Keywords
Key points
- •Coronavirus disease 2019 can affect the bowel, liver, bile ducts, gallbladder, pancreas, spleen, kidney, and blood vessels.
- •Radiologists should scrutinize these organs in imaging studies, regardless of presenting symptomatology, for complications.
- •Bowel ischemic imaging findings may precede gross findings of necrotic change on laparotomy and require to take back to the operating room for a second look.
- •Dual-energy computed tomography can increase the conspicuity of abnormalities, such as enteritis using monoenergetic low kiloelectron volts and iodine overlay reconstructions.
Introduction
- Moheb M.E.
- Naar L.
- Christensen M.A.
- et al.
- Melquist S.
- Estepp K.
- Aleksandrovich Y.
- et al.
- Mauro A.
- De Grazia F.
- Lenti M.V.
- et al.
- Phipps M.M.
- Barraza L.H.
- lasota E.D.
- et al.
- Zhai L.L.
- Xiang F.
- Wang W.
- et al.
- Afshar-Oromieh A.
- Prosch H.
- Schaefer-Prokop C.
- et al.
- Bütikofer S.
- Lenggenhager D.
- Garcia P.D.W.
- et al.
- Palacios S.
- Schiappacasse G.
- Valdes R.
- et al.
- Taya M.
- Paroder V.
- Redelman-Sidi G.
- et al.
- Melquist S.
- Estepp K.
- Aleksandrovich Y.
- et al.
- Afshar-Oromieh A.
- Prosch H.
- Schaefer-Prokop C.
- et al.
- Moheb M.E.
- Naar L.
- Christensen M.A.
- et al.
- Afshar-Oromieh A.
- Prosch H.
- Schaefer-Prokop C.
- et al.
Discussion
Luminal Gastrointestinal Tract
- Taya M.
- Paroder V.
- Redelman-Sidi G.
- et al.
- Funt S.A.
- Cohen S.L.
- Wang J.J.
- et al.
- Zhang M.L.
- Jacobsen F.
- Pepe-Mooney B.J.
- et al.
- Palacios S.
- Schiappacasse G.
- Valdes R.
- et al.
- Zhang M.L.
- Jacobsen F.
- Pepe-Mooney B.J.
- et al.



- Iqbal U.
- Anwar H.
- Siddiqui H.U.
- et al.

Hepatobiliary
- Phipps M.M.
- Barraza L.H.
- lasota E.D.
- et al.
- Phipps M.M.
- Barraza L.H.
- lasota E.D.
- et al.
- Zhai L.L.
- Xiang F.
- Wang W.
- et al.
- Afshar-Oromieh A.
- Prosch H.
- Schaefer-Prokop C.
- et al.
- Bütikofer S.
- Lenggenhager D.
- Garcia P.D.W.
- et al.
- Palacios S.
- Schiappacasse G.
- Valdes R.
- et al.
- Afshar-Oromieh A.
- Prosch H.
- Schaefer-Prokop C.
- et al.
- Bütikofer S.
- Lenggenhager D.
- Garcia P.D.W.
- et al.
- Bütikofer S.
- Lenggenhager D.
- Garcia P.D.W.
- et al.

Pancreas
- Taya M.
- Paroder V.
- Redelman-Sidi G.
- et al.
- Palacios S.
- Schiappacasse G.
- Valdes R.
- et al.
- Palacios S.
- Schiappacasse G.
- Valdes R.
- et al.
- Taya M.
- Paroder V.
- Redelman-Sidi G.
- et al.

Kidneys
- Afshar-Oromieh A.
- Prosch H.
- Schaefer-Prokop C.
- et al.
- Palacios S.
- Schiappacasse G.
- Valdes R.
- et al.
- Palacios S.
- Schiappacasse G.
- Valdes R.
- et al.
Spleen

Vasculature
- Taya M.
- Paroder V.
- Redelman-Sidi G.
- et al.
- Dane B.
- Smereka P.
- Wain R.
- et al.
- Qiu C.
- Li T.
- Wei G.
- et al.
- Dane B.
- Smereka P.
- Wain R.
- et al.
- Palacios S.
- Schiappacasse G.
- Valdes R.
- et al.
- Qiu C.
- Li T.
- Wei G.
- et al.


