Considerations in imaging interpretations for colitis in critically ill patients during the COVID-19 era
| Autor: | Sooyoung Martin, Jonathan D. Pierce, Elias Kikano, Derek Vos, Nikhil H. Ramaiya, Sree Harsha Tirumani |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Multi-detector computed tomography Coronavirus disease 2019 (COVID-19) medicine.medical_treatment Critical Illness Pneumonia Viral Terminal Ileitis 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences 0302 clinical medicine law Risk Factors Internal medicine Extracorporeal membrane oxygenation Medicine Humans Radiology Nuclear Medicine and imaging In patient Colitis Retrospective Studies Coronavirus disease 2019 business.industry Critically ill SARS-CoV-2 COVID-19 030208 emergency & critical care medicine Retrospective cohort study Middle Aged medicine.disease Intensive care unit Intensive Care Units Emergency Medicine Original Article Female business Tomography X-Ray Computed |
| Zdroj: | Emergency Radiology |
| ISSN: | 1438-1435 1070-3004 |
| Popis: | Objective The study aims to demonstrate risk factors for colitis in intensive care unit patients with and without coronavirus disease 2019 (COVID-19). Methods Retrospective review was performed to identify intensive care unit (ICU) patients with the diagnosis of COVID-19 with computed tomography (CT) between March 20 and December 31, 2020. ICU patients without COVID-19 diagnosis with CT between March 20 and May 10, 2020 were also identified. CT image findings of colitis or terminal ileitis as well as supportive treatment including ventilator, vasopressors, or extracorporeal membrane oxygenation (ECMO) were recorded. Statistical analysis was performed to determine if clinical factors differed in patients with and without positive CT finding. Results Total 61 ICU patients were selected, including 32 (52%) COVID-19-positive patients and 29 (48%) non-COVID-19 patients. CT findings of colitis or terminal ileitis were identified in 27 patients (44%). Seventy-four percent of the patients with positive CT findings (20/27) received supportive therapies prior to CT, while 56% of the patients without abnormal CT findings (19/34) received supportive therapies. Vasopressor treatment was significantly associated with development of colitis and/or terminal ileitis (p = 0.04) and COVID-19 status was not significantly different between these groups (p = 0.07). Conclusions In our study, there was significant correlation between prior vasopressor therapy and imaging findings of colitis or terminal ileitis in ICU patients, independent of COVID-19 status. Our observation raises a possibility that the reported COVID-19-related severe gastrointestinal complications and potential poor outcome could have been confounded by underlying severe critically ill status, and warrants a caution in diagnosis of gastrointestinal complication. |
| Databáze: | OpenAIRE |
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