Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Apr 28, 2022; 14(4): 91-103
Published online Apr 28, 2022. doi: 10.4329/wjr.v14.i4.91
Outcome of percutaneous drainage for septic complications coexisted with COVID-19
Mohamed A Deif, Ahmad M Mounir, Sherif A Abo-Hedibah, Ahmed M Abdel Khalek, Ali H Elmokadem
Mohamed A Deif, Department of Radiology, National Liver Institute, Menoufia University, Shibin Al Kawm 32521, Egypt
Ahmad M Mounir, Ahmed M Abdel Khalek, Ali H Elmokadem, Department of Radiology, Mansoura University, Mansoura 35516, Egypt
Sherif A Abo-Hedibah, Department of Radiology, Cairo university, Cairo 12613, Egypt
Author contributions: Deif MA and Elmokadem AH designed the research study; Deif MA and Mounir AM performed the research; Elmokadem AH, Abo-Hedibah SA and Abdel Khalek AM analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Mansoura university Institutional Review Board (R.21.12-1545).
Informed consent statement: A local institutional review board approved this retrospective study, and waivers of consent of medical record review were received.
Conflict-of-interest statement: All authors declare no conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at mokadem83@yahoo.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ali H Elmokadem, MD, PhD, Associate Professor, Department of Radiology, Mansoura University, Elgomhoria St, Mansoura 35516, Egypt. mokadem83@yahoo.com
Received: December 29, 2021
Peer-review started: December 29, 2021
First decision: February 21, 2022
Revised: March 13, 2022
Accepted: April 9, 2022
Article in press: April 9, 2022
Published online: April 28, 2022
Processing time: 116 Days and 10.5 Hours
ARTICLE HIGHLIGHTS
Research background

The resulting tissue hypoxia and increased inflammation secondary to severe coronavirus disease 2019 (COVID-19) combined with viral load, and other baseline risk factors contribute to an increased risk of severe sepsis or co-existed septic condition exaggeration.

Research motivation

We performed percutaneous drainage for septic complications of COVID-19 and wanted to report our experience.

Research objectives

To describe the clinical, radiological, and laboratory characteristics of a small cohort of patients infected by severe acute respiratory syndrome coronavirus 2 who underwent percutaneous drainage for septic complications and their post-procedural outcomes.

Research methods

This retrospective study consisted of 11 patients who were confirmed to have COVID-19 by RT-PCR test and required drain placement for septic complications. The mean age ± SD of the patients was 48.5 ± 14 years (range 30-72 years). Three patients underwent cholecystostomy for acute acalculous cholecystitis. Percutaneous drainage was performed in seven patients; two peripancreatic collections; two infected leaks after hepatic resection; one recurrent hepatic abscess, one psoas abscess and one lumbar abscess. One patient underwent a percutaneous nephrostomy for acute pyelonephritis.

Research results

Technical success was achieved in 100% of patients, while clinical success was achieved in 4 out of 11 patients (36.3%). Six patients (54.5%) died despite proper percutaneous drainage and adequate antibiotic coverage. One patient (9%) needed operative intervention. Two patients (18.2%) had two drainage procedures to drain multiple fluid collections. Two patients (18.2%) had repeat drainage procedures due to recurrent fluid collections. The average volume of the drained fluid immediately after tube insertion was 85 mL. Follow-up scans show a reduction of the retained content and associated inflammatory changes after tube insertion in all patients. There was no significant statistical difference (P = 0.6 and 0.4) between the mean of WBCs and neutrophils count before drainage and seven days after drainage. The lymphocyte count shows significant increased seven days after drainage (P = 0.03).

Research conclusions

In this study, patients having septic complications associated with COVID-19 showed relatively poor clinical outcomes despite technically successful percutaneous drainage.

Research perspectives

Prospective, larger multicentric study is needed to validate our results.