ABSTRACT
OBJECTIVE: The aim of this study was to explore the impact of smoking history on the severity of coronavirus disease 2019 radiologic findings. Therefore, we compared the computed tomography severity scores of smoking coronavirus disease 2019 patients with those of non-smoking coronavirus disease 2019 patients. MATERIAL AND METHODS: A total of 121 patients were included in our study group. We retrospectively reviewed 121 patients who underwent reverse transcription-polymerase chain reaction sampling and computed tomography examination in our hospital between April 1, 2020, and July 30, 2020. All computed tomography images were independently reviewed by 2 radiologists. RESULTS: There were 15 (12.4%) active smokers, 38 (31.4%) former smokers, and 68 (56.2%) never-smokers in this study. Among the 85 patients with evidence of pneumonia in thorax computed tomography, mean computed tomography severity scores were 8.02 and standard deviation 5.812. Computed tomography severity scores for patients with pathological computed tomography scans (n = 85) were performed for evaluating smoking status (never-smokers and smokers). We found a statistically significant relationship between computed tomography severity scores of never-smokers (n = 39) and smokers (n = 46) (Z = 2.243, P = .025). The computed tomography severity scores threshold for differentiating smokers in our study group was 8, with a sensitivity of 52.2% and a specificity of 79.5%. Among the 121 patients, 34 (28.1%) were in the asymptomatic group, 36 (29.75%) were in the mild group, 28 (23.14%) were in the common group, and 23 (19.0%) were in the severe group with severe pneumonia and respiratory distress. Five (1.47%), 16 (44.44%), 14 (50%), and 18 (78.26%) of the patients in these groups were smoking, respectively. CONCLUSION: Among coronavirus disease 2019 patients, smoking is associated with the progression of the disease and increased adverse effects. In our study, smoking status was significantly correlated with thorax computed tomography findings on admission. Computed tomography severity scores assessment helps to evaluate the disease extent in coronavirus disease 2019 patients.
ABSTRACT
Coronavirus disease 2019 (COVID-19) pneumonia computed tomography imaging features have been described in detail in many studies. The pseudocavitation sign has not been described in the previous COVID-19 studies. We present chest computed tomography scans of 5 reverse transcriptase-polymerase chain reaction positive patients with COVID-19 pneumonia who has bare areas among pulmonary infiltrates. All 5 also had previous scans with similarly sized low attenuated areas in the same location prior to the addition of pulmonary infiltrates. The pre-existing cystic changes had become remarkable due to the contrast around them after the pulmonary infiltrates added. Therefore, they should be termed as "pseodocavity" according to Fleischner Society glossary. Small air-containing spaces between pulmonary infiltrates have been termed in previous COVID-19 studies as a new sign called "round cystic changes/air bubble sign/vacuolar sign." We would like to draw attention that the vacuolar sign and the synonyms may be the pseudocavity sign that is due to pre-existing changes rather than a new defined sign.