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Bowel Abnormalities Described in Inpatients With COVID-19

Bowel wall abnormalities identified on 31 percent of 42 CT scans, associated with ICU admission

THURSDAY, May 14, 2020 (HealthDay News) -- Bowel abnormalities have been identified on abdominal imaging of some inpatients with COVID-19, according to a study published online May 11 in Radiology.

Rajesh Bhayana, M.D., from Massachusetts General Hospital in Boston, and colleagues describe abdominal imaging findings in patients with COVID-19 in a retrospective study involving patients admitted from March 27 to April 10, 2020.

A total of 412 patients were evaluated and 224 abdominal imaging studies were performed in 134 patients (33 percent). The researchers observed positive associations for abdominal imaging with age (odds ratio, 1.03 per-year increase) and intensive care unit (ICU) admission (odds ratio, 17.3). Thirty-one percent of the 42 computed tomography (CT) scans showed bowel wall abnormalities; these findings were associated with ICU admission (odds ratio, 15.5). In 20 percent of the 20 CT scans in ICU patients, bowel findings included pneumatosis or portal venous gas. Unusual yellow discoloration of bowel and bowel infarction were seen in surgical correlation. Ischemic enteritis with patchy necrosis and fibrin thrombi in arterioles was observed in pathology. Eighty-seven percent of right upper quadrant ultrasounds (32 of 37) were performed for liver laboratory findings; 54 percent demonstrated a dilated sludge-filled gallbladder indicative of cholestasis.

"Further studies are required to clarify the cause of bowel findings in patients with COVID-19, in particular the role of small vessel thrombi and coagulopathy in bowel ischemia, and to determine whether severe acute respiratory syndrome coronavirus 2 plays a direct role in bowel or vascular injury," the authors write.

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