Summary
Clinics care points
- •Coronavirus disease 2019 can affect the bowel, liver, bile ducts, gallbladder, pancreas, spleen, kidney, and blood vessels.
- •Radiologists should scrutinize these organs in imaging studies, regardless of presenting symptomatology, for complications.
- •Bowel ischemic imaging findings may precede gross findings of necrotic change on laparotomy and require to take back to the operating room for a second look.
- •Dual-energy computed tomography can increase the conspicuity of abnormalities, such as enteritis using monoenergetic low kiloelectron volt and iodine overlay reconstructions.
Disclosure
References
- Abdominal imaging findings in COVID-19: preliminary observations.Radiology. 2020; 297: E207-E215
- Gastrointestinal complications in critically ill patients with and without COVID-19.JAMA. 2020; https://doi.org/10.1001/jama.2020.19400
- Gastrointestinal complications in critically ill patients with COVID-19.Ann Surg. 2020; 272: e61-e62
Bertolini A, van de Peppel IP, Bodewes FAJA, et al. Abnormal liver function tests in COVID-19 patients: relevance and potential pathogenesis. HepatologyN/a(n/a). Doi:10.1002/hep.31480
- COVID-19 presenting as fulminant hepatic failure.Medicine (Baltimore). 2020; 99https://doi.org/10.1097/MD.0000000000022818
- Upper gastrointestinal bleeding in COVID-19 inpatients: incidence and management in a multicenter experience from Northern Italy.Clin Res Hepatol Gastroenterol. 2020; https://doi.org/10.1016/j.clinre.2020.07.025
- Acute liver injury in COVID-19: prevalence and association with clinical outcomes in a large US cohort.Hepatology. 2020; https://doi.org/10.1002/hep.31404
- Severe liver failure during SARS-Cov-2 infection.Gut. 2020; 69: 1365-1367
- COVID-19 presenting as acute hepatitis.Am J Gastroenterol. 2020; 115: 941-942
- Atypical presentations of coronavirus disease 2019 in a patient with acute obstructive suppurative cholangitis.Clin Res Hepatol Gastroenterol. 2020; https://doi.org/10.1016/j.clinre.2020.05.003
- Recurrent acute pancreatitis in a patient with COVID-19 infection.Am J Case Rep. 2020; 21: e927076-1-e927076-3
- Pancreatic injury patterns in patients with coronavirus disease 19 pneumonia.Gastroenterology. 2020; 159: 367-370
- COVID-19 presenting as acute pancreatitis.Pancreatology. 2020; 20: 1026-1027
- A comprehensive review of imaging findings in COVID-19 - status in early 2021.Eur J Nucl Med Mol Imaging. 2021; https://doi.org/10.1007/s00259-021-05375-3
- Secondary sclerosing cholangitis as cause of persistent jaundice in patients with severe COVID-19.Liver Int. 2021; https://doi.org/10.1111/liv.14971
- Gastrointestinal: COVID-19 related ischemic bowel disease.J Gastroenterol Hepatol. 2021; 36: 850https://doi.org/10.1111/jgh.15254
- Ischemic gastrointestinal complications Of COVID-19: A systematic review on imaging presentation.Clin Imaging. 2020; 73: 86-95
- COVID-19: Abdominal and pelvic imaging findings: a primer for radiologists.J Comput Assist Tomogr. 2021; https://doi.org/10.1097/RCT.0000000000001152
- Does COVID-19 cause an increase in spleen dimensions? possible effects of immune activation, hematopoietic suppression and microthrombosis.Clin Imaging. 2021; 79: 104-109
- Abdominal imaging findings on computed tomography in patients acutely infected with SARS-Cov-2: what are the findings?.Emerg Radiol. 2021; https://doi.org/10.1007/s10140-021-01986-3
- COVID-19 induced haemobilia: a novel entity.J Gastrointest Liver Dis JGLD. 2021; 30: 528-530
- Prevalence of gastrointestinal symptoms and fecal viral shedding in patients with coronavirus disease 2019: a systematic review and meta-analysis.JAMA Netw Open. 2020; 3: e2011335
- AGA institute rapid review of the gastrointestinal and liver manifestations of COVID-19, meta-analysis of international data, and recommendations for the consultative management of patients with COVID-19.Gastroenterology. 2020; 159: 320-334.e27
- SARS-Cov-2 infection presenting as colitis with chest and abdomen CT findings.Radiol Case Rep. 2020; 15: 2427-2432
- Gastrointestinal manifestations of SARS-cov-2 infection and virus load in fecal samples from a hong kong cohort: systematic review and meta-analysis.Gastroenterology. 2020; 159: 81-95
- Single cell RNA sequencing of 13 human tissues identify cell types and receptors of human coronaviruses.Biochem Biophys Res Commun. 2020; 526: 135-140
- Binding of SARS Coronavirus to its receptor damages islets and causes acute diabetes.Acta Diabetol. 2010; 47: 193-199
- Abdominal pelvic CT findings compared between COVID-19 positive and COVID-19 negative patients in the emergency department setting.Abdom Radiol N Y. 2020; https://doi.org/10.1007/s00261-020-02796-w
