Abdominal CT in COVID-19 patients: incidence, indications, and findings

Abstract

Purpose The purpose of this study was to evaluate the frequency, indications, and findings of abdominal CTs ordered in the initial evaluation of patients who had a positive COVID-19 test performed in our institution. Methods Retrospective chart review was performed on all patients who had a positive test for COVID-19 performed at a single quaternary care center from 1/20/2020 through 5/8/2020. In a subset of patients undergoing abdominal CT as part of the initial evaluation, the demographics, suspected COVID-19 status at the time of scan, presenting complaints, and abdominal CT findings were recorded. Cardiothoracic radiologists reviewed and scored the visualized lung bases for the likelihood of COVID-19. Results Only 43 (4.1%) of 1057 COVID-19 patients presented with abdominal complaints sufficient to warrant an abdominal CT. Of these 43 patients, the vast majority (39, 91%) were known or suspected to have COVID-19 at the time of the scan. Most (27/43, 63%) scans showed no acute abdominal abnormality, and those that were positive did not share a discernable pattern of abnormalities. Lung base abnormalities were common, and there was moderate inter-reviewer reliability. Conclusion A minority of COVID-19 patients present with abdominal complaints sufficient to warrant a dedicated CT of the abdomen, and most of these studies will be negative or have abdominal findings not associated with COVID-19. Appropriate lung base findings are a more consistent indication of COVID-19 infection than abdominal findings.

Are asymptomatic gastrointestinal findings on imaging more common in COVID-19 infection? Study to determine frequency of abdominal findings of COVID-19 infection in patients with and without abdominal symptoms and in patients with chest-only CT scans

“…Similar to the GI findings, the overall incidence of abdominal findings especially biliary or gallbladder findings were also low in incidence in our study compared to other studies [ 12 – 14 , 18 ]. This is similar to the observation of Barkmeier et al who found that 63% of patients with abdominal symptoms and COVID-19 had negative CT scans [ 10 ]. The incidence of gallbladder sludge was 2/24 patients with abdominal CT and 1/4 patients with ultrasound.…”

Incidence of Missed Diagnosed COVID-19 Pneumonia on Patients Who Admitted Urology Outpatient Clinic

“…Moreover, in their study, Barkmeier et al stated that there were 42 patients with COVID-19 have abdominal CT that visualized lung bases. They also stated that 79% of these patients have abnormal CT findings on lung bases (13). In this present study, we found that 9.7% of the patients had abnormal CT findings consistent with COVID-19 pneumonia.…”

“…The patients who are not yet suspected COVID-19 may have been characteristic pulmonary findings of COVID-19 pneumonia. Also, CT findings are could be support COVID-19 in patients who are investigated to novel viral pneumonia infection (13). The commonly characteristic CT patterns for COVID are included in; ground-glass opacities, bilateral or multilobar involvement, cavitation, bilateral patchy shadowing, septal or pleural thickening, linear opacities, and discrete pulmonary nodules etc.…”

Imaging in the COVID-19 era: Lessons learned during a pandemic

“…In a study of 1057 patients with COVID-19 and GI complaints, abdominal CTs were warranted in just 4%, the majority of which (63%) showed no acute abnormality[ 120 ]. Bowel wall abnormalities have been observed in 3% of hospitalized patients with COVID-19[ 122 ].…”