ABSTRACT
Background: Lung diseases are common in Patients with End Stage Kidney Disease (ESKD) making the differential diagnosis with COVID-19 a challenge. This study describes pulmonary chest tomography (CT) findings in hospitalized ESKD on renal replacement therapy (RRT) patients with clinical suspicion of COVID-19 and compare image characteristics of positive versus negative cases. Method(s): ESKD individuals referred to Emergency Department older than 18 with clinical suspicion of COVID-19 were recruited. Epidemiological, baseline clinical information was extracted from electronic health records. Pulmonary CT was classified as typical, indeterminate, atypical or negative. We then compare CT findings of positive and negative COVID-19 patients. Result(s): We recruited 109 patients (62,3% COVID-19 positive) between March and December 2020. Mean age was 60 +/- 12.5 years-old, 43% were female and the most common etiology of ESKD was diabetes. Median time on dialysis was 36 months, Interquartile range=12-84. The most common pulmonary lesion on CT was ground glass opacities. Typical CT pattern was more common in COVID-19 patients (40(61%) vs 0(0%), p<0.001). Sensitivity was 60.61% (40/66) and specificity was 100% (40/40). Positive predictive value and negative predictive value were 100% and 62.3%, respectively. Atypical CT pattern was more frequent in COVID-19 negative patients (9(14%) vs 24(56%), p<0.001), while the indeterminate pattern was similar in both groups (13(20%) vs 6(14%), p=0.606), and the negative pattern was more common in COVID-19 negative patients (4(6%) vs 12(28%), p=0.002). Conclusion(s): In hospitalized patients with ESKD on RRT an atypical chest CT pattern cannot adequately rule out the diagnosis of COVID-19.