Abdominal radiology must stay vigilant as almost 20% of COVID cases report with only GI symptoms

Almost one out of every five COVID-19 cases comes with only gastrointestinal symptoms, signaling the need for abdominal radiologists to remain vigilant during the pandemic, experts advised Monday.

Fever, cough and fatigue are often recognized as the most common signs of the novel virus, but physicians are increasingly seeing solely GI indicators among this population. Those can include loss of appetite, nausea, vomiting, diarrhea and abdominal pain.

Roughly 18% of patients present with such indications and 16% present only with GI issues, University of Alberta researchers detailed this week in Abdominal Radiology.

“Gastrointestinal manifestations and imaging manifestations of SARS-CoV-2 infection are increasingly reported and warrant specific attention during abdominal imaging,” Kevin Lui, with the Department of Radiology and Diagnostic Imaging at the Edmonton-based institution, and colleagues wrote Sept. 14.

To reach their conclusions, Lui and colleagues conducted a systematic review of studies related to the radiologic manifestations of COVID in stomach imaging. They pinpointed 36 studies, published through July 15, to include in the review.

Common imaging findings of the disease can include bowel wall thickening, a fluid-filled colon, pneumatosis, pneumoperitoneum, intussusception and ascites. These indications are rare, researchers noted, and oftentimes radiologists may spot COVID-19 incidentally at the base of the lungs while conducting CT imaging of the stomach.

“Identifying these features on abdominal imaging highlight the need to consider and evaluate for other manifestations of COVID-19 such as lung parenchymal findings,” the team concluded. “In the appropriate setting, COVID-19 can be raised as a consideration, particularly in patients presenting with atypical symptoms.”

Read more of their results in Abdominal Radiology here.