Coincidental Respiratory Findings of COVID-19 on Abdominal CT in Patients with Predominant Abdominal Indications

Abstract

Objective: Our aim in this study was to report the findings related to coronavirus disease (COVID-19) in abdominal Computed Tomography (CT) in patients presenting with abdominal symptoms. Methods: The study includes 40 adult patients (22-88 ages), who underwent abdominal CT from March-June 2020. Clinical findings, laboratory data and imaging findings were analyzed. All patients were confirmed by Revers-Transcriptase Polymerase Chain Reaction (RT-PCR). Results: This study included patients with abdominal pain, nausea, diarrhea, and anorexia but without respiratory symptoms consistent with COVID-19. Abdominal pain, was the most common indication for CT in these patients without clinical suspicion of COVID-19 (n = 31) and 32 patients had no extrapulmonary findings. Conclusion: When evaluating CT scans of patients with abdominal pain, attention to lung bases may reveal clinically unexpected diagnoses of COVID-19, which may lead to early diagnosis and treatment, as well as prevention of the disease spread.

Keywords

• COVID-19
• extrapulmonary
• abdominal CT

Abdominal Endikasyonlar ile Elde Edilen BT Taramalarında COVID-19'a Ait Rastlantısal Respiratuar Bulgular

Abstract

Amaç: Bu çalışmada amacımız abdominal semptomları olan hastalarda abdominal Bilgisayarlı Tomografi (BT)’de koronavirüs hastalığı (COVID-19) ile ilgili bulguları bildirmektir. Yöntem: Bu retrospektif çalışmaya Mart-Haziran 2020'den itibaren batın BT çekilen 40 erişkin hasta (22-88 yaş) dahil edildi. Klinik bulgular, laboratuvar verileri ve görüntüleme bulguları analiz edildi. Tüm hastalar Revers-Transkriptaz Polimeraz Zincir Reaksiyonu (RT-PCR) ile doğrulandı. Bulgular: Bu çalışma, karın ağrısı, mide bulantısı, ishal ve anoreksiyası olan, ancak COVID-19 ile uyumlu solunum semptomları olmayan hastaları içermekte idi. Karın ağrısı, klinik COVID-19 şüphesi olmayan bu hastalarda (n = 31) en sık BT endikasyonuydu ve 32 hastada ekstrapulmoner bulgu yoktu. Sonuç: Abdominal semptomlar ile başvuran hastalarda batın BT incelemelerini değerlendirirken akciğer bazallerine dikkat edilmesi klinik olarak şüphelenilmeyen olgularda COVID-19 tanısını sağlayarak gerek erken tanı ve tedavide gerekse hastalığın yayılımını önlemede yarar sağlayabilir

Keywords

• COVID-19
• ekstrapulmoner
• abdominal BT

References

1. World Health Organization. Novel coronavirus-China.https://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/.(2020). Accessed January 12, 2020.
2. Li G, Fan Y, Lai Y, Han T, Li Z, et al. Coronavirus infections and immune responses. J. Med. Virol.2002;92, 424–432.
3. U.S. Centers for Disease Control and Prevention (CDC). COVID-19 infection prevention and control in healthcare settings: questions and answers. CDC website. www.cdc.gov/coronavirus/2019ncov/infection-control/infection-prevention-controlfaq.html. Updated April 1, 2020. Accessed April 10, 2020.
4. Chen J, Peng S, Zhang B, Liu Z, Liu L, Zhang W. An uncommon manifestation of COVID-19 pneumonia on CT scan with small cavities in the lungs: A case report. Medicine (Baltimore). 2020:10;99(28):e21240. doi: 10.1097/MD.0000000000021240.
5. Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N et al. Chest CT findings in coronavirus disease-19(COVID-19):relationship to duration of infection. Radiology 2020:295(3):200463. doi:10.1148/radiol.2020200463.
6. Gao QY, Chen YX, Fang JY. 2019 novel coronavirus infection and gastrointestinal tract. J Dig Dis. 2020;21(3):125-126. doi: 10.1111/1751-2980.12851.
7. Zhao X, Liu B, Yu Y, Wang X, Du Y, Gu J et al. The characteristics and clinical value of chest CT images of novel coronavirus pneumonia. Clin Radiol. 2020:75(5):335–340. doi.org/10.1016/j.crad.2020.03.002.
8. Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19): a systematic review of imaging findings in 919 patients. AJR Am J Roentgenol. 2020;215(1):87-93. doi: 10.2214/AJR.20.23034

9. Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020;92(6):552-555. doi: 10.1002/jmv.25728
10. Pan L, Mu M, Yang P, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study. Am J Gastroenterol. 2020;115(5):766-773. doi: 10.14309/ajg.0000000000000620.