Study Design
We reviewed the files of patients who were admitted to the urology outpatient clinic from 1 April to 1 November. We selected this date as an origin. Because, in our country, it was announced COVID-19 was spread all over Turkey on 1 April (https://tr.wikipedia.org/wiki/T%C3%BCrkiye%27de_COVID-19_pandemisi).
We included the patients who performed abdominal CT at the urology outpatient clinic for any reason. We recorded demographic data of these patients such as age, sex, complaints of admission, and abdominal CT findings. Also, we examined the lung bases findings on abdominal CT imaging of these patients.
The lung bases findings on these abdominal CT were accepted with COVID-19 pneumonia and were classified as incidental (Figure1, Figure 2);
- Ground-glass opacities
- Bilateral patchy shadowing
- Bronchial wall thickening
- Linear opacities
- Discrete pulmonary nodules(7, 9).
We excluded patients with pulmonary symptoms and previously diagnosed with COVID-19. Also, patients without abdominal CT were excluded.
We evaluated the rates of missed diagnosed COVID-19 pneumonia detection on the lung base images of abdominal CT. The pulmonary findings on the abdominal CT associated with COVID-19 are reviewed with the lung window settings owing to findings is not visible on abdominal window settings.
These CT imaging, each of the patients, were evaluated by three authors (MSO, MBH, and BY) to increase the reliability of the analysis. These authors have been actively involved in the diagnosis and treatment of COVID-19 since the outbreak began. Therefore, they are sufficiently familiar with lung findings in the diagnosis of this disease. The evaluated CT findings were confirmed by the author EE who is a specialist Infectious Diseases and Clinical Microbiology.
Each study was reviewed with the lung, abdominal, and mediastinal window settings. All CT studies were performed by high-resolution thin section datasets (Slice thickness of 2 mm and an increment of 1 mm were used).
The institutional human research ethics committee approved the protocol 20/483. The analysis and data collection were performed after written informed consent was obtained from all patients according to Helsinki Declaration.