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Erschienen in: Abdominal Radiology 9/2020

06.08.2020 | COVID-19 | Practice Zur Zeit gratis

Abdominopelvic CT findings in patients with novel coronavirus disease 2019 (COVID-19)

verfasst von: Shlomit Goldberg-Stein, Adam Fink, Viktoriya Paroder, Mariya Kobi, Judy Yee, Victoria Chernyak

Erschienen in: Abdominal Radiology | Ausgabe 9/2020

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Abstract

Purpose

Some patients with novel coronavirus disease 2019 (COVID-2019) present with abdominal symptoms. Abdominal manifestations of COVID on imaging are not yet established. The goal of this study was to quantify the frequency of positive findings on abdominopelvic CT in COVID-positive patients, and to identify clinical factors associated with positive findings to assist with imaging triage.

Materials and methods

This retrospective study included adult COVID-positive patients with abdominopelvic CT performed within 14 days of their COVID PCR nasal swab assay from 3/1/2020 to 5/1/2020. Clinical CT reports were reviewed for the provided indication and any positive abdominopelvic findings. Demographic and laboratory data closest to the CT date were recorded. Multivariate logistic regression model with binary outcome of having no reported positive abdominopelvic findings was constructed.

Results

Of 141 COVID-positive patients having abdominopelvic CT (average age 64 years [± 16], 91 [64%] women), 80 (57%) had positive abdominopelvic findings. Abdominal pain was the most common indication, provided in 54% (43/80) and 74% (45/61) of patients with and without reported positive abdominopelvic findings, respectively (p = 0.015). 70% (98/141) of patients overall had reported findings in the lung bases. Findings either typical or intermediate for COVID were reported in 50% (40/80) and 64% (39/61) of patients with and without positive abdominopelvic findings, respectively (p = 0.099). Of 80 patients with positive abdominopelvic findings, 25 (31%) had an abnormality of gastrointestinal tract, and 14 (18%) had solid organ infarctions or vascular thromboses. In multivariate analysis, age (OR 0.85, p = 0.023), hemoglobin (OR 0.83, p = 0.029) and male gender (OR 2.58, p = 0.032) were independent predictors of positive abdominopelvic findings, adjusted for race and Charlson comorbidity index.

