[en] During the COVID-19 pandemic induced by the SARS-CoV-2, numerous chest scans were carried out in order to establish the diagnosis, quantify the extension of lesions but also identify the occurrence of potential pulmonary embolisms. In this perspective, the performed chest scans provided a varied database for a retrospective analysis of non-COVID-19 chest pathologies discovered de novo. The fortuitous discovery of de novo non-COVID-19 lesions was generally not detected by the automated systems for COVID-19 pneumonia developed in parallel during the pandemic and was thus identified on chest CT by the radiologist. The objective is to use the study of the occurrence of non-COVID-19-related chest abnormalities (known and unknown) in a large cohort of patients having suffered from confirmed COVID-19 infection and statistically correlate the clinical data and the occurrence of these abnormalities in order to assess the potential of increased early detection of lesions/alterations. This study was performed on a group of 362 COVID-19-positive patients who were prescribed a CT scan in order to diagnose and predict COVID-19-associated lung disease. Statistical analysis using mean, standard deviation (SD) or median and interquartile range (IQR), logistic regression models and linear regression models were used for data analysis. Results were considered significant at the 5% critical level (p < 0.05). These de novo non-COVID-19 thoracic lesions detected on chest CT showed a significant prevalence in cardiovascular pathologies, with calcifying atheromatous anomalies approaching nearly 35.4% in patients over 65 years of age. The detection of non-COVID-19 pathologies was mostly already known, except for suspicious nodule, thyroid goiter and the ascending thoracic aortic aneurysm. The presence of vertebral compression or signs of pulmonary fibrosis has shown a significant impact on inpatient length of stay. The characteristics of the patients in this sample, both from a demographic and a tomodensitometric point of view on non-COVID-19 pathologies, influenced the length of hospital stay as well as the risk of intra-hospital death. This retrospective study showed that the potential importance of the detection of these non-COVID-19 lesions by the radiologist was essential in the management and the intra-hospital course of the patients.
Disciplines :
Cardiovascular & respiratory systems Radiology, nuclear medicine & imaging
Author, co-author :
CANIVET, Perrine ; Centre Hospitalier Universitaire de Liège - CHU > > Service médical de radiodiagnostic
DESIR, Colin ; Centre Hospitalier Universitaire de Liège - CHU > > Service médical de radiodiagnostic
THYS, Marie ; Centre Hospitalier Universitaire de Liège - CHU > > Service des informations médico économiques (SIME)
WHO Landing Page. Available online: https://www.who.int/(accessed on 20 December 2020).
Wu, Z.; McGoogan, J.M. Characteristics of and important lessons from the Coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese center for disease control and prevention. JAMA 2020, 323, 1239– 1242. https://doi.org/10.1001/jama.2020.2648.
Johns Hopkins University & Medicine Coronavirus Resource Center. Available online: https://coronavirus.jhu.edu/map.html (accessed on 20 December 2020).
Stang, A.; Robers, J.; Schonert, B.; Jöckel, K.H.; Spelsberg, A.; Keil, U.; Cullen, P. The performance of the SARS-CoV-2 RT-PCR test as a tool for detecting SARS-CoV-2 infection in the population. J. Infect. 2021, 83, 237–279. https://doi.org/10.1016/j.jinf.2021.05.022. Epub 2021 Jun 1.
Wu, T.; Ge, Y.; Zhao, K.; Zhu, X.; Chen, Y.; Wu, B.; Zhu, F.; Zhu, B.; Cui, L. A reverse-transcription recombinase-aided amplification assay for the rapid detection of N gene of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2). Virology 2020, 549, 1–4. https://doi.org/10.1016/j.virol.2020.07.006.
Li, B.; Li, X.; Wang, Y.; Han, Y.; Wang, Y.; Wang, C.; Zhang, G.; Jin, J.; Jia, H.; Fan, F.; et al. Diagnostic value and key features of computed tomography in Coronavirus Disease 2019. Emerg. Microbes Infect. 2020, 9, 787–793. https://doi.org/10.1080/22221751.2020.1750307.
Salehi, S.; Abedi, A.; Balakrishnan, S.; Gholamrezanezhad, A. Coronavirus disease 2019 (COVID-19) imaging reporting and data system (COVID-RADS) and common lexicon: A proposal based on the imaging data of 37 studies. Eur. Radiol. 2020, 30, 4930– 4942. https://doi.org/10.1007/s00330-020-06863-0.
Guillo, E.; Bedmar Gomez, I.; Dangeard, S.; Bennani, S.; Saab, I.; Tordjman, M.; Jilet, L.; Chassagnon, G.; Revel, M. COVID-19 pneumonia: Diagnostic and prognostic role of CT based on a retrospective analysis of 214 consecutive patients from Paris, France. Eur. J. Radiol. 2020, 131, 109209.
