in a multisystem thrombotic disease. In addition to the crucial role of imaging for assessment of COVID-19 pneumonia, CT is important for assessment of the thromboembolic complications, such as pulmonary embolism, ischaemic stroke, mesenteric ischaemia, and peripheral ischaemia, especially in patients with elevated d-dimer levels and those with sudden clinical deterioration.

Imaging of COVID-19 vasculopathy from head to toe: Egyptian collective experience after 2 years of the pandemic

“…Omar et al [ 15 ] targeted the multi-systemic thrombo-embolic complications of COVID-19 infection but without other vasculopathy disorders. It was a four-month study that ended earlier in July 2020.…”

“…This was matching with Saleh et al [ 16 ]. On the other hand, diabetes mellitus was the most common comorbidity in Omar et al [ 15 ].…”

“…Agreeing with Yassin et al [ 19 ], COVID-19 vasculopathy was most commonly seen in the second week after infection with a strong to relation elevated D-dimer levels. On the other hand, Omar et al [ 15 ] reported them earlier during the first week of infection.…”

Imaging spectrum of extrapulmonary manifestations of COVID-19 infection- a multi-centre descriptive study from Southern India

“…Commonly reported vascular syndromes include deep vein thrombosis (DVT), pulmonary embolism (PE), stroke, cerebral venous sinus thrombosis, myocardial infarction, mesenteric ischemia and limb ischemia. 4,5 This preponderance of vascular involvement could be explained by high level of ACE-2 receptor expression in vascular endothelium. CT angiography provides comprehensive information about the vascular system and is the modality of choice for evaluation of vascular complications.…”

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“…Based on the information currently available, the new and natural host of the new coronavirus appears to be bats, and then the virus enters an intermediate host, possibly an anteater or other wild animals for sale in Wuhan Bazaar and subsequently transmitted from this host to the average human. Then, the process of human-tohuman transmission begins and the present epidemic is formed [28][29][30][31]. The fact that the anteater is specifically named as the intermediate host is due to the fact that 70% of the anteaters were positive for coronavirus.…”