Clinical and morphological changes of the spleen in COVID-19 patients with and without splenectomy

Patients diagnosed with COVID-19 were seen to develop splenic infarction or abscess. This study aims to estimate the incidence of splenic infarction/abscess in COVID-19 patients and to examine the clinical and morphological changes in the infected spleen. In the splenectomy group, 63.5% of patients had an enlarged spleen measuring between 12.1 cm × 5.1 cm and 19.2 cm × 12.2 cm. The incidence of splenic infarction was 36.4%, while the incidence of splenic infarction complicated by abscess was 18.1%. The size of splenic infarcts varied from 3.1 cm × 1.4 cm to 10.2 cm × 4.3 cm. Splenic abscesses were present in 72.3% of patients. Of 596 patients with severe COVID-19, 12 had at least one splenic abscess (2.3%): three patients had multiple splenic abscesses, while the rest had a single abscess pocket. Splenic infarction was found in 116 patients (22.5%), including 6 patients who later developed splenic abscesses.