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Abdominal Imaging Findings in Laboratory-Confirmed COVID-19 Patients: A Retrospective Observational Study
Tareq Al Taei1, Zainab Yusuf1, Sarah Al Mail1
1Radiology, Salmaniya Medical Complex, Manama, BHR.
Insights
COVID-19 often causes digestive symptoms, prompting imaging. This study found variable abdominal imaging findings in COVID-19 patients, with CT scans more likely to show positive results than ultrasound.
Area of Science:
- Medical Imaging
- Infectious Diseases
- Gastroenterology
Background:
- Coronavirus disease 2019 (COVID-19) commonly presents with respiratory symptoms, but a significant number of patients exhibit digestive symptoms.
- These non-specific gastrointestinal symptoms often necessitate further imaging evaluation to aid diagnosis.
- Understanding abdominal imaging findings in COVID-19 is crucial for accurate diagnosis and patient management.
Purpose of the Study:
- To describe abdominal imaging findings (CT and ultrasound) in COVID-19 patients.
- To evaluate the reasons for ordering these imaging studies.
- To correlate imaging findings with patient demographics.
Main Methods:
- A retrospective observational study was conducted.
- Abdominal CT and ultrasound data from 97 PCR-confirmed COVID-19 patients were analyzed.
- Data on demographics, imaging request reasons, and findings were collected from electronic health records and PACS.
Main Results:
- The majority of patients (57.7%) were male.
- Abdominal pain (60.8%) was the most frequent reason for imaging, followed by abnormal liver enzymes (18.6%).
- Over 75% of imaging studies revealed positive abdominal findings, including non-specific inflammation (19.6%) and gallbladder disease (13.4%). CT scans yielded more positive findings than ultrasound (P < 0.01).
Conclusions:
- Abdominal manifestations of COVID-19 are diverse and research, particularly in certain regions, remains limited.
- Variable presentations of abdominal organ involvement in COVID-19 cases were observed.
- Further data are needed to optimize imaging study selection, protocols, and interpretation for improved patient care.
Background And Aim:
Coronavirus disease 2019 (CO-VID-19) is known to predominantly present with respiratory symptoms; however, a significant proportion of patients present with digestive symptoms. These symptoms are often non-specific and as such prompt the treating physician to request further imaging evaluation. Understanding the abdominal imaging findings in COVID-19 and their possible associations is thus crucial to direct patient care and prevent misdiagnosis. The aim of this study was to describe abdominal imaging findings on both computed tomography (CT) and ultrasound scans in cases with positive COVID-19 polymerase chain reaction (PCR) tests performed at our institution, and also, to evaluate the reason for requesting these imaging studies, and to correlate these findings with patients' demographics.
Methods:
A retrospective observational study was conducted at Salmaniya Medical Complex, Bahrain, between February 2021 and March 2022. We examined the abdominal CT and ultrasound data for PCR-confirmed COVID-19 patients. The demographic data, reason for requesting imaging and imaging findings were gathered by reviewing the hospital's electronic health records and picture archiving and communicating system (PACS).
Results:
The study included 97 patients, with the majority being male (57.7%). The most common reason for imaging was abdominal pain, as seen in over half of the patients (60.8%), followed by deranged liver enzymes (18.6%). More than 75% of imaging studies showed positive abdominal findings with the majority (19.6%) showing non-specific inflammatory findings, followed by gallbladder disease (13.4%). The CT studies were more likely to yield positive findings as compared to ultrasound, with only 7 (11.3%) CT scans yielding normal findings (χ2 = 14.65; P < 0.01).
Conclusion:
To our knowledge, the research conducted on the abdominal manifestations of COVID-19 is still limited, especially in our region. Our study showed that there are variable presentations of abdominal organ involvement in COVID-19 cases, and as such more data is required to direct choice of imaging study, protocol, and interpretation of findings to better guide patient management.
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