Lessmann, N.; Sánchez, C.I.; Beenen, L.; Boulogne, L.H.; Brink, M.; Calli, E.; Charbonnier, J.P.; Dofferhoff, T.; van Everdingen, W.M.; Gerke, P.K.; et al. Automated Assessment of COVID-19 Reporting and Data System and Chest CT Severity Scores in Patients Suspected of Having COVID-19 Using Artificial Intelligence. Radiology 2021, 298, E18–E28. https://doi.org/10.1148/ra-diol.2020202439.
Prokop, M.; van Everdingen, W.; van Rees Vellinga, T.; van Ufford, J.Q.; Stöger, L.; Beenen, L.; Geurts, B.; Gietema, H.; Krdzalic, J.; Schaefer-Prokop, C.; et al. CO-RADS: A categorical CT assessment scheme for patients suspected of having COVID-19— definition and evaluation. Radiology 2020, 296, E97–E104.
Guiot, J.; Vaidyanathan, A.; Deprez, L.; Zerka, F.; Danthine, D.; Frix, A.N.; Thys, M.; Henket, M.; Canivet, G.; Mathieu, S.; et al. Development and Validation of an Automated Radiomic CT Signature for Detecting COVID-19. Diagnostics 2020, 11, 41. https://doi.org/10.3390/diagnostics11010041.
Byrne, S.C.; Hammer, M.M. Malignant Nodules Detected on Lung Cancer Screening CT: Yield of Short-Term Follow-Up CT in Demonstrating Nodule Growth. AJR Am. J. Roentgenol. 2022, 218, 929–1112. https://doi.org/10.2214/AJR.22.27869.
Couraud, S.; Ferretti, G.; Milleron, B.; Cortot, A.; Girard, N.; Gounant, V.; Laurent, F.; Leleu, O.; Quoix, E.; Revel, M.P.; et al. Intergroupe francophone de cancérologie thoracique, Société de pneumologie de langue française, and Société dʹimagerie tho-racique statement paper on lung cancer screening. Diagn. Interv. Imaging 2021, 102, 199–211.
Detterbeck, F.C.; Mazzone, P.J.; Naidich, D.P.; Bach, P.B. Screening for lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013, 143 (Suppl. 5), e78S–e92S. https://doi.org/10.1378/chest.12-2350.
Siemens Edge Plus. Available online: https://www.siemens-healthineers.com/fr-be/computed-tomography/single-source-ct-scanner/somatom-edge-plus (accessed on 24 June 2022).
GE Revolution CT, GE Brightspeed. Available online: https://www.gehealthcare.com/(accessed on 24 June 2022).
Austin, J.H.; Muller, N.L.; Friedman, P.J.; Hansell, D.M.; Naidich, D.; Remy-Jardin, M.; Webb, W.R.; A Zerhouni, E. Glossary of terms for CT of the lungs: Recommendations of the Nomenclature Committee of the Fleischner Society. Radiology 1996, 200, 327–331. https://doi.org/10.1148/radiology.200.2.8685321.
Corwin, M.T.; Schieda, N.; Remer, E.M.; Caoili, E.M. Management of incidental adrenal nodules: A survey of abdominal radiologists conducted by the Society of Abdominal Radiology Disease-Focused Panel on Adrenal Neoplasms. Abdom. Radiol. 2022, 47, 1360–1368.
Mori, M.; Bin Mahmood, S.U.; Yousef, S.; Shioda, K.; Vinholo, T.F.; Mangi, A.A.; Elefteriades, J.A.; Geirsson, A. Prevalence of Incidentally Identified Thoracic Aortic Dilations: Insights for Screening Criteria. Can. J. Cardiol. 2019, 35, 892–898.
Grenier, P.; Beigelman, C.; Lucidarme, O. Imagerie des BPCO [Imaging of COPD]. Rev. Prat. 1995, 45, 1233–1237.
Raghu, G.; Collard, H.R.; Egan, J.J.; Martinez, F.J.; Behr, J.; Brown, K.K.; Colby, T.V.; Cordier, J.; Flaherty, K.R.; Lasky, J.A.; et al. An official ATS/ERS/JRS/ALAT statement: Idiopathic pulmonary fibrosis: Evidence-based guidelines for diagnosis and man-agement. Am. J. Respir. Crit. Care Med. 2011, 183, 788–824.
Weber, A.L.; Randolph, G.; Aksoy, F.G. The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings. Radiol. Clin. N. Am. 2000, 38, 1105–1129. https://doi.org/10.1016/S0033-8389(05)70224-4.
Allaire, B.T.; Lu, D.; Johannesdottir, F.; Kopperdahl, D.; Keaveny, T.M.; Jarraya, M.; Guermazi, A.; Bredella, M.A.; Samelson, E.J.; Kiel, D.P.; et al. Prediction of incident vertebral fracture using CT-based finite element analysis. Osteoporos. Int. 2019, 30, 323–331. https://doi.org/10.1007/s00198-018-4716-1.
