INCIDENTAL PULMONARY FINDINGS ON CHEST CT SCANS IN PATIENTS WITH SUSPECTED COVID-19 PNEUMONIA: DATA FROM AN OUTPATIENT HOSPITAL

ABSTRACT

SESSION TITLE Outcomes in Pneumonia and NTM SESSION TYPE Rapid Fire Original Inv PRESENTED ON 10/17/2022 1215 pm - 115 pm PURPOSE: The number of patients with respiratory symptoms who underwent computed tomography (CT) for suspected COVID-19 pneumonia is high. In this study, we decided to investigate the incidental non-COVID 19 related pulmonary findings due to a large number of CT scans. METHODS: It was retrospective study in Funda Hospital of Heath Ministry of Azerbaijan, Baku city and the number of enrolled patients to the study was 2567 from 1st of October 2020 to 10 30 th of March 2021.In all patients the positive RT-PCR test for COVID-19 were confirmed.Depending on COVID-19 viral pneumonia findings in lung there were two groups1) 1589 patients with non-COVID-19 viral pneumonia;2) 978 pateins with COVID-19 viral pneumonia RESULTS: In our study CT screening for COVID-19 viral pneumonia has detected typical viral pneumonia in 38.1%(978 of 2567) patients and in 61.9%(1689 of 2567 ) was not found CT abnormalities accordingly COVID-19 viral pneumonia.Among typical CT suggested COVID19 viral pneumonia patients the incidental pulmonary findings were found in 197(20,15%) cases, was significantly common compared to non- CT suggested viral pneumonia (OR 5.34 [0.94-12.57]95%CI;p<0.001).Common CT incidental pulmonary finding was solitary pulmonary nodule (56[28.43%] vs 21[29.58%];p<0.01) and further histopathological evaluation has detected lung cancer(primary and metastatic) in 19 patients(24.68%). Bronchectasis (commonly small size syctic and tubular bronchectasis) which was also commonest in patients with viral pneumonia (OR 2.78[0.75-6.43]95%CI;p<0.004). Emphysema was found in 69(2.69%) and was common in patients with pulmonary viral manifestation(p<0.01).Lung tuberculosis with further histological and mycobacterial confirmation was as incidentally finding in 49 cases (1.87%)( focal changes, lung inflitrate,cavitation) and commonly was found in patients with CT suggested viral pneumonia (OR 2.11[0.69-5.86]95%CI;p=0.006).Pulmonary sarcoidosis was found totally in 38(1.48%) and was common in patients with viral pneumonia (p<0.01).Idiopatic pulmonary fibrosis(IPF) with typical features of usual interstitial pneumonia(UIP) was found in 31(1,21%) patients and was commonly in male with smoking history and older age (>60 years).Common risk factors for incidental pulmonary findings weremale gender(p<0.01);tobacco smoke (p<0.01);older age(p<001);previous history of lung tuberculosis(p<0.05) comorbidities such as DM and autoimmune disorders(p<0.01) CONCLUSIONS: Risk factors for COVID-19 related viral pneumonia and incidental pulmonary findings in CT scan are similar and so incidental pulmonary findings are common in CT screening for COVID-19 related viral pnemonia.Incidental pulmonary abnormalities were not associated with increased risk for ICU admission and mortality of patients. CLINICAL IMPLICATIONS Clinicians in paracitce with COVID-19 patients,for pulmonologists,radiologists, respiratory educators, thoracic oncologists DISCLOSURES No relevant relationships by Alizamin Sadigov