Conclusion

Abdominopelvic CT performed on COVID-positive patients yielded a positive finding in 57% of patients. Younger age, male gender, and lower hemoglobin were associated with higher odds of having reportable positive abdominopelvic CT findings.
Literatur
2.
Zurück zum Zitat Wadman M, Couzin-Frankel J, Kaiser J, Matacic C. A rampage through the body. Science. 2020;368(6489):356-60.PubMed Wadman M, Couzin-Frankel J, Kaiser J, Matacic C. A rampage through the body. Science. 2020;368(6489):356-60.PubMed
3.
Zurück zum Zitat Luo S, Zhang X, Xu H. Don’t Overlook Digestive Symptoms in Patients With 2019 Novel Coronavirus Disease (COVID-19). Clin Gastroenterol Hepatol. 2020. Luo S, Zhang X, Xu H. Don’t Overlook Digestive Symptoms in Patients With 2019 Novel Coronavirus Disease (COVID-19). Clin Gastroenterol Hepatol. 2020.
4.
Zurück zum Zitat Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.CrossRef Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.CrossRef
5.
Zurück zum Zitat Sultan S, Altayar O, Siddique SM, Davitkov P, Feuerstein JD, Lim JK, et al. AGA Institute Rapid Review of the GI and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19. Gastroenterology. 2020. Sultan S, Altayar O, Siddique SM, Davitkov P, Feuerstein JD, Lim JK, et al. AGA Institute Rapid Review of the GI and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19. Gastroenterology. 2020.
6.
Zurück zum Zitat Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, et al. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med. 2020;382(10):929-36.CrossRef Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, et al. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med. 2020;382(10):929-36.CrossRef
7.
Zurück zum Zitat Dane B, Brusca-Augello G, Kim D, Katz DS. Unexpected Findings of Coronavirus Disease (COVID-19) at the Lung Bases on Abdominopelvic CT. AJR Am J Roentgenol. 2020:1-4. Dane B, Brusca-Augello G, Kim D, Katz DS. Unexpected Findings of Coronavirus Disease (COVID-19) at the Lung Bases on Abdominopelvic CT. AJR Am J Roentgenol. 2020:1-4.
8.
Zurück zum Zitat Hossain R, Lazarus MS, Roudenko A, Dako F, Mehta V, Alis J, et al. CT Scans Obtained for Nonpulmonary Indications: Associated Respiratory Findings of COVID-19. Radiology. 2020:201743. Hossain R, Lazarus MS, Roudenko A, Dako F, Mehta V, Alis J, et al. CT Scans Obtained for Nonpulmonary Indications: Associated Respiratory Findings of COVID-19. Radiology. 2020:201743.
9.
Zurück zum Zitat Siegel A, Chang PJ, Jarou ZJ, Paushter DM, Harmath CB, Arevalo JB, et al. Lung Base Findings of Coronavirus Disease (COVID-19) on Abdominal CT in Patients With Predominant Gastrointestinal Symptoms. AJR Am J Roentgenol. 2020:1-3. Siegel A, Chang PJ, Jarou ZJ, Paushter DM, Harmath CB, Arevalo JB, et al. Lung Base Findings of Coronavirus Disease (COVID-19) on Abdominal CT in Patients With Predominant Gastrointestinal Symptoms. AJR Am J Roentgenol. 2020:1-3.
10.
Zurück zum Zitat Bhayana R, Som A, Li MD, Carey DE, Anderson MA, Blake MA, et al. Abdominal Imaging Findings in COVID-19: Preliminary Observations. Radiology. 2020:201908. Bhayana R, Som A, Li MD, Carey DE, Anderson MA, Blake MA, et al. Abdominal Imaging Findings in COVID-19: Preliminary Observations. Radiology. 2020:201908.
11.
Zurück zum Zitat Poyiadi N, Cormier P, Patel PY, Hadied MO, Bhargava P, Khanna K, et al. Acute Pulmonary Embolism and COVID-19. Radiology. 2020:201955. Poyiadi N, Cormier P, Patel PY, Hadied MO, Bhargava P, Khanna K, et al. Acute Pulmonary Embolism and COVID-19. Radiology. 2020:201955.
12.
Zurück zum Zitat Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020. Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020.
13.
Zurück zum Zitat Lushina N, Kuo JS, Shaikh HA. Pulmonary, Cerebral, and Renal Thromboembolic Disease Associated with COVID-19 Infection. Radiology. 2020:201623. Lushina N, Kuo JS, Shaikh HA. Pulmonary, Cerebral, and Renal Thromboembolic Disease Associated with COVID-19 Infection. Radiology. 2020:201623.
14.
Zurück zum Zitat Prokop M, van Everdingen W, van Rees Vellinga T, Quarles van Ufford J, Stoger L, Beenen L, et al. CO-RADS - A categorical CT assessment scheme for patients with suspected COVID-19: definition and evaluation. Radiology. 2020:201473. Prokop M, van Everdingen W, van Rees Vellinga T, Quarles van Ufford J, Stoger L, Beenen L, et al. CO-RADS - A categorical CT assessment scheme for patients with suspected COVID-19: definition and evaluation. Radiology. 2020:201473.
15.
Zurück zum Zitat Austin SR, Wong YN, Uzzo RG, Beck JR, Egleston BL. Why Summary Comorbidity Measures Such As the Charlson Comorbidity Index and Elixhauser Score Work. Medical care. 2015;53(9):e65-72.CrossRef Austin SR, Wong YN, Uzzo RG, Beck JR, Egleston BL. Why Summary Comorbidity Measures Such As the Charlson Comorbidity Index and Elixhauser Score Work. Medical care. 2015;53(9):e65-72.CrossRef