Mazzone, P.J.; Gould, M.K.; Arenberg, D.A.; Chen, A.C.; Choi, H.K.; Detterbeck, F.C.; Farjah, F.; Fong, K.M.; Iaccarino, J.M.; Janes, S.M.; et al. Management of Lung Nodules and Lung Cancer Screening During the COVID-19 Pandemic: CHEST Expert Panel Report. J. Am. Coll. Radiol. 2020, 17, 845.
MacMahon, H.; Naidich, D.P.; Goo, J.M.; Lee, K.S.; Leung, A.N.C.; Mayo, J.R.; Mehta, A.C.; Ohno, Y.; Powell, C.A.; Prokop, M.; et al. Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017. Radiology 2017, 284, 228.
Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020; Noncommunicable Diseases, World Health Organization; World Health Organization: Geneva, Switzerland, 2013. ISBN 978 92 4 150623 6.
Storti, K.L.; Pettee Gabriel, K.K.; Underwood, D.A.; Kuller, L.H.; Kriska, A.M. Physical activity and coronary artery calcification in two cohorts of women representing early and late postmenopause. Menopause 2010, 17, 1146–1151. https://doi.org/10.1097/gme.0b013e3181e3a356.
Harrison, S.L.; Buckley, B.J.R.; Rivera-Caravaca, J.M.; Zhang, J.; Lip, G.Y.H. Cardiovascular risk factors, cardiovascular disease, and COVID-19: An umbrella review of systematic reviews. Eur. Hear. J. Qual. Care Clin. Outcomes 2021, 7, 330–339. https://doi.org/10.1093/ehjqcco/qcab029.
Gerayeli, F.V.; Milne, S.; Cheung, C.; Li, X.; Yang, C.W.T.; Tam, A.; Choi, L.H.; Bae, A.; Sin, D.D. COPD and the risk of poor outcomes in COVID-19: A systematic review and meta-analysis. eClinicalMedicine 2021, 33, 100789, https://doi.org/10.1016/j.eclinm.2021.100789.
Hussain, A.; Mahawar, K.; Xia, Z.; Yang, W.; El-Hasani, S. Obesity and mortality of COVID-19. Meta-analysis. Obes. Res. Clin. Pract. 2020, 14, 295–300. https://doi.org/10.1016/j.orcp.2020.07.002. Retraction in Obes. Res. Clin. Pract. 2021, 15, 100.
Tadic, M.; Cuspidi, C.; Sala, C. COVID-19 and diabetes: Is there enough evidence? J. Clin. Hypertens. 2020, 22, 943–948. https://doi.org/10.1111/jch.13912.
Wong, N.D.; Kouwabunpat, D.; Vo, A.N.; Detrano, R.C.; Eisenberg, H.; Goel, M.; Tobis, J.M. Coronary calcium and atheroscle-rosis by ultrafast computed tomography in asymptomatic men and women: Relation to age and risk factors. Am. Hear. J. 1994, 127, 422–430.
Jain, V.; Yuan, J.M. Predictive symptoms and comorbidities for severe COVID-19 and intensive care unit admission: A systematic review and meta-analysis. Int. J. Public Health 2020, 65, 533–546. https://doi.org/10.1007/s00038-020-01390-7.
Petrilli, C.M.; Jones, S.A.; Yang, J.; Rajagopalan, H.; OʹDonnell, L.; Chernyak, Y.; Tobin, K.A.; Cerfolio, R.J.; Francois, F.; Horwitz, L.I. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: Prospective cohort study. BMJ 2020, 369, m1966. https://doi.org/10.1136/bmj.m1966.
Dai, M.; Liu, D.; Liu, M.; Zhou, F.; Li, G.; Chen, Z.; Zhang, Z.; You, H.; Wu, M.; Zheng, Q.; et al. Patients with Cancer Appear More Vulnerable to SARS-CoV-2: A Multicenter Study during the COVID-19 Outbreak. Cancer Discov. 2020, 10, 783–791. https://doi.org/10.1158/2159-8290.CD-20-0422.
Larsson, E.; Brattström, O.; Agvald-Öhman, C.; Grip, J.; Campoccia Jalde, F.; Strålin, K.; Nauclér, P.; Oldner, A.; Konrad, D.; Persson, B.P.; et al. Characteristics and outcomes of patients with COVID-19 admitted to ICU in a tertiary hospital in Stockholm, Sweden. Acta Anaesthesiol. Scand. 2021, 65, 76–81. https://doi.org/10.1111/aas.13694.
Grasselli, G.; Greco, M.; Zanella, A.; Albano, G.; Antonelli, M.; Bellani, G.; Bonanomi, E.; Cabrini, L.; Carlesso, E.; Castelli, G.; et al. Risk Factors Associated with Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy. JAMA Intern. Med. 2020, 180, 1345–1355. https://doi.org/10.1001/jamainternmed.2020.3539.