Chest CT Scan In Patients With Contusion and COVID-19, A Comparative Study With Pure Lung Contusion

Author(s): Amin Sadraei M.D., Seyed Hamed Jafari M.D., Seyed Mehdi Shahnematollahi M.D. Mohammadamir Taherinezhad M.D., Nazanin Sadraei M.D., Zahra Hooshanginezhad M.DAmin Sadraei M.D., Seyed Hamed Jafari M.D., Seyed Mehdi Shahnematollahi M.D. Mohammadamir Taherinezhad M.D., Nazanin Sadraei M.D., Zahra Hooshanginezhad M.D

Resource allocation for traumatic patients who are positive/negative for COVID-19 challenges the diagnosis. This study aims to compare the chest CT of COVID-19 associated with lung contusion versus those with lung contusion only. CT-scans of 9 RT-PCR positive patients with lung contusion due to MVA (CC group) and 16 patients with lung contusions from pre-COVID-19 (CO group) were revaluated. The distribution and characteristics of presenting CT-scan findings; including presence, shape, distribution of GGO, consolidations, subpleural sparing, crazy-paving and Atoll sign. Presence of effusions and cavities were compared. Time course of the opacities was compared. Bilateral distribution of opacities was noted in 100% of CC and 87.5% of CO group. There was no significant difference between GGO or consolidation shapes (P=0.44 and P=0.66). Both GGO and consolidations were more diffusely distributed in CC, a predominantly peripheral distribution was more commonly seen in the CO group (P=0.03 and P=0.01). Subpleural sparing was noted in 93.8% of CO as compared to 44% of CC group (p=0.04). Time to resolution was significantly longer in CC (15±6days) comparing to CO patients (P=0.02). 'Typical' chest CT findings including bilateral peripheral GGO and consolidations, crazypaving, Atoll signs and also less typical findings e.g. subpleural sparing is seen in lung contusion and COVID-19 pneumonitis. Lesion Time course might be a better radiologic discriminator between the two entities.