COVID-19-Related Lung Involvement at Different Time Intervals: Evaluation of Computed Tomography Images With Semiquantitative Scoring System and COVID-19 Reporting and Data System Scoring.

İnan Korkmaz,Fatma Keleş

doi:10.7759/cureus.18554

Abstract

Introduction: This study aimed to evaluate the frequency of typical and atypical thoracic CT findings in patient groups diagnosed during different periods of the pandemic, examine disease severity using radiological scoring methods, and determine the relationship between atypical CT findings and disease severity.Materials and methods: One hundred fifty-one patients with positive reverse transcription polymerase chain reaction (RT-PCR) test and thoracic CT scan were included in the study. The patients were divided into two groups as group 1 (March to August 2020) diagnosed in the first six months of the pandemic and group 2 (September 2020 to February 2021) diagnosed in the second six months. CT images of the patients were analyzed for the frequency of typical and atypical findings. Evaluation was made in terms of disease suspicion and severity by scoring methods, and the relationship between atypical findings and disease severity was examined.Results: There was no statistically significant difference between the frequency and distribution patterns of typical CT findings observed in both groups. The most common atypical finding in both groups was nodular lesions. Central distribution, one of the atypical findings, was not seen in group 1, whereas it was present in nine patients in group 2 (p=0.001). The mean CT severity score was higher in group 2, and there was a statistically significant difference between the mean CT scores of both groups (p<0.001). In addition, six (7.2%) patients in group 1 and 34 (50%) patients in group 2 had CT scores above the cut-off value (p<0.001). There was no statistically significant relationship between atypical findings and severity score.Conclusion: Other diseases and atypical findings that may accompany COVID-19 pneumonia may increase the rate of misdiagnosis. In the diagnosis of the disease, clinical signs and symptoms and radiological findings should be evaluated together, and it should be kept in mind that lung findings in thorax CT change over time.

Highlights

This study aimed to evaluate the frequency of typical and atypical thoracic computed tomography (CT) findings in patient groups diagnosed during different periods of the pandemic, examine disease severity using radiological scoring methods, and determine the relationship between atypical CT findings and disease severity
Other diseases and atypical findings that may accompany COVID-19 pneumonia may increase the rate of misdiagnosis
In which we compared the severity of the disease using typical and atypical thoracic CT findings and radiological scoring methods in the patient groups diagnosed at different periods of the pandemic, the most common lesion patterns in both groups were ground-glass opacities and/or consolidations, which is consistent with the literature

Summary

Introduction

This study aimed to evaluate the frequency of typical and atypical thoracic CT findings in patient groups diagnosed during different periods of the pandemic, examine disease severity using radiological scoring methods, and determine the relationship between atypical CT findings and disease severity. In December 2019, a new coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), which was pointed as the cause of coronavirus disease 2019 (COVID-19), was identified [1]. It was understood that the clinical findings of the disease vary from symptoms such as fever, myalgia, and headache, which can be seen in other viral infections, to pneumonia that can cause severe respiratory failure and death [2,3]. It was understood that the reverse transcription polymerase chain reaction (RT-PCR) test, which is the gold standard in diagnosis, showed false negatives due to different reasons. Thorax computed tomography (CT) examination has gained importance and has started to play a role in diagnosing, triage, and determining disease severity [5,8,10]

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