Elsevier

Clinical Imaging

Volume 79, November 2021, Pages 104-109
Clinical Imaging

Body Imaging
Does COVID-19 cause an increase in spleen dimensions? Possible effects of immune activation, hematopoietic suppression and microthrombosis

https://doi.org/10.1016/j.clinimag.2021.04.035Get rights and content

Highlights

  • COVID-19 patients with progressive lung involvement had a significant increase in spleen size in early stage.

  • The COVID-19 pneumonia severity score measured on CT correlates with the increase in spleen size.

  • The slight increase in spleen size in COVID-19 may be due to cytokine storm.

Abstract

Purpose

To radiologically examine how the spleen size, which has important functions in hematological and immunological balance, is affected in COVID-19.

Methods

Between July 1 and August 31, 2020, consecutive patients diagnosed with COVID-19 were analyzed. Among these patients, those who underwent chest computed tomography (CT) examination at the time of presentation, patients with follow-up CT due to clinical deterioration were included in the study. The CTs of the patients were evaluated in terms of spleen size and volume.

Results

A total of 160 patients (88 females, 55%) were included in the study. The mean time between the initial and follow-up CT was 7.2 ± 2.8 days. The splenic volume (244.3 ± 136.7 vs. 303.5 ± 156.3 cm3) and splenic index (421.2 ± 235.5 vs. 523.2 ± 269.4 cm3) values were significantly higher in the follow-up CT compared to the initial CT (p < 0.001). The increase in the splenic volume and splenic index values was 59.2 ± 52.4 cm3 and 101.9 ± 90.3 cm3 (p < 0.001), respectively. The COVID-19 severity score was significantly higher in the follow-up CT compared to the initial CT (3.7 ± 4.2 vs. 12.5 ± 5.7, respectively; p < 0.001). The spleen width measured separately on the initial and follow-up CTs showed a highest positive correlation (r = 0.982, p < 0.001).

Conclusion

Our study indicates that spleen size increases slightly-moderately in the first stages of the infection, and this increase is correlated with the COVID-19 severity score calculated on the chest CT data, and in this respect, it is similar to infections presenting with cytokine storm.

Keywords

COVID-19
Spleen
Splenomegaly
Severity score
Follow-up computed tomography

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