Incidental tomographic findings in patients with a Confirmed Diagnosis of COVID-19: An Observational Study

Authors

DOI:

https://doi.org/10.11606/issn.2176-7262.rmrp.2023.199172

Keywords:

Coronavirus infections, COVID-19, Multidetector computed tomography, Incidental findings, SARS-CoV-2

Abstract

Objective: Describe incidental tomographic findings in the sample, correlating them with risk factors for chest diseases and sociodemographic data. Methods: This is a retrospective and observational study covering 162 patients admitted to the COVID sector of the HU/UFJF, from April 1, 2020, to July 7, 2021, with a confirmed laboratory diagnosis of COVID-19. The variables were described in absolute and relative frequencies. The comparison of the correlation between the outcome variable (the tomographic findings) for independent samples was performed using Pearson's chi-square test (without correction) or Fisher's test when relevant. Results: Of the 162 patients, 15.4% had a solitary pulmonary nodule; 14.8% had multiple pulmonary nodules; 1.8%, lung mass; 3.1%, mediastinal mass, and 9.3% had mediastinal adenomegaly. Findings such as excavations, pleural effusion, emphysema, PTE, pneumothorax, chronic interstitial disease, cavitation, aneurysms, and significant atheromatosis, classified in this study in the “Other” category showed impressive results, with an overall prevalence of 81.5%. This study demonstrated that 34% of patients had two or more types of incidental CT findings and that 88.3% of patients had at least some type of incidental CT finding. Conclusion: The pandemic of SARS-CoV-2 infections has brought a series of challenges and lessons learned to healthcare teams around the world. The massive implementation of highly sensitive diagnostic methods, such as chest tomography, ends up bringing an additional challenge, which is to deal with incidental findings, making good clinical reasoning necessary to avoid unnecessary investigations and not leave without diagnosis and treatment of diseases in early and asymptomatic stages.

Downloads

Download data is not yet available.

Author Biographies

  • Juliana Dias Nascimento Ferreira, Universidade Federal de Juiz de Fora. Hospital Universitário. Juiz de Fora, (MG), Brazil.

    General and Thoracic Surgeon

  • Marcus da Matta Abreu, Universidade Federal de Juiz de Fora. Hospital Universitário. Juiz de Fora, (MG), Brazil.

    General and Thoracic Surgeon

  • Lígia Menezes do Amaral, Universidade Federal de Juiz de Fora. Hospital Universitário. Juiz de Fora, (MG), Brazil.

    Preceptor and deputy supervisor

  • Erick Sabbagh de Hollanda, Universidade Federal de Juiz de Fora. Hospital Universitário. Juiz de Fora, (MG), Brazil.

    Radiologist and preceptor

  • Raphael Zimmermmann Chaves, Universidade Federal de Juiz de Fora. Hospital Universitário. Juiz de Fora, (MG), Brazil.

    Resident in Radiology and Diagnostic Imaging

  • Caique Rodrigues dos Santos, Universidade Federal de Juiz de Fora. Faculdade de Medicina. Juiz de Fora, (MG), Brazil.

    Academic of Medicine

References

- Shoji H, Fonseca EKUN, Teles GBS, Passos RBD, Yanata E, Silva MMA, Funari MBG, et al. Relatório estruturado de tomografia computadorizada de tórax para a pandemia do COVID-19. einstein (São Paulo). 2020;18:eED5720. https://doi.org/10.31744/einstein_journal/2020ED5720.

- Deroose CM, Lecouvet FE, Collette L, et al. Impacto da crise do COVID-19 na imagem em estudos oncológicos. Eur J Nucl Med Mol Imaging. 2020;47(9):2054-2058.

- Meirelles GSP. COVID-19: a brief update for radiologists. Radiol Bras. 2020. 53(5):320-328. https://doi.org/10.1590/0100-3984.2020.0074.

- Yekedüz E, Karcıoğlu AM, Utkan G, Ürün Y. A clinical dilemma amid COVID-19 pandemic: missed or encountered diagnosis of cancer? Future Oncol. 2020;16(25):1879-81.

- Bertolazzi P, Melo HJ de F e. A importância da Tomografia Computadorizada no diagnóstico da COVID-19 / The importance of Computed Tomography in diagnosis of COVID-19. Arq Med Hosp Fac Cienc Med Santa Casa São Paulo [Internet]. 6º de maio de 2020 [citado 2º de agosto de 2021];65(1):1 of 4. Disponível em: https://arquivosmedicos.fcmsantacasasp.edu.br/index.php/AMSCSP/article/view/590.

- Oliveira Pinheiro D, Franco Costa Lima C, Santos Leite Pessoa M, Bezerra Holanda JL. ACHADOS NA TOMOGRAFIA DE TÓRAX NO PACIENTE COM COVID-19. Cadernos ESP [Internet]. 21º de maio de 2021 [citado 3º de agosto de 2021];15(1):122-8. Disponível em: //cadernos.esp.ce.gov.br/index.php/cadernos/article/view/353.

- Rosa MEE, Matos MJR, Furtado RSOP, Brito VM, Amaral LTW, Beraldo GL, Fonseca EKUN, et al. Achados da COVID-19 identificados na tomografia computadorizada de tórax: ensaio pictórico. einstein (São Paulo). 2020;18:eRW5741. https://doi.org/10.31744/einstein_journal/2020RW5741.

- Koo MM, Rubin G, McPhail S, Lyratzopoulos G. Câncer diagnosticado incidentalmente e cenários clínicos comumente anteriores: uma análise descritiva transversal de dados de auditoria em inglês. BMJ Aberto . 2019;9(9):e028362.

- Kilsdonk ID, de Roos MP, Bresser P, Reesink HJ, Peringa J. Frequency and spectrum of incidental findings when using chest CT as a primary triage tool for COVID-19. Eur J Radiol Open. 2021;8:100366.

- Koning, HJ, et al. Reduced lung-cancer mortality with volume CT screening in a randomized trial. N Engl J Med. 2020;382:503–513.

- Passaro A, Addeo A, Von Garnier C, Blackhall F, Planchard D, Felip E, et al. ESMO Management and treatment adapted recommendations in the COVID-19 era: Lung cancer. ESMO Open. 2020;5(Suppl 3).

- Mazzone PJ, Gould MK, Arenberg DA, Chen AC, Choi HK, Detterbeck FC, et al. Management of Lung Nodules and Lung Cancer Screening During the COVID-19 Pandemic: CHEST Expert Panel Report. Radiol Imaging Cancer. 2020;2(3):e204013.

- Centers for Disease Control. Framework for healthcare systems providing non-covid-19 clinical care during the COVID-19 pandemic (2020).

Downloads

Published

2023-04-14 — Updated on 2023-04-25

Issue

Section

Original Articles

How to Cite

1.
Ferreira JDN, Abreu M da M, Amaral LM do, Hollanda ES de, Chaves RZ, Santos CR dos. Incidental tomographic findings in patients with a Confirmed Diagnosis of COVID-19: An Observational Study. Medicina (Ribeirão Preto) [Internet]. 2023 Apr. 25 [cited 2024 Aug. 24];56(1):e-199172. Available from: https://journals.usp.br/rmrp/article/view/199172