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Lung base CT findings in COVID-19 adult patients presenting with acute abdominal complaints: case series from a major New York City health system.
King, Michael J; Lewis, Sara; El Homsi, Maria; Hernandez Meza, Gabriela; Bernheim, Adam; Jacobi, Adam; Chung, Michael; Taouli, Bachir.
  • King MJ; Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA.
  • Lewis S; Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA. Sara.Lewis@mountsinai.org.
  • El Homsi M; BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA. Sara.Lewis@mountsinai.org.
  • Hernandez Meza G; Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA.
  • Bernheim A; Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA.
  • Jacobi A; Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA.
  • Chung M; Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA.
  • Taouli B; Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA.
Eur Radiol ; 30(12): 6685-6693, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-631205
Semantic information from SemMedBD (by NLM)
1. Acute abdominal complaint PROCESS_OF Patients
Subject
Acute abdominal complaint
Predicate
PROCESS_OF
Object
Patients
2. Abdomen LOCATION_OF Chief complaint (finding)
Subject
Abdomen
Predicate
LOCATION_OF
Object
Chief complaint (finding)
3. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
4. Chief complaint (finding) PROCESS_OF Patients
Subject
Chief complaint (finding)
Predicate
PROCESS_OF
Object
Patients
5. CT of lungs ADMINISTERED_TO radiologist
Subject
CT of lungs
Predicate
ADMINISTERED_TO
Object
radiologist
6. Hypertensive disease PROCESS_OF Woman
Subject
Hypertensive disease
Predicate
PROCESS_OF
Object
Woman
7. Senility PROCESS_OF Patients
Subject
Senility
Predicate
PROCESS_OF
Object
Patients
8. Abdominal symptom PROCESS_OF Patients
Subject
Abdominal symptom
Predicate
PROCESS_OF
Object
Patients
9. Infected PROCESS_OF Patients
Subject
Infected
Predicate
PROCESS_OF
Object
Patients
10. Acute abdominal complaint PROCESS_OF Patients
Subject
Acute abdominal complaint
Predicate
PROCESS_OF
Object
Patients
11. Abdomen LOCATION_OF Chief complaint (finding)
Subject
Abdomen
Predicate
LOCATION_OF
Object
Chief complaint (finding)
12. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
13. Chief complaint (finding) PROCESS_OF Patients
Subject
Chief complaint (finding)
Predicate
PROCESS_OF
Object
Patients
14. CT of lungs ADMINISTERED_TO radiologist
Subject
CT of lungs
Predicate
ADMINISTERED_TO
Object
radiologist
15. Hypertensive disease PROCESS_OF Woman
Subject
Hypertensive disease
Predicate
PROCESS_OF
Object
Woman
16. Senility PROCESS_OF Patients
Subject
Senility
Predicate
PROCESS_OF
Object
Patients
17. Abdominal symptom PROCESS_OF Patients
Subject
Abdominal symptom
Predicate
PROCESS_OF
Object
Patients
18. Infected PROCESS_OF Patients
Subject
Infected
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PROCESS_OF
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Patients
ABSTRACT

OBJECTIVE:

To describe demographic, clinical, and lung base CT findings in COVID-19 patients presenting with abdominal complaints.

METHODS:

In this retrospective study, 76 COVID-19 patients who underwent abdominal CT for abdominal complaints from March 1 to April 15, 2020, in a large urban multihospital Health System were included. Those with positive abdominal CT findings (n = 14) were then excluded, with 62 patients undergoing final analysis (30M/32F; median age 63 years, interquartile range (IQR) 52-75 years, range 30-90 years). Demographic and clinical data were extracted. CT lung base assessment was performed by a cardiothoracic radiologist. Data were compared between discharged and hospitalised patients using Wilcoxon or Fisher's exact tests.

RESULTS:

The majority of the population was non-elderly (56.4%, < 65 years) and most (81%) had underlying health conditions. Nineteen percent were discharged and 81% were hospitalised. The most frequent abdominal symptoms were pain (83.9%) and nausea/vomiting/anorexia (46.8%). Lung base CT findings included ground-glass opacities (95.2%) in a multifocal (95.2%) and peripheral (66.1%) distribution. Elevated laboratory values (when available) included C-reactive protein (CRP) (97.3%), D-dimer (79.4%), and ferritin (68.8% of males and 81.8% of females). Older age (p = 0.045), hypertension (p = 0.019), and lower haemoglobin in women (p = 0.042) were more frequent in hospitalised patients. There was no difference in lung base CT findings between discharged and hospitalised patients (p > 0.165).

CONCLUSIONS:

COVID-19 patients can present with abdominal symptoms, especially in non-elderly patients with underlying health conditions. Lung base findings on abdominal CT are consistent with published reports. Radiologists should be aware of atypical presentations of COVID-19. KEY POINTS • COVID-19 infected patients can present with acute abdominal symptoms, especially in non-elderly patients with underlying health conditions, and may frequently require hospitalisation (81%). • There was no difference in lung base CT findings between patients who were discharged and those who were hospitalised. • Lung base CT findings included multifocal and peripheral ground-glass opacities, consistent with published reports.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Tomography, X-Ray Computed / Abdominal Pain / Coronavirus Infections / Betacoronavirus / Lung Type of study: Controlled clinical trial / Diagnostic study / Etiology study / Observational study / Risk factors Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Eur Radiol Journal subject: Radiology Year: 2020 Document Type: Article Affiliation country: S00330-020-07040-z

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Tomography, X-Ray Computed / Abdominal Pain / Coronavirus Infections / Betacoronavirus / Lung Type of study: Controlled clinical trial / Diagnostic study / Etiology study / Observational study / Risk factors Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Eur Radiol Journal subject: Radiology Year: 2020 Document Type: Article Affiliation country: S00330-020-07040-z