ABSTRACT
BackgroundSince 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.ResultsThis 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.ConclusionPatients 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.
ABSTRACT
PURPOSE: To report imaging findings at computed tomography angiography (CTA) and venography (CTV) of the abdomen and pelvis in evaluation of hemorrhagic and thrombotic lesions in hospitalized patients with COVID-19. METHODS: In this retrospective observational study, patients admitted to a single tertiary care center from April 1 to July 20, 2020, who tested positive for SARS-CoV-2 and developed acute abdominal pain or decreasing hemoglobin levels over the course of hospitalization were included. Abdominal CTA/CTV imaging studies performed in these patients were reviewed, and acute hemorrhagic or thromboembolic findings were recorded. RESULTS: A total of 40 patients (mean age, 59.7 years; 20 men, 20 women) were evaluated. Twenty-five patients (62.5%) required intensive care unit (ICU) admission and 15 patients (37.5%) were treated in the medical ward. Hemorrhagic complications were detected in 19 patients (47.5%), the most common was intramuscular hematoma diagnosed in 17 patients; It involved the iliopsoas compartment unilaterally in 10 patients, bilaterally in 2 patients and the rectus sheath in 5 cases. Pelvic extraperitoneal hemorrhage was found in 3 patients, and mesenteric hematoma in one patient. Thromboembolic events were diagnosed in 8 patients (20%) including; arterial thrombosis (n = 2), venous thrombosis (n = 2), splenic infarct (n = 1), bowel ischemia (n = 1) and multiple sites of thromboembolism (n = 2). CONCLUSION: Our study highlights that both hemorrhagic and thromboembolic complications can be seen in hospitalized patients with COVID-19. It is important that radiologists maintain a high index of suspicion for early diagnosis of these complications.