- Clinicopathologic findings in COVID-19-associated ischemic enterocolitis.Histopathology. 2021; https://doi.org/10.1111/his.14457
Al Argan RJ, Alqatari SG, Al Said AH, et al. Gastrointestinal perforation secondary to COVID-19: Case reports and literature review. Medicine (Baltimore). 2021 May 14;100(19):e25771.
- An unusual cause of gastrointestinal perforation in an adolescent patient with beta-thalassemia on deferasirox and SARS-cov-2 infection.J Hematol. 2021; 10: 76-79
- Acute gastrointestinal bleeding in COVID-19 patients: a systematic review and meta-analysis.Clin Endosc. 2021; https://doi.org/10.5946/ce.2021.071
- Gastrointestinal bleeding in COVID-19 patients: a systematic review with meta-analysis.Can J Gastroenterol Hepatol. 2021; 2021: 2534975
- Gastrointestinal bleeding at CT angiography and CT enterography: imaging atlas and glossary of terms.Radiographics. 2021; 41: 1632-1656
- Use of dual-energy CT and iodine maps in evaluation of bowel disease.Radiographics. 2016; 36: 393-406
- Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study.Lancet Lond Engl. 2020; 395: 507-513
- Liver biochemistries in hospitalized patients with COVID-19.Hepatology. 2021; 73: 890-900
- Secondary sclerosing cholangitis in critically ill patients: a rare disease precipitated by severe SARS-Cov-2 infection.BMJ Case Rep. 2020; 13: e237984https://doi.org/10.1136/bcr-2020-237984
- Abdominopelvic CT findings in patients with novel coronavirus disease 2019 (COVID-19).Abdom Radiol N Y. 2020; : 1-11https://doi.org/10.1007/s00261-020-02669-2
- The role of ultrasound and magnetic resonance cholangiopancreatography for the diagnosis of biliary stricture after liver transplantation.Eur J Radiol. 2012; 81: 2089-2092
- Abdominal computed tomography imaging findings in hospitalized COVID-19 patients: a year-long experience and associations revealed by explainable artificial intelligence.J Imaging. 2021; 7: 258
- A systematic review of abdominal imaging findings in COVID-19 patients.Visc Med. 2021; 26: 1-12https://doi.org/10.1159/000518473
- Dual-energy CT in evaluation of the acute abdomen.Radiographics. 2019; 39: 264-286
- Ischemic-like cholangiopathy with secondary sclerosing cholangitis in critically ill patients.Am J Gastroenterol. 2007; 102: 1221-1229
- Cholangiopathy in critically ill patients surviving beyond the intensive care period: a multicentre survey in liver units.Aliment Pharmacol Ther. 2017; 46: 1070-1076
- Mechanisms of SARS-Cov-2 entry into cells.Nat Rev Mol Cell Biol. 2022; 23: 3-20
- SARS-Cov-2 Targets by The Pscrna Profiling of ACE2, TMPRSS2 And Furin Proteases.Iscience. 2020; 23: 101744
- COVID-19: a fatal case of acute liver failure associated with SARS-Cov-2 infection in pre-existing liver cirrhosis.BMC Infect Dis. 2021; 21: 901
- Liver Infection and COVID-19: the electron microscopy proof and revision of the literature.Eur Rev Med Pharmacol Sci. 2021; 25: 2146-2151
- Cholangiopathy after severe COVID-19: clinical features and prognostic implications.Am J Gastroenterol. 2021; 116: 1414-1425
- A case of secondary sclerosing cholangitis due To COVID-19.Clin Imaging. 2021; 80: 239-242
- Secondary sclerosing cholangitis as a complication of severe COVID-19: a case report and review of the literature.Clin Case Rep. 2021; 9: e04068
- Post-COVID-19 cholangiopathy: a novel entity.Am J Gastroenterol. 2021; 116: 1077-1082
- Abdominal imaging utilization during the first COVID-19 surge and utility of abdominal MRI.Tomogr Ann Arbor Mich. 2021; 7: 972-979
- Acute reversible renal failure requiring temporary dialysis in a patient with COVID-19.Radiol Case Rep. 2020; 15: 2449-2452
- Pulmonary, cerebral, and renal thromboembolic disease in a patient with COVID-19.Radiology. 2020; 296: E181-E183
- COVID-19 with an initial presentation of intraperitoneal hemorrhage secondary to spontaneous splenic rupture.Cureus. 2021; 13: e15310
- Hypercoagulability in COVID-19: identification of arterial and venous thromboembolism in the abdomen, pelvis, and lower extremities.Am J Roentgenol. 2020; (AJR.20.23617)https://doi.org/10.2214/AJR.20.23617
- Anticoagulation and bleeding risk in patients with COVID-19.Thromb Res. 2020; 196: 227-230
- hemorrhage and venous thromboembolism in critically ill patients with COVID-19.SAGE Open Med. 2021; 9https://doi.org/10.1177/20503121211020167
- Coagulation abnormalities and thrombosis in patients with COVID-19.Lancet Haematol. 2020; 7: e438-e440
- SARS-cov-2 and portal vein thrombosis: a rare gastrointestinal manifestation of COVID-19.Cureus. 2021; 13: e14340