ABSTRACT
Background: The novel worldwide coronavirus (COVID-19) pandemic, first appearing in Wuhan, China, has allured immense global attention. To our comprehension, this research work accommodates the largest isolation hospital-conducted cohort of coronavirus patients in which neuro-radiological complications were retrospectively assessed. To the present day, our full understanding of COVID-19 and its spectrum of diverse complications still remains insufficient. Moreover, the number of reported neurological complications albeit the global spread of the coronavirus pandemic is also widely lacking due to the constrained implementation of MR neuro-imaging in COVID-19 patients. Results: Forty-eight males and 26 females met the inclusion criteria, with a mean age 60.55 (ranged from 22 to 88 years old). The frequent clinical manifestation has impaired level of consciousness 55.4%. Most commonly recurring radiological findings were ischemic stroke 54.06% and parenchymal hematomas and hemorrhage 25.69%. Other less imaging brain findings were certain diagnostic entities, i.e., PRES, cerebral edema, leuko-encephalopathic WM abnormalities, microhemorrhages, vascular thrombosis and acute necrotizing encephalopathy. Soaring mortality rates correlated with serious neuro-radiological manifestations, being highest with infarction 57.5%, p = 0.908 and hemorrhage/hematomas 63.2%, p = 0.604. Conclusions: Intra-cranial complications were significantly detectable in COVID-19 infection and correlated with severity of illness. Outstanding higher mortality rates were associated with worsening neuro-radiological complications.
ABSTRACT
Background: Since late 2019, COVID-19 infection has quickly spread substantially in all countries, forcing the appropriation of noteworthy lockdown and social separating measures. It has been considered as a pandemic by the World Health Organization. Positive pressure ventilation is a non-physiological and invasive intervention that can be lifesaving in COVID-19 patients. Similar to any other interventions, it can cause its own danger and complications as it can prompt ventilator-induced lung injury and barotrauma. The aim of the work was to identify the incidence of invasive mechanical ventilation complication in COVID-19 pneumonias, and to describe patient characteristics and patterns of barotrauma in COVID-19 patients. Results: This retrospective study included 103 patients with COVID-19 pneumonia, 76 males and 27 females are on invasive mechanical ventilation. Their mean age was 56.6, ranged from 21 to 85 years old. Barotraumas event type in the studied patients, (NB: one or multiple barotrauma events occurring on the same day were considered as single event (95/103 patients-92.23%), while separate multiple events (8/103 patients-7.77%) were recorded when occurring separated by at least 24 h). Single barotrauma events were subdivided into: one event (67/95 patients—70.53%), & multiple events (28/95 patients—29.47%). The mean interval between invasive mechanical ventilation and developing barotraumas was 3–7 days included 41 patients (39.98%). We revealed a strong prevalence of COVID-19 IMV complication with worsening prognosis and subsequent higher death rates in elderly smoker or obese males, as well as those suffering from ARDS. Past medical history (hypertension, DM, chronic renal or cardiac disease) or surgical history of CABG was more liable for these types of complications. Conclusion: Patients with COVID-19 pneumonia were more liable to the higher incidence of barotraumas with presence of predisposition and high risk factors. In general, an outstanding bad prognostic outcome and a significantly high mortality rate prevailed in COVID-19 patients associated with mechanically ventilated patients. © 2021, The Author(s).
ABSTRACT
Studies available in the literature have shown alterations in blood coagulation tests in severe cases of COVID-19 pneumonia, with a significant risk of venous thromboembolism (VTE). Since microvascular thrombosis is a well-known fact in COVID-19 disease, requiring therapeutic anticoagulation, low-molecular weight heparin (LMWH) in prophylactic dose is a part of the clinical management of hospitalized COVID-19 patients. In this scenario, we describe three cases of abdominal spontaneous retroperitoneal hematoma (SRH) in hospitalized reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 patients.
ABSTRACT
Background: Corona virus disease 2019 (COVID-19) pandemic—as declared by the World Health Organization—is a major threatening public health problem. At the time of writing, more than 60,000,000 patients and more than 1,500,000 deaths were recorded worldwide. Besides the classical chest symptoms, gastrointestinal tract-related symptoms were noted, like diarrhea, abdominal distention, and hematochezia, adding more difficulties in the diagnosis of the disease. Although there are many publications evaluated, the thoracic imaging signs and complications of COVID-19, there are few articles—to the best of our knowledge—that evaluated the gastrointestinal tract imaging features and complications related to COVID-19. Results: In this retrospective study, positive COVID-19 patients who underwent diagnostic computed tomography (CT) for abdominal complaints along a 3-month duration in a large isolation hospital were evaluated. Strict infection control measures were taken during the CT examinations. The data were reviewed on picture archiving and communications systems with clinical data and laboratory result correlation. Thirty patients (30%) showed gastrointestinal (GI) findings, and 70 patients showed unremarkable or non-related GI findings. The 30 patients were classified into four groups: the ischemic group including 10 patients (10/30: 33.33%), the bleeding group included six patients (6/30: 20%), the inflammatory group included nine patients (9/30: 30%), and fluid-filled bowel group included five patients (5/30: 16.6%). Conclusions: COVID-19 should be evaluated as a systemic disease with extra pulmonary highlights. GI imaging should be considered for COVID-19 patients with related suspicious symptoms. Ischemic GI complications were the most common GI findings. © 2021, The Author(s).
ABSTRACT
Background: In December 2019, a large outbreak of a novel coronavirus infection occurred in Wuhan, China. The pneumonic disease caused by this virus is called coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO). As case numbers have increased worldwide, gastro-intestinal symptoms like diarrhea, constipation, abdominal pain, and vomiting have been increased, these symptoms associated with positive laboratory results including abnormal liver function tests, renal function tests, and D-Dimer levels. Although there are multiple articles evaluated the imaging findings in HRCT of COVID-19 patients that helped in understanding the disease course and potential complications in the chest, yet there are—to our knowledge—limited data about the abdominal imaging findings of the course and potential abdominal complications of COVID-19 notably in the intensive care units (ICU). Results: Forty-one sonographic examinations were done for 30 confirmed COVID-intensive care patients presented with abdominal symptoms. Of the 30 patients, 26 were males (86.66%), and 4 were females (13.3%), the average age of the patients was 57.7 years old. The most common sonographic observation was hepatomegaly (n, 23/41, 56%) and biliary system disease (n, 17/41, 41.4%);the imaging findings were correlated with the clinical and laboratory data. CT examination when indicated (in our study to assess hematomas for active extravasation and to assess bowel obstruction and its level). Conclusion: Abdominal sonographic imaging was often performed for inpatients with COVID-19. Hepatobiliary dysfunction as well as nephropathy was the most common imaging findings.