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01-02-2021 | Coronavirus | Urogenital

Acute adrenal infarction as an incidental CT finding and a potential prognosis factor in severe SARS-CoV-2 infection: a retrospective cohort analysis on 219 patients

Authors: Pierre Leyendecker, Sébastien Ritter, Marianne Riou, Antoine Wackenthaler, Ferhat Meziani, Catherine Roy, Mickaël Ohana

Published in: European Radiology | Issue 2/2021

Abstract

Objectives

To retrospectively investigate the incidence of acute adrenal infarction (AAI) in patients who underwent chest CT for severe SARS-CoV-2 infection and to correlate findings with prognosis.

Methods

The local ethics committee approved this retrospective study and waived the need of informed consent. From March 9 to April 10, 2020, all patients referred to our institution for a clinical suspicion of COVID-19 with moderate to severe symptoms underwent a chest CT for triage. Patients with a/parenchymal lesion characteristics of COVID-19 involving at least 50% of lung parenchyma and b/positive RT-PCR for SARS-CoV-2 were retrospectively included. Adrenal glands were reviewed by two independent readers to look for AAI. Additional demographics and potential biological markers of adrenal insufficiency were obtained. Correlations with ICU stay and mortality were sought.

Results

Out of the 219 patients with critical (n = 52) and severe lung (n = 167) parenchyma lesions, 51 (23%) had CT scan signs of AAI, which was bilateral in 45 patients (88%). Four patients had an acute biological adrenal gland insufficiency (8%). Univariate analysis in AAI+ patients demonstrated a higher rate of ICU stay (67% vs. 45%, p < 0.05) and a longer stay (more than 15 days for 31% for AAI+ vs. 19%, p < 0.05) compared with AAI− patients. Mortality rate was similar (27%, p = 0.92).

Conclusions

Acute adrenal infarction on initial chest evaluation of severe COVID-19 is frequent (51/219, 23%) and might be a sign of poorer prognosis.

Key Points

• Acute adrenal infarction on initial chest CT evaluation of severe COVID-19 is frequent (51/219).

• AAI might be a factor of poorer prognosis, with increased rate of ICU hospitalization and length of stay.

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Title: Acute adrenal infarction as an incidental CT finding and a potential prognosis factor in severe SARS-CoV-2 infection: a retrospective cohort analysis on 219 patients
Authors: Pierre Leyendecker
Sébastien Ritter
Marianne Riou
Antoine Wackenthaler
Ferhat Meziani
Catherine Roy
Mickaël Ohana
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Keywords: Coronavirus
Computed Tomography
Computed Tomography
SARS-CoV-2
COVID-19
Published in: European Radiology / Issue 2/2021
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-07226-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Acute adrenal infarction as an incidental CT finding and a potential prognosis factor in severe SARS-CoV-2 infection: a retrospective cohort analysis on 219 patients

Abstract

Objectives

Methods

Results

Conclusions

Key Points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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