CT-Severity Analysis of Covid-19 Pneumonia in Rheumatic Musculoskeletal Diseases

• Published in: Ankara medical journal Vol. 21; no. 3; pp. 454 - 470
• Main Authors: Koc, Ali Murat, Akcay, Seniz, Dogan, Nesibe, Ozkan Ozdemir, Hülya, Adibelli, Zehra Hilal
• Format: Journal Article
• Language: English
• Published: Ankara Yildirim Beyazit University 2021
• Subjects: coronavirus; pneumonia; rheumatic diseases; tomography
• ISSN: 2148-4570; 2148-4570
• DOI: 10.5505/amj.2021.02223

INTRODUCTION: This study aims to focus on the radiological severity of covid-19 pneumonia in patients with rheumatic musculoskeletal diseases (RMD). METHODS: A total of 342 Polymerase Chain Reaction positive patients were retrospectively reviewed. The patients were divided into two groups in terms of the presence of RMD. Chest Computed Tomography (CT) severity scores, demographic characteristics, hospitalization, intensive care unit (ICU) requirement, length of stay at the hospital were compared between RMD and non-RMD groups. Typical and atypical findings on CT images were identified with their incidence in both groups of patients. RESULTS: Age and female gender were significantly higher in the RMD group (p=0.001, p=0.041). The average CT-severity score was higher in the RMD group, but the difference was not statistically significant (p=0.081). ICU transfer and mortality rates were higher in the RMD, whereas no difference was found in hospitalization rates and length of stay (p=0.002, p=0.036, p=0.280, p=0.168). Ground glass opacities, superimposed consolidation, and crazy paving patterns were the most common typical findings seen on both groups. Atypical CT findings for covid-19 pneumonia were found to be higher in the RMD group than in the non-RMD group. DISCUSSION AND CONCLUSION: Chronic inflammation and the use of immunosuppressive drugs constitute a vulnerability to infections in RMD patients. In this study, mortality and ICU requirements were found to be higher in patients with RMD. Similarly, the higher rate of atypical chest CT findings in the RMD group may be of particular importance in the diagnosis and differential diagnosis of covid-19 pneumonia in this patient group.