Abdominal Imaging Findings in COVID-19: Preliminary Observat
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Angiotensin converting enzyme 2 (ACE2), a target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), demonstrates its highest surface expression in the lung, small bowel, and vasculature, suggesting abdominal viscera may be susceptible to injury.

The purpose of this study was to report abdominal imaging findings in patients with COVID-19. In this retrospective cross-sectional study, patients consecutively admitted to a single quaternary care center who tested positive for SARS-CoV-2 were included. Abdominal imaging studies performed in these patients were reviewed and salient findings recorded. Medical records were reviewed for clinical data. Univariable analysis and logistic regression were performed.

Results: 412 patients (average age 57 years; range 18->90 years; 241 men, 171 women) were evaluated.
-- 33% of inpatients with COVID-19 had abdominal imaging and 17% had cross-sectional imaging. Imaging was associated with age (OR 1.03 per year increase) and intensive care unit (ICU) admission (OR 17.3).
-- 54% of right upper quadrant ultrasounds demonstrated findings of cholestasis.
-- 31% of CTs showed bowel wall abnormalities. Signs of late ischemia were seen on 20% of CTs in ICU patients (2.7% of ICU patients), with pathologic correlation suggesting small vessel thrombosis.

Conclusively, Bowel abnormalities and cholestasis were common findings on abdominal imaging of inpatients with COVID-19. Patients who went to laparotomy often had ischemia, possibly due to small vessel thrombosis.

Source: https://pubs.rsna.org/doi/10.1148/radiol.2020201908