Evaluation of Non-COVID-19 CT Scan Findings Detected on CT Images Performed due to Suspected COVID-19 Pneumonia: A Retrospective Analysis of 6669 Cases

Abstract

Objective: For the past years, COVID-19 infection has continued to play a significant role in our lives as a serious threat and concern due to increase in the number of cases. During this pandemic stage, chest computed tomography (CT) has been proven to have great importance for rapid and accurate diagnosis and a pivotal role in assisting the clinical management of patients with uncertain clinical scenarios. The present retrospective study aimed to inform the clinicians who referred chest CT and the radiologists reporting these CTs about the frequency and variety of non-COVID-19 findings in patients who underwent chest CT examination with the suspicion of COVID-19 pneumonia. Material and Method: This retrospective study was approved by our Institutional Ethics Committee. The requirement for written informed consent was waived. Our study included 6669 patients who applied to the emergency room with the suspicion of COVID-19 infection between March 20th and April 20th, 2020. The inclusion criteria were patients who had suspicious symptoms of having COVID-19 infection and/or had close contact with a patient with COVID-19 infection and (ii) patients who underwent chest CT. They evaluated CT scans individually, and all non-COVID-19 findings (NCF) were recorded manually Results: The study population consisted of 6669 consecutive patients (males 55.5% and females 44.5%). The overall mean age was 41.7 years [SD±15.1]. There were incidental non-COVID-19 findings in 3159 (47.4%) patients and none in 3510 (52.6%) patients Conclusion: CT examinations performed in patients with suspected COVID-19 pneumonia should be examined in detail regarding clinically significant findings. It is vital to take necessary precautions in advance regarding pathologies that may be clinically significant regarding appropriate treatment and follow-up planning at the appropriate time. The clues must be stated in the radiology report so that the clinician can make appropriate management regarding these pathologies.

Keywords

• Incidental Finding
• Computerized Tomography
• X-Ray

COVİD-19 Pnömonisi Şüphesiyle Yapılan Bilgisayarlı Tomografi Görüntülemede Saptanan COVİD-19 Dışı Bulguların Değerlendirilmesi: 6669 Vakanın Restrospektif Analizi

Abstract

Amaç: Birkaç yıldır, vaka sayılarının artmasıyla birlikte ciddi bir tehdit ve endişe kaynağı olarak COVİD-19 enfeksiyonu hayatımızda önemli bir rol oynamaya devam etmektedir. Bu pandemi aşamasında toraks bilgisayarlı tomografisinin (BT) hızlı ve doğru tanı açısından büyük öneme sahip olduğu ve belirsiz klinik senaryolara sahip hastaların klinik yönetimine yardımcı olmada önemli bir role sahip olduğu kanıtlanmıştır. Bu retrospektif çalışmada, COVİD-19 pnömonisi şüphesiyle toraks BT incelemesi yapılan hastalarda, toraks BT’ye yönlendiren klinisyenlere ve bu BT’leri raporlayan radyologlara, COVİD-19 dışı bulguların sıklığı ve çeşitliliği hakkında bilgi verilmesi amaçlandı. Gereç ve Yöntem: Bu retrospektif çalışma kurumsal etik kurulumuz tarafından onaylandı. Yazılı bilgilendirilmiş onam alma zorunluluğundan feragat edildi. Çalışmamıza 20 Mart- 20 Nisan 2020 tarihleri arasında acil servise COVİD-19 enfeksiyonu şüphesiyle başvuran 6669 hasta dahil edildi. Dahil edilme kriterleri, COVİD-19 enfeksiyonuna dair şüpheli semptomları olan ve/ya yakın temasta COVİD-19 enfeksiyonlu bir hastaya yakın teması olan hastalar ve toraks BT çekilen hastalardı. Toraks BT tetkikleri değerlendirildi ve COVİD-19 dışı tüm bulgular manuel olarak kaydedildi. Bulgular: Çalışma popülasyonu ardışık 6669 hastadan oluşmuştur (%55.5 erkek ve %44.5 kadın). Genel ortalama yaş 41,7 yıl idi. 3159 (%47.4) hastada rastlantısal olarak COVİD-19 dışı bulgular görüldü, 3510 (%52.6) hastada ise COVİD-19 dışı bulgu yoktu. Sonuç: COVİD-19 pnömonisi şüphesi olan hastalarda yapılan toraks BT incelemeleri klinik açıdan anlamlı bulgular açısından ayrıntılı olarak incelenmelidir. Klinik açıdan anlamlı olabilecek patolojilerde gerekli önlemlerin önceden alınması, uygun zamanda tedavi ve takip planlaması yapılması hayati önem taşımaktadır. Klinisyenin bu patolojilere yönelik doğru yönetimi yapabilmesi için ipuçlarının radyoloji raporunda belirtilmesi önemlidir.

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