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E2118. Abdominal Imaging of COVID-19
Authors
  1. Bari Dane; NYU Langone Health
  2. Geraldine Brusca-Augello; NYU Langone Health
  3. Danny Kim; NYU Langone Health
  4. Douglas Katz; NYU Langone Health
Background
Although COVID-19 typically presents with respiratory symptoms including fever, cough, and shortness of breath, many patients may be asymptomatic, particularly initially in the course of infection. Patients with COVID-19 may also present with non-specific gastrointestinal signs and symptoms, most commonly abdominal pain, which may be referred pain from lung base infection, and/or may be due to abdominal manifestations of the virus. Lung base CT findings of COVID-19 infection in patients without respiratory symptoms are frequently ground-glass opacities in a peripheral or peribronchovascular distribution. We have also seen other findings within the abdomen and pelvis on CT which may be related directly to COVID-19 infection, such as hepatitis or pancreatitis. Patients initially presenting with primarily gastrointestinal complaints may ultimately develop respiratory symptoms. The purpose of this exhibit is to review the unexpected findings of COVID-19 at the lung bases on abdominal CT and also to show a spectrum of findings on abdominopelvic CT which appear to be related to COVID-19.

Educational Goals / Teaching Points
Unexpected lung base findings concerning for COVID-19 in patients previously not expected to have COVID-19 infection, as identified on abdominal CT -Typically ground-glass opacities, peripheral or peribronchovascular -No other findings to explain the patients’ pain, or concurrent findings of mild luminal tract involvement Abdominopelvic CT findings in patients with COVID-19 -Urinary calculi, specifically uric acid -Pancreatitis -Hepatitis -Worsened splenomegaly -Pyelonephritis Outcomes of patients presenting with abdominal symptoms -Later development of respiratory symptoms -Hospitalization

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Unexpected lung base findings concerning for COVID-19 are typically ground-glass opacities, peripheral or peribronchovascular. Abdominopelvic CT findings in patients with COVID-19 include urinary calculi, pancreatitis, hepatitis, splenomegaly, and pyelonephritis.

Conclusion
Unsuspected COVID-19 infection may be strongly suggested based on abdominal CT lung findings, in patients presenting with abdominal signs and symptoms. Patients with COVID-19 may also develop abdominopelvic manifestations of viral infection.