Emergency room imaging findings in patients presenting after COVID-19 vaccination.

Objectives: Data on potential side effects of COVID-19 vaccines remains limited. This study aims to evaluate the relationship between the clinical presentations and imaging findings of emergency room (ER) patients presenting with suspected side effects or complications of recent COVID-19 vaccination. Materials and Methods: An Institutional Review Board-approved retrospective analysis of vaccinated patients who underwent imaging studies in the ER between December 2020 and August 2021 was conducted. Reports were analyzed for imaging modality, chief complaints, and imaging findings. Results: A total of 173 studies on 161 patients were included: 73 X-rays, 57 computed tomographys, 12 magnetic resonance imagings, and 31 ultrasounds. Analysis of the 168 reports dictated in these 173 studies revealed chest pain (27%), shortness of breath (17%), headache (12.5%), fever (10%), and cough (11.9%) as the most common presenting signs/symptoms. About 57.7% of reports showed no post-vaccine complications. Of the 42.3% of reports with findings, lung opacities/consolidation (36.6%) and cervical and/or axillary adenopathy (35.2%) were most commonly seen; other major findings included saddle embolus (1.4%) and vertebral artery occlusion (1.4%). Conclusion: Chest pain, cough, shortness of breath, and headache were the most common presenting symptoms in the ER after COVID-19 vaccination, and chest X-ray and computed tomography chest angiography were the most commonly ordered studies to assess vaccine-related complications. Lung opacities/consolidations were the most common findings. Given that vascular post-vaccine complications are considered the most dangerous and 2.8% of reports demonstrated positive vascular findings, concern for vascular complications should initiate appropriate imaging to ensure prompt diagnosis and management.

Multisystem Imaging Manifestations of COVID-19, Part 2: From Cardiac Complications to Pediatric Manifestations.

Infection with severe acute respiratory syndrome coronavirus 2 results in coronavirus disease 2019 (COVID-19), which was declared an official pandemic by the World Health Organization on March 11, 2020. COVID-19 has been reported in most countries, and as of August 15, 2020, there have been over 21 million cases of COVID-19 reported worldwide, with over 800 000 COVID-19-associated deaths. Although COVID-19 predominantly affects the respiratory system, it has become apparent that many other organ systems can also be involved. Imaging plays an essential role in the diagnosis of all manifestations of the disease and its related complications, and proper utilization and interpretation of imaging examinations is crucial. A comprehensive understanding of the diagnostic imaging hallmarks, imaging features, multisystem involvement, and evolution of imaging findings is essential for effective patient management and treatment. In part 1 of this article, the authors described the viral pathogenesis, diagnostic imaging hallmarks, and manifestations of the pulmonary and peripheral and central vascular systems of COVID-19. In part 2 of this article, the authors focus on the key imaging features of the varied pathologic manifestations of COVID-19, involving the cardiac, neurologic, abdominal, dermatologic and ocular, and musculoskeletal systems, as well as the pediatric and pregnancy-related manifestations of the virus. Online supplemental material is available for this article. ©RSNA, 2020.

Multisystem Imaging Manifestations of COVID-19, Part 1: Viral Pathogenesis and Pulmonary and Vascular System Complications.

Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) results in coronavirus disease 2019 (COVID-19), which was declared an official pandemic by the World Health Organization on March 11, 2020. The infection has been reported in most countries around the world. As of August 2020, there have been over 21 million cases of COVID-19 reported worldwide, with over 800 000 COVID-19-associated deaths. It has become apparent that although COVID-19 predominantly affects the respiratory system, many other organ systems can also be involved. Imaging plays an essential role in the diagnosis of all manifestations of the disease, as well as its related complications, and proper utilization and interpretation of imaging examinations is crucial. With the growing global COVID-19 outbreak, a comprehensive understanding of the diagnostic imaging hallmarks, imaging features, multisystemic involvement, and evolution of imaging findings is essential for effective patient management and treatment. To date, only a few articles have been published that comprehensively describe the multisystemic imaging manifestations of COVID-19. The authors provide an inclusive system-by-system image-based review of this life-threatening and rapidly spreading infection. In part 1 of this article, the authors discuss general aspects of the disease, with an emphasis on virology, the pathophysiology of the virus, and clinical presentation of the disease. The key imaging features of the varied pathologic manifestations of this infection that involve the pulmonary and peripheral and central vascular systems are also described. Part 2 will focus on key imaging features of COVID-19 that involve the cardiac, neurologic, abdominal, dermatologic and ocular, and musculoskeletal systems, as well as pediatric and pregnancy-related manifestations of the virus. Vascular complications pertinent to each system will be also be discussed in part 2. Online supplemental material is available for this article. ©RSNA, 2020.