16.
Zurück zum Zitat Quan H, Li B, Couris CM, Fushimi K, Graham P, Hider P, et al. Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. American Journal of Epidemiology. 2011;173(6):676-82.CrossRef Quan H, Li B, Couris CM, Fushimi K, Graham P, Hider P, et al. Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. American Journal of Epidemiology. 2011;173(6):676-82.CrossRef
17.
Zurück zum Zitat Fan Z, Chen L, Li J, Cheng X, Yang J, Tian C, et al. Clinical Features of COVID-19-Related Liver Functional Abnormality. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2020;18(7):1561-6.CrossRef Fan Z, Chen L, Li J, Cheng X, Yang J, Tian C, et al. Clinical Features of COVID-19-Related Liver Functional Abnormality. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2020;18(7):1561-6.CrossRef
18.
Zurück zum Zitat Park SJ, Kim JD, Seo YS, Park BJ, Kim MJ, Um SH, et al. Computed tomography findings for predicting severe acute hepatitis with prolonged cholestasis. World journal of gastroenterology : WJG. 2013;19(16):2543-9.CrossRef Park SJ, Kim JD, Seo YS, Park BJ, Kim MJ, Um SH, et al. Computed tomography findings for predicting severe acute hepatitis with prolonged cholestasis. World journal of gastroenterology : WJG. 2013;19(16):2543-9.CrossRef
19.
Zurück zum Zitat Cheung KS, Hung IF, Chan PP, Lung KC, Tso E, Liu R, et al. Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples from the Hong Kong Cohort and Systematic Review and Meta-analysis. Gastroenterology. 2020. Cheung KS, Hung IF, Chan PP, Lung KC, Tso E, Liu R, et al. Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples from the Hong Kong Cohort and Systematic Review and Meta-analysis. Gastroenterology. 2020.
20.
Zurück zum Zitat Organization WH, Organization WH. Report of the WHO-China joint mission on coronavirus disease 2019 (COVID-19). Geneva; 2020. Organization WH, Organization WH. Report of the WHO-China joint mission on coronavirus disease 2019 (COVID-19). Geneva; 2020.
21.
Zurück zum Zitat Kakodkar P, Kaka N, Baig MN. A Comprehensive Literature Review on the Clinical Presentation, and Management of the Pandemic Coronavirus Disease 2019 (COVID-19). Cureus. 2020;12(4):e7560.PubMedPubMedCentral Kakodkar P, Kaka N, Baig MN. A Comprehensive Literature Review on the Clinical Presentation, and Management of the Pandemic Coronavirus Disease 2019 (COVID-19). Cureus. 2020;12(4):e7560.PubMedPubMedCentral
22.
Zurück zum Zitat Jin X, Lian JS, Hu JH, Gao J, Zheng L, Zhang YM, et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut. 2020;69(6):1002-9.CrossRef Jin X, Lian JS, Hu JH, Gao J, Zheng L, Zhang YM, et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut. 2020;69(6):1002-9.CrossRef
23.
Zurück zum Zitat Chen A, Agarwal A, Ravindran N, To C, Zhang T, Thuluvath PJ. Are Gastrointestinal Symptoms Specific for COVID-19 Infection? A Prospective Case-Control Study from the United States. Gastroenterology. 2020. Chen A, Agarwal A, Ravindran N, To C, Zhang T, Thuluvath PJ. Are Gastrointestinal Symptoms Specific for COVID-19 Infection? A Prospective Case-Control Study from the United States. Gastroenterology. 2020.
24.
Zurück zum Zitat Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844-7.CrossRef Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844-7.CrossRef
25.
Zurück zum Zitat Sun S, Cai X, Wang H, He G, Lin Y, Lu B, et al. Abnormalities of peripheral blood system in patients with COVID-19 in Wenzhou, China. Clin Chim Acta. 2020;507:174-80.CrossRef Sun S, Cai X, Wang H, He G, Lin Y, Lu B, et al. Abnormalities of peripheral blood system in patients with COVID-19 in Wenzhou, China. Clin Chim Acta. 2020;507:174-80.CrossRef
26.
Zurück zum Zitat Zheng Y, Sun LJ, Xu M, Pan J, Zhang YT, Fang XL, et al. Clinical characteristics of 34 COVID-19 patients admitted to intensive care unit in Hangzhou, China. J Zhejiang Univ Sci B. 2020;21(5):378-87.CrossRef Zheng Y, Sun LJ, Xu M, Pan J, Zhang YT, Fang XL, et al. Clinical characteristics of 34 COVID-19 patients admitted to intensive care unit in Hangzhou, China. J Zhejiang Univ Sci B. 2020;21(5):378-87.CrossRef
27.
Zurück zum Zitat RSNA COVID-19 Task Force rsnaorg/COVID-19. RSNA COVID-19 Task Force rsnaorg/COVID-19.
Metadaten
Titel
Abdominopelvic CT findings in patients with novel coronavirus disease 2019 (COVID-19)
verfasst von
Shlomit Goldberg-Stein
Adam Fink
Viktoriya Paroder
Mariya Kobi
Judy Yee
Victoria Chernyak
Publikationsdatum
06.08.2020
Verlag
Springer US
Schlagwort
COVID-19
Erschienen in
Abdominal Radiology / Ausgabe 9/2020
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-020-02669-2

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