According to an open-access article in ARRS' American Journal of Roentgenology (AJR), because coronavirus disease (COVID-19) may present with medium to large arterial and venous abdominal and extremity macrothrombi, radiologists should raise concern for COVID-19 when identifying thromboembolic abdominopelvic findings.
Bari Dane of NYU Langone Medical Center in New York City and colleagues at NYU Winthrop in Mineola, New York retrospectively compared 82 patients (58 men, 24 women; mean age 58.8) with COVID-19 who underwent abdominal ultrasound or CT with 82 patients (43 men, 39 women; mean age 53.5) without COVID-19 for thromboembolism and solid-organ infarction.
Nine (11%) patients with COVID-19 had thromboembolic findings (seven men, two women; mean age 67.0). Thromboembolism was described in four of the 38 CT reports (10.5%). Two others described splenic infarctions with patent vasculature (overall positivity rate, 15.8% [6/38]). Three patients had arterial thromboembolism in the aorta or major branches.
Noting one patient without COVID-19 had known portal vein thrombus on CT, "thromboembolic findings occurred more frequently in patients with than without COVID-19 (p = 0.02)," Dane et al. concluded.
Acknowledging this study's small sample size and single-institution nature, Dane pointed out that the cohort describing patients with "COVID" in the radiology report may not include all patients with COVID-19.
"Additionally," the authors of this AJR article continued, "not all patients with thromboembolism undergo confirmative imaging, and some may not experience symptoms. Consequently, the prevalence is likely larger than reported."
Bari Dane et al, Hypercoagulability in Patients With Coronavirus Disease (COVID-19): Identification of Arterial and Venous Thromboembolism in the Abdomen, Pelvis, and Lower Extremities, American Journal of Roentgenology (2020). DOI: 10.2214/AJR.20.23617
Hypercoagulability in patients with COVID-19 (2020, September 24)
retrieved 22 October 2020
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no
part may be reproduced without the written permission. The content is provided for information purposes only.
Your feedback will go directly to Science X editors.
E-mail the story
Hypercoagulability in patients with COVID-19