Characteristic Abdominal Imaging in Positive Obese SARS-COV-2 Patients

Abstract

Background/aim: The fatal potential of the SARS-COV-2 pandemic is its association with multiple clinical presentations, beyond the chest manifestations. The gastrointestinal manifestations were detected in patients and could be imaged using ultrasonography and CT of the abdomen. Obesity is a major risk factor for adverse outcomes of SARS-CoV-2 infection specifically abdominal (visceral
fat). This study aims to highlight the abdominal imaging findings in patients with SARS-COV-2 (COVID-19) and evaluate the association between the severity of COVID-19 outcomes with general (BMI) & abdominal (visceral) adiposity. Subject and Methods: This is a cross-section study done on 1500 Egyptian patients; 780 males and 720 females, aged from 28 to 70 years old. The patients were classified according to manifestations into two groups (chest and gastrointestinal) and according to BMI; normal-weight (n = 300), overweight (n = 385) and obese (n = 485). Then abdominal imaging using sonographic and CT examination was done, as well as assessing of visceral fat and finding its correlation with manifestations. Results: This study revealed that 740 patients had chest manifestation, 430 patients had gastrointestinal manifestations and 330 patients (22%) were admitted to the intensive care unit (ICU). There was an insignificant sex difference. The cough (92%) and fever (96%) were mostly common with chest manifestations. While diarrhea (73%) and abdominal pain (71%) were the commonest gastrointestinal manifestations. These manifestations were more frequently noted in obese, moreover dilated bowels with thickened walls. While gall bladder distension was noted frequently in overweight patients. There was a significant increase in visceral fat area in obese patients with GI manifestation. There was a positive correlation between gastrointestinal manifestations with BMI and visceral fat. While insignificant correlation with total abdominal fat and subcutaneous fat areas, Conclusion: Abdominal imaging had an important role in early diagnosis of COVID-19. Gastrointestinal manifestations of SARS-COV-2 (COVID-19) have been recognized frequently. Patients had critical conditions are obese with higher abdominal visceral fat.