ABSTRACT
The purpose of this article is to describe arterial and venous thromboembolism in the abdomen, pelvis, and lower extremities in patients with coronavirus disease (COVID-19). Eighty-two patients with COVID-19 who underwent abdominal ultrasound or CT were retrospectively compared with 82 patients without COVID-19 for thromboembolism and solid-organ infarction. Nine (11%) patients with COVID-19 had thromboembolic findings, with medium to large arterial thrombi in five. One patient without COVID-19 had known portal vein thrombus on CT. Thromboembolic findings occurred more frequently in patients with than without COVID-19 (p = 0.02).
Subject(s)
COVID-19/complications , Thromboembolism/diagnostic imaging , Thromboembolism/etiology , Thrombophilia , Abdomen/blood supply , Aged , Female , Humans , Lower Extremity/blood supply , Male , Middle Aged , New York , Pelvis/blood supply , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed , UltrasonographyABSTRACT
A high incidence of thrombotic events has been reported in patients with coronavirus disease (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. We report 3 clinical cases of patients in Italy with COVID-19 who developed abdominal viscera infarction, demonstrated by computed tomography.
Subject(s)
Anticoagulants/therapeutic use , Betacoronavirus/pathogenicity , Coronavirus Infections/complications , Heparin, Low-Molecular-Weight/therapeutic use , Infarction/complications , Pneumonia, Viral/complications , Thrombosis/complications , Abdomen/blood supply , Abdomen/pathology , Abdomen/virology , Aged , Antiviral Agents/therapeutic use , Betacoronavirus/drug effects , COVID-19 , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/therapy , Coronavirus Infections/virology , Drug Combinations , Humans , Hydroxychloroquine/therapeutic use , Infarction/diagnostic imaging , Infarction/therapy , Infarction/virology , Italy , Lopinavir/therapeutic use , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , Ritonavir/therapeutic use , SARS-CoV-2 , Thrombosis/diagnostic imaging , Thrombosis/therapy , Thrombosis/virology , Tomography, X-Ray Computed , Viscera/blood supply , Viscera/drug effects , Viscera/pathology , Viscera/virologyABSTRACT
In the hands of experienced examiners, the contrast enhanced sonography (CEUS) offers the possibility to analyze dynamic microcirculatory disturbances in real time dynamically without any risk for kidneys and thyroid gland even in severe progressing disease bedside. Based on severe COVID-19 infections, first experiences with abdominal CEUS examinations are presented. In the stage of an imminent organ failure with significantly reduced kidney and liver function, CEUS can be used to show a narrowing of the organ-supplying arteries, as well as a delayed capillary filling of vessels near the capsule, a regional reduced parenchymal perfusion or an inflammatory hyperemia with capillary hypercirculation. It is possible to quickly rule out organ infarction and to dynamically record the mesenteric arterial and venous blood flow.