Background:
COVID-19 pneumonia has a variety of chest computed tomography (CT) manifestations, and its diagnosis can be challenging, especially in a trauma center. Here, we assessed the diagnostic dilemma of COVID-19 with a pulmonary contusion in Imam Reza (general hospital) and Kamyab hospitals (trauma center) in Mashhad, Iran.
Methods:
using available data from the pre-covid19 pandemic period, we reviewed 610 CT scans performed in March, 2019 (a year before the first COVID-19 reports) in a general and a trauma center hospital to evaluate the typical and indeterminate findings of COVID-19 (according to the Radiological Society of North America).
Results:
We found similar findings of COVID-19 infection (false positive) in 10% and 20% of CT scans performed in Imam Reza (general) hospital and Kamyab (trauma center) hospital, respectively. The percentage of the typical findings for COVID-19 (false positive cases) in our trauma center was twice that of the general hospital before the COVID-19 pandemic
Conclusion:
Our results showed that although chest CT scan is highly sensitive for COVID-19 diagnosis, it is not specific, and its specificity in a trauma center might be even less than that in general hospital. Due to overlapping characteristics of the pulmonary contusion and COVID-19 pneumonitis in chest CT scan, other associated findings in each condition and also temporal evolution of CT findings might be useful in differentiating COVID-19 from lung contusion.