Clinical Relevance and Follow-Up of Incidental CT Imaging Findings for COVID-19 Diagnosis: A Retrospective Analysis.

Background/

Objectives

The aim of this study was to evaluate the prevalence of incidental findings in thoracic computed tomography (CT) performed because of COVID-19 and their potential impact on patient management.

Methods

This retrospective analysis included 683 CT scans from 327 patients who underwent CT imaging of the thorax with or without the application of intravenous contrast-agents because of the primary indication of COVID-19. Radiological findings were categorized according to the COVID-19 Pneumonia Imaging Classification by four independent readers. Incidental findings were categorized according to a scale ranging from 0 (no patient impairment) to 3b (severe permanent impairment).

Results

In the 683 CT-scans, typical COVID-19 findings were present in 273 scans (40.0%), atypical signs in 97 (14.2%), indeterminate findings in 40 (5.9%), and no signs of COVID-19 in 273 (40.0%). Incidental findings were reported in 94 out of 683 cases (13.8%), of which 63 (67.0%) were classified as category 0, 12 (12.8%) as category 1, 9 (9.6%) as category 2a, none (0.0%) as category 2b, 5 (5.3%) as category 3a, and 5 (5.3%) as category 3b.

Conclusions

CT scans of the thorax for COVID-19 show a small but significant number of incidental findings that require further investigation.