Abdominal Imaging Findings in COVID-19: Preliminary Observations

Inclusion of 412 patients (mean age 57 years, 58.5% male, 136 (33%) admitted to intensive care). 134 patients (33%) received abdominal imaging (total of 224 images: 137 X-rays, 44 ultrasounds, 42 computed tomography (CT) scans, 1 MRI).

Abdominal imaging was associated with age (OR 1.03 per year plus, p = 0.001) and admission to intensive care (OR 17.3, p < 0.001). Bowel wall abnormalities were observed on 13 CT scans (31%) and were associated with admission to the intensive care unit (OR 15.5, p = 0.01). Intestinal findings included pneumatosis or portal vein gas, observed on 20% of the CT scans in intensive care patients (4 of 20). Surgical exploration (n = 4) revealed unusual yellow discoloration of the bowel (n = 3) and intestinal infarction (n = 2). Pathology revealed ischemic enteritis with uneven necrosis and fibrin thrombus in the arterioles (n = 2). For right upper quadrant ultrasound, 87% (32 out of 37) were performed to explore abnormal liver biology findings, and 54% (20 out of 37) showed a dilated gallbladder filled with sludge suggesting cholestasis. Patients with cholecystostomy (n = 4) had negative bacterial cultures.