Abstract

We sought to determine relative utilization of abdominal imaging modalities in coronavirus disease 2019 (COVID-19) patients at a single institution during the first surge and evaluate whether abdominal magnetic resonance imaging (MRI) changed diagnosis and management. 1107 COVID-19 patients who had abdominal imaging were analyzed for modality and imaging setting. Patients who underwent abdominal MRI were reviewed to determine impact on management. Of 2259 examinations, 80% were inpatient, 14% were emergency, and 6% were outpatient consisting of 55% radiograph (XR), 31% computed tomography (CT), 13% ultrasound (US), and 0.6% MRI. Among 1107 patients, abdominal MRI was performed in 12 within 100 days of positive SARS-CoV-2 PCR. Indications were unrelated to COVID-19 in 75% while MRI was performed for workup of acute liver dysfunction in 25%. In 1 of 12 patients, MRI resulted in change to management unrelated to COVID-19 diagnosis. During the first surge of COVID-19 at one institution, the most common abdominal imaging examinations were radiographs and CT followed by ultrasound with the majority being performed as inpatients. Future COVID-19 surges may place disproportionate demands on inpatient abdominal radiography and CT resources. Abdominal MRI was rarely performed and did not lead to change in diagnosis or management related to COVID-19 but needs higher patient numbers for accurate assessment of utility.

Highlights

  • A number of gastrointestinal (GI) manifestations have been reported in patients with coronavirus disease 2019 (COVID-19), including ileus, Ogilvie syndrome, GI bleeding, bowel ischemia, liver function abnormalities, acute hepatitis, fulminant liver failure, cholestasis, acalculous cholecystitis, cholangitis, and pancreatitis [1,2,3,4,5,6,7,8,9,10,11,12,13]

  • A total of 2259 abdominal computed tomography (CT), magnetic resonance imaging (MRI), US, and XR examinations were performed for 1107 COVID-19 patients (Table 1)

  • Based on this data from a single institution, if abdominal imaging demand is similar, future COVID-19 illness surges may place disproportionate demands on inpatient radiograph and CT resources compared to other abdominal imaging modalities and care settings

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Summary

Introduction

A number of gastrointestinal (GI) manifestations have been reported in patients with coronavirus disease 2019 (COVID-19), including ileus, Ogilvie syndrome, GI bleeding, bowel ischemia, liver function abnormalities, acute hepatitis, fulminant liver failure, cholestasis, acalculous cholecystitis, cholangitis, and pancreatitis [1,2,3,4,5,6,7,8,9,10,11,12,13]. Gastrointestinal symptoms are common, with meta-analyses of COVID-19 patients showing pooled incidence of any GI symptom in 12%, including abdominal pain in 4–5%, diarrhea in 7–8%, and nausea or vomiting in 5–8% [14,15]. Acute liver injury is common in patients with COVID-19, but is most often mild [4,7]. Abdominal magnetic resonance imaging (MRI), should play in this workup has not been defined

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