Incidentally discovered COVID-19 in low-suspicion patients—a threat to front line health care workers

Nicholas Xiao, Samir Abboud, Danielle M. McCarthy, Nishant Parekh*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Purpose: The COVID-19 pandemic has been responsible for thousands of deaths worldwide. Testing remains at a premium, and criteria for testing remains reserved for those with lower respiratory infection symptoms and/or a known high-risk exposure. The role of imaging in COVID-19 is rapidly evolving; however, few algorithms include imaging criteria, and it is unclear what should be done in low-suspicion patients with positive imaging findings. Methods: From 03/01/2020–03/20/2020, a retrospective review of all patients with suspected COVID-19 on imaging was performed. Imaging was interpreted by a board-certified, fellowship-trained radiologist. Patients were excluded if COVID-19 infection was suspected at the time of presentation, was the reason for imaging, or if any lower respiratory symptoms were present. Results: Eight patients with suspected COVID-19 infection on imaging were encountered. Seven patients received testing due to suspicious imaging findings with subsequent lab-confirmed COVID-19. No patients endorsed prior exposure to COVID-19 or recent international travel. COVID-19 was suggested in six patients incidentally on abdominal CT and two on chest radiography. At the time of presentation, no patients were febrile, and seven endorsed gastrointestinal symptoms. Five COVID-19 patients eventually developed respiratory symptoms and required intubation. Two patients expired during the admission. Conclusions: Patients with imaging findings suspicious for COVID-19 warrant prompt reverse transcription polymerase chain reaction (RT-PCR) testing even in low clinical suspicion cases. The prevalence of disease in the population may be underestimated by the current paradigm of RT-PCR testing with the current clinical criteria of lower respiratory symptoms and exposure risk.

Original languageEnglish (US)
Pages (from-to)589-595
Number of pages7
JournalEmergency Radiology
Volume27
Issue number6
DOIs
StatePublished - Dec 2020

Funding

This research study was conducted retrospectively from data obtained for clinical purposes. We consulted extensively with the IRB of Northwestern University who determined that our study did not need ethical approval. An IRB official waiver of ethical approval was granted from the IRB of Northwestern University.

Keywords

  • COVID-19
  • Incidental findings

ASJC Scopus subject areas

  • Emergency Medicine
  • Radiology Nuclear Medicine and imaging

Fingerprint

Dive into the research topics of 'Incidentally discovered COVID-19 in low-suspicion patients—a threat to front line health care workers'. Together they form a unique fingerprint.

Cite this