Thrombosis and organ ischemia/inflammation in ICU admitted COVID-19. [COVID-19]
Research type
Research Study
Full title
Computer Tomography findings of vascular thrombosis, and abdominal organ ischemia and inflammation in Critically Ill COVID-19 patients.
IRAS ID
286154
Contact name
Saeed Mirsadree
Contact email
Sponsor organisation
Royal Brompton and Harefield Trust
Duration of Study in the UK
0 years, 2 months, 2 days
Research summary
There is emerging evidence that the rate of thrombosis and abdominal organ ischemia/inflammation is significant in COVID-19. The incidence of image-diagnosed thrombosis appears higher in COVID-19 than in comparably ill patients with different aetiologies. In a recent study, 22% of COVID-19 ICU patients had pulmonary embolism (PE) (without systematic imaging) compared to 6.1% in the same period the previous year and 7.5% in influenza patients admitted a month previously, despite similar severity of respiratory disease (Poissy, Circulation, 2020).One of the earliest reports to alert the global community that patients may present with digestive symptoms including anorexia, diarrhoea, vomiting and abdominal pain, also suggested evidence of longer coagulation, and liver enzymes level derangement. Interestingly, this study indicated that nearly one-half of patients with COVID-19 admitted to the hospital reported digestive symptoms. A systematic review and meta-analysis of data from 35 studies, including 6686 patients with COVID-19 demonstrated that in 29 studies (6064 cases) reporting gastrointestinal symptoms in patients with COVID-19, the pooled prevalence of digestive symptoms was 15%. Of note, the authors report that only around 10% of these patients presented with purely gastrointestinal symptoms, that is to say in the absence of respiratory features when infected with COVID-19. Critical ill intubated COVID-19 patients are not capable of reporting symptoms of thrombosis or abdominal organ inflammation. Further, they are susceptible to multiple organ dysfunction. Pancreatitis has been reported in 11 cases out of 67 severe cases of COVID-19, these patients had either elevated amylase and/or lipase, and /or showed imaging alterations. Overall, there is a paucity of data with respect to pancreatic injury in COVID-19 patients. The etiology of pancreatitis and other abdominal organ injuries in COVID-19 is not known and can be secondary to thrombotic ischemia or direct virus involvement. CT scan allows the diagnosis of vascular thrombosis and abdominal organ injury. In this study, we aim to identify the prevalence of vascular thrombosis and abdominal organ ischemic/inflammatory changes on CT images in ICU admitted COVID-19 patients and relate that to the ultimate outcome.
REC name
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REC reference
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