Abdominal imaging in ICU patients with viral pneumonia: Are findings in COVID-19 patients really different from those observed with non-SARS-CoV-2 viral pneumonia?

Purpose: To evaluate and compare the prevalence and type of abdominal involvements identified on CT scans in COVID-19 critically ill patients to those observed in critically ill patients with non-SARS-CoV-2 viral pneumonia. Methods: Monocentric IRB approved retrospective study comparing all abdominal CT scans performed for patients admitted in the ICU with COVID-19 and those performed in a historical cohort of ICU patients with non-SARS-CoV-2 viral pneumonia. For each patient, gallbladder abnormality, acute pancreatitis signs, acute adrenal infarction, renal infarcts, bowel wall thickening and CT scan signs of bowel ischemia were assessed. Results were then compared between critically ill COVID-19 and non-COVID-19 patients (Chi-2 or Fisher exact tests for categorical data and Student t-test or Mann-Whitney U test for continuous data as appropriate). Results: Ninety-nine COVID-19 patients and 45 non-COVID-19 patients were included.No difference was found between the rate of abnormal findings comparing COVID-19 patients and patients with other viral pneumonia (63/99 [64%] vs 27/45 [61%], p=0.94). Acute pancreatitis signs were more commonly seen in COVID-19 patients but without statistically difference between groups (14/99 [14%] vs 3/45 [6.7%], p=0.31). Bowel wall thickening was slightly more commonly seen in patients with other viral pneumonia (18/99 [18%] vs 11/45 [24%], p=0.52), however ischemic features were observed in higher rate in the COVID-19 group, although without reaching statistically significant differences (7/99 [7.1%] vs 2/45 [4.4%], p=0.75). Conclusion: The rate and severity of abdominal involvement demonstrated by CT in ICU patients hospitalized for COVID-19 although high were not different to that observed in patients with other severe viral pneumoniae.