An Imaging Overview of COVID-19 ARDS in ICU Patients and Its Complications: A Pictorial Review

Abstract

A significant proportion of patients with COVID-19 pneumonia could develop acute respiratory distress syndrome (ARDS), thus requiring mechanical ventilation, and resulting in a high rate of intensive care unit (ICU) admission. Several complications can arise during an ICU stay, from both COVID-19 infection and the respiratory supporting system, including barotraumas (pneumothorax and pneumomediastinum), superimposed pneumonia, coagulation disorders (pulmonary embolism, venous thromboembolism, hemorrhages and acute ischemic stroke), abdominal involvement (acute mesenteric ischemia, pancreatitis and acute kidney injury) and sarcopenia. Imaging plays a pivotal role in the detection and monitoring of ICU complications and is expanding even to prognosis prediction. The present pictorial review describes the clinicopathological and radiological findings of COVID-19 ARDS in ICU patients and discusses the imaging features of complications related to invasive ventilation support, as well as those of COVID-19 itself in this particularly fragile population. Radiologists need to be familiar with COVID-19's possible extra-pulmonary complications and, through reliable and constant monitoring, guide therapeutic decisions. Moreover, as more research is pursued and the pathophysiology of COVID-19 is increasingly understood, the role of imaging must evolve accordingly, expanding from the diagnosis and subsequent management of patients to prognosis prediction.

Co-Infections and Superinfections in COVID-19 Critically Ill Patients Are Associated with CT Imaging Abnormalities and the Worst Outcomes

“…Although it has been more than 2 years since the first outbreak, the coronavirus disease 2019 (COVID-19) pandemic is still having a profound and devastating impact on global healthcare systems. COVID-19 is responsible for a respiratory disease whose broad spectrum of severity ranges from asymptomatic or mildly symptomatic infection to severe bilateral pneumonia, which may lead to acute respiratory distress syndrome (ARDS), requiring non-invasive or invasive mechanical ventilation and Intensive Care Unit (ICU) admission [ 1 ].…”

Characterization and Outcomes of SARS-CoV-2 Infection in Overweight and Obese Patients: A Dynamic Comparison of COVID-19 Pandemic Waves

“…The most often seen symptoms of the 2019 coronavirus disease (COVID-19) are mostly unspecific, such as fever, fatigue and dry cough with high prevalence [ 10 , 11 , 12 ]. Pneumonia, pulmonary embolism, and acute respiratory distress syndrome (ARDS) are all respiratory symptoms and possible severe manifestations of severe COVID-19 [ 13 , 14 , 15 ]. All age groups are susceptible to infection, and the median age of hospitalized cohorts ranges between 50 and 60 years [ 16 , 17 ].…”

Novel COVID-19 Diagnosis Delivery App Using Computed Tomography Images Analyzed with Saliency-Preprocessing and Deep Learning

“…CT also plays a fundamental role in intensive care units for detecting and monitoring life-threatening complications related to COVID-19. Using CT improves prognosis and survival predictions in patients with COVID-19 [15].…”

“…ography 2022, 8, 2 of 14 units for detecting and monitoring life-threatening complications related to COVID-19. Using CT improves prognosis and survival predictions in patients with COVID-19 [15]. Deep learning can be used to perform a quantitative and rigorous analysis of the infected volume on CT images [16,17].…”