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Traumatic lung pathologies confused with COVID-19

Ozlem Akdogan, Derya Yapar, Hulya Topcu, Sertac Arslan, Hilal Boyaci, Yasemin Ari Yilmaz, Aysel Kocagul Celikbas, Nurcan Baykam.




Abstract

While the COVID-19 pandemic affected the whole world, lung radiologic imaging has become widely used for diagnosis. Ground glass opacity is the most detected radiologic findings in pulmonary tomography. However, in the first 6-8 hours of CT scans of patients admitted to the hospital with injuries affecting the chest cavity, single or multiple patchy and/or diffuse ground-glass parenchymal infiltrates can be seen usually. Due to these appearances, it is necessary to eliminate COVID-19 in cases with a lung contusion. This study aims to evaluate the clinical and laboratory characteristics of patients who presented with pulmonary trauma and were suspected of COVID-19 due to lung images. Between the March 2020 and December 2020 pandemic period, patients who applied to our hospital in emergency services due to trauma and who were discharged or hospitalized in COVID services or followed in intensive care units because COVID-19 could not be excluded due to lung tomography findings were included in the study. It was evaluated retrospectively with laboratory tests and thoracic CTs in patients over 18 years old. Fourteen cases were included in the study, seven of them were males (50%), with a mean age of 45 (19-74). The COVID-19 PCR result was negative for all patients except one patient (case 11) with lymphopenia. Peripherally located ground-glass opacity (GGO) (92.9%), subpleural line (85.7%), air bronchogram (64.3%), pleural thickening (64.3%), atelectasis (% 64.3), consolidation (50%), ground glass mixed consolidation (42.9%) was detected in chest CT cases. Eleven cases (78.6%) were hospitalized to the COVID service or intensive care unit. Thoracic CT images of patients with lung trauma may be confused with COVID-19. It is appropriate to evaluate the cases together with epidemiological data, clinical and laboratory findings. Lymphopenia may help physicians to consider the diagnosis of COVID-19 in trauma patients.

Key words: COVID-19, pulmonary contusion, computed tomography






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