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Extrapulmonary manifestations of COVID-19 pneumonia – An institutional experience

Background: The purpose of this article is to provide insight into the varied extrapulmonary manifestations associated with the novel corona virus disease 2019 (COVID-19). This study mainly focuses to identify the most common extrapulmonary manifestations encountered in patients with COVID-19 pneumonia as noted in the Indian subcontinent. Materials and methods: A total of 145 hospitalized patients with COVID-19 disease were retrospectively evaluated for extrapulmonary imaging findings or complications. These patients had undergone various imaging examinations during the course of hospital stay. Images were reviewed using the institutional PACS database system over a period of three months (August to October 2020). Results: Among the 145 patients (91 males and 54 females), 54 patients (37.2%) had extrapulmonary findings or complications on imaging. Various extrapulmonary findings observed are as follows: ischemic brain infarcts (n=12), intracranial hemorrhage (n=5), viral encephalitis (n=1), perinephric fat stranding (n=3), small bowel ischemia (n=1), acute pancreatitis (n=2), splenomegaly (n=15), pericardial effusion (n=2), mediastinal lymphadenopathy (n=9), and pneumomediastinum (n=4). Conclusion: With increasing spread of COVID-19 infection worldwide, it is important to identify the spectrum of extrapulmonary manifestations related to COVID-19 pneumonia in the long run. A clear understanding of the extrapulmonary imaging findings in COVID-19 pneumonia is essential so that the radiologist can make a timely and accurate diagnosis to aid in patient management. Keywords: severe acute respiratory syndrome (SARS); COVID-19 pneumonia; extrapulmonary manifestations; viral encephalitis, renal dysfunction; pneumomediastinum