Lung Base Findings of Coronavirus Disease (COVID-19) on Abdominal CT in Patients With Predominant Gastrointestinal Symptoms

Siegel, Avielle; Chang, Paul; Jarou, Zachary J.; Paushter, David M.; Harmath, Carla; Arévalo, Julián; Dachman, Abraham H.

doi:10.2214/ajr.20.23232

Cited by 64 publications

(65 citation statements)

References 2 publications

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“…Pre-pandemic reports have assessed the value of close examination of the lung bases for clinically significant abnormalities [16]. Our study, and others [8][9][10]15], show that lung base abnormalities on abdominal CT may now include findings that suggest a diagnosis of COVID-19 disease in a substantial percentage of cases.…”

Section: Discussionsupporting

confidence: 51%

“…The pulmonary manifestations have tended to overshadow the abdominal symptoms of the disease, even though some reports [7] have indicated that as many as 57% of patients with low-severity COVID-19 disease have abdominal complaints alone or in combination with pulmonary symptoms. If abdominal CT is performed, the radiologist may be the first to suggest COVID-19 when imaging of the lung bases show typical findings of COVID-19 pulmonary disease [8][9][10]. In other patients, the diagnosis of COVID-19 may already be known or suspected, but abdominal symptoms are of sufficient severity to result in requests for abdominal CT.…”

Section: Introductionmentioning

confidence: 99%

“…However, radiologists may be less familiar with the frequency of abdominal symptoms in these patients and that abdominal complaints may be present in the absence of clinical pulmonary disease. Findings at the lung bases in abdominal CT scans may be the first hint of novel coronavirus disease [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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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.

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Section: Discussionsupporting

confidence: 51%

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…Two recent studies have been published in patients presenting with abdominal symptoms who had imaging findings suggestive of COVID-19 in the lung bases, the largest report consisting of 23 patients undergoing abdominal CT that retrospectively evaluated the findings in the lungs but not their impact on diagnosis. (9,10).…”

Section: Discussionmentioning

confidence: 99%

CT Scans Obtained for Nonpulmonary Indications: Associated Respiratory Findings of COVID-19

Hossain

Lazarus

Roudenko³

et al. 2020

Radiology

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Background: Atypical manifestations of COVID-19 are being encountered as the pandemic unfolds, leading to non-chest CT scans that may uncover unsuspected pulmonary disease.Purpose: To investigate patients with primary non-respiratory symptoms who underwent abdomen/pelvis or cervical spine/neck CT with unsuspected findings highly suspicious for pulmonary COVID-19. three institutions, two in a region considered a hotspot (area of high prevalence) for COVID-19. Patients without known COVID-19 were included who presented to the emergency room (ER) with primary non-respiratory [gastrointestinal (GI) or neurological] symptoms, had lung parenchymal findings suspicious for COVID-19 on a non-chest CT but no concurrent chest CT and had COVID-19 testing in the ER. Group 1 patients had RT PCR obtained pre-CT read (COVID-19 suspected on presentation); Group 2 had RT PCR obtained post-CT read (COVID-19 not suspected). Presentation and imaging findings were compared and outcomes were evaluated. Descriptive statistics and Fisher exact tests were used for analysis.Results: Group 1 comprised 62 patients [31 men, 31 women, mean age 67(SD ±17) years] and group 2 comprised 57 patients [28 men, 29 women, mean age 63(SD ± 16) years). Cough and fever were more common in group 1 (37/62, 60%, 29/62, 47%) than group 2

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“…CT scans suggestive of typical findings of COVID-19 in lung bases. 8 Patients can even have GI symptoms in the absence of respiratory symptoms, as seen in 16% of patients in a study by Luo et al 9 Therefore, accurate history taking and documenting gastrointestinal complaints is essential to prevent missing out on the diagnosis of COVID-19 in patients who lack respiratory symptoms.…”

Section: Gi Symptomatologymentioning

confidence: 99%

Gastrointestinal and Liver Manifestations of COVID-19

Taneja

Mehtani

Chawla

2020

Annals of the National Academy of Medical Sciences (India)

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A novel Coronavirus, SARS-CoV-2 illness, has spread throughout the world after the first case was reported from Wuhan, China, in December 2019. This illness typically causes respiratory symptoms like fever, cough, and shortness of breath, although atypical presentation with gastrointestinal symptoms like abdominal pain, nausea, vomiting, or diarrhea are being increasingly reported. The viral RNA has been detected in saliva and stool of such patients, which raises concerns regarding the risk of transmission during gastrointestinal (GI) endoscopy. Many patients also have liver involvement, with the most common manifestation being deranged liver function tests. This review highlights the symptomatology, mechanism, and histopathology findings of SARS-CoV-2 in GI tract and liver. This review also focuses on implications of COVID-19 in patients afflicted with chronic liver disease and in patients undergoing liver transplantation.

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Lung Base Findings of Coronavirus Disease (COVID-19) on Abdominal CT in Patients With Predominant Gastrointestinal Symptoms

Cited by 64 publications

References 2 publications

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

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

CT Scans Obtained for Nonpulmonary Indications: Associated Respiratory Findings of COVID-19

Gastrointestinal and Liver Manifestations of COVID-19

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