CT Scans Obtained for Nonpulmonary Indications: Associated Respiratory Findings of COVID-19
PublisherRadiological Society of North America
MetadataShow full item record
AbstractBackground: Atypical manifestations of COVID-19 are being encountered as the pandemic unfolds, leading to non-chest CT scans that may uncover unsuspected pulmonary disease. Purpose: To investigate patients with primary non-respiratory symptoms who underwent abdomen/pelvis or cervical spine/neck CT with unsuspected findings highly suspicious for pulmonary COVID-19. Materials and Methods: This retrospective study from March 10, 2020 to April 6, 2020 involved three institutions, two in a region considered a hotspot (area of high prevalence) for COVID-19. Patients without known COVID-19 were included who presented to the emergency room (ER) with primary non-respiratory [gastrointestinal (GI) or neurological] symptoms, had lung parenchymal findings suspicious for COVID-19 on a non-chest CT but no concurrent chest CT and had COVID-19 testing in the ER. Group 1 patients had RT PCR obtained pre-CT read (COVID-19 suspected on presentation); Group 2 had RT PCR obtained post-CT read (COVID-19 not suspected). Presentation and imaging findings were compared and outcomes were evaluated. Descriptive statistics and Fisher exact tests were used for analysis. Results: Group 1 comprised 62 patients [31 men, 31 women, mean age 67(SD ±17) years] and group 2 comprised 57 patients [28 men, 29 women, mean age 63(SD ± 16) years). Cough and fever were more common in group 1 (37/62, 60%, 29/62, 47%) than group 2 (9/57, 16%, 12/57, 21%) respectively, with no significant difference in the remaining symptoms. There were 101 abdomen/pelvis and 18 cervical spine/neck CTs. In Group 1, non-chest CT findings provided the initial evidence of COVID-19 related pneumonia in 32/62 (52%); for Group 2, it was 44/57 (77%). Overall, the most common CT findings were ground glass opacity (114/119, 96%) and consolidation (47/119,40%). 29/119 (24%) patients required major interventions (vasopressor medication or intubation) and 27/119 (23%) died. Patients who underwent cervical spine/neck CT had worse outcomes than those with abdominal/pelvic CT (p =0.01). Conclusion: In a substantial percentage of patients with primary non-respiratory symptoms who underwent non-chest CT, the CT provided the first evidence of COVID-19 related pneumonia.
KeywordCoronavirus Disease 2019 (COVID-19)
cervical spine/neck CT
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85084616448&doi=10.1148%2fradiol.2020201743&partnerID=40&md5=935e43fa7a52c037348c38f295a67703; http://hdl.handle.net/10713/12829
- Lung apical findings in coronavirus disease (COVID-19) infection on neck and cervical spine CT.
- Authors: Applewhite BP, Buch K, Yoon BC, Lang M, Li MD, Rincon SP, Mehan WA Jr
- Issue date: 2020 Dec
- Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19).
- Authors: Pan F, Ye T, Sun P, Gui S, Liang B, Li L, Zheng D, Wang J, Hesketh RL, Yang L, Zheng C
- Issue date: 2020 Jun
- Clinical Features and Chest CT Manifestations of Coronavirus Disease 2019 (COVID-19) in a Single-Center Study in Shanghai, China.
- Authors: Cheng Z, Lu Y, Cao Q, Qin L, Pan Z, Yan F, Yang W
- Issue date: 2020 Jul
- Chest CT Features of COVID-19 in Rome, Italy.
- Authors: Caruso D, Zerunian M, Polici M, Pucciarelli F, Polidori T, Rucci C, Guido G, Bracci B, De Dominicis C, Laghi A
- Issue date: 2020 Aug
- Performance of Radiologists in Differentiating COVID-19 from Non-COVID-19 Viral Pneumonia at Chest CT.
- Authors: Bai HX, Hsieh B, Xiong Z, Halsey K, Choi JW, Tran TML, Pan I, Shi LB, Wang DC, Mei J, Jiang XL, Zeng QH, Egglin TK, Hu PF, Agarwal S, Xie FF, Li S, Healey T, Atalay MK, Liao WH
- Issue date: 2020 Aug