Review of COVID-19, part 1: Abdominal manifestations in adults and multisystem inflammatory syndrome in children

• Published in: Clinical imaging Vol. 80; pp. 88 - 110
• Main Authors: Kanmaniraja, Devaraju, Kurian, Jessica, Holder, Justin, Gunther, Molly Somberg, Chernyak, Victoria, Hsu, Kevin, Lee, Jimmy, Mcclelland, Andrew, Slasky, Shira E., Le, Jenna, Ricci, Zina J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2021; Elsevier Limited
• Subjects: Abdomen; Abdominal imaging; Adult; Adults; Body Imaging; Child; Children; Complications; Coronaviruses; COVID-19; COVID-19 - complications; Humans; Inflammation; Medical imaging; Morbidity; Multisystem inflammatory syndrome; Multisystem inflammatory syndrome in children; Organs; Pandemics; Respiratory diseases; Reviews; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Systemic Inflammatory Response Syndrome; Thorax; Vascular system; Viral diseases; Viruses; United States > US; COVID-19; Abdominal imaging; Multisystem inflammatory syndrome
• ISSN: 0899-7071; 1873-4499
• DOI: 10.1016/j.clinimag.2021.06.025

The coronavirus disease 2019 (COVID -19) pandemic caused by the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) has affected almost every country in the world, resulting in severe morbidity, mortality and economic hardship, and altering the landscape of healthcare forever. Although primarily a pulmonary illness, it can affect multiple organ systems throughout the body, sometimes with devastating complications and long-term sequelae. As we move into the second year of this pandemic, a better understanding of the pathophysiology of the virus and the varied imaging findings of COVID-19 in the involved organs is crucial to better manage this complex multi-organ disease and to help improve overall survival. This manuscript provides a comprehensive overview of the pathophysiology of the virus along with a detailed and systematic imaging review of the extra-thoracic manifestation of COVID-19 with the exception of unique cardiothoracic features associated with multisystem inflammatory syndrome in children (MIS-C). In Part I, extra-thoracic manifestations of COVID-19 in the abdomen in adults and features of MIS-C will be reviewed. In Part II, manifestations of COVID-19 in the musculoskeletal, central nervous and vascular systems will be reviewed. •Hepatic steatosis, gallbladder distension and sludge are common imaging findings in COVID-19 hospitalized patients.•Acute kidney injury is seen in about one third of hospitalized COVID-19 patients with increased or heterogeneous renal echogenicity seen on ultrasound and preserved cortical thickness.•Splenic and renal infarcts are reported in up to 5% on CT scans of COVID-19 patients.•Ileus is the most commonly reported bowel abnormality in hospitalized COVID-19 patients.•Children with multisystem inflammatory syndrome most commonly present with gastrointestinal symptoms and less frequently with respiratory symptoms.