COVID-19 Computed tomography patterns in renal replacement therapy patients.

Area of Science:

• Nephrology
• Pulmonology
• Infectious Diseases
• Radiology

Background:

• End-stage kidney disease (ESKD) patients frequently experience lung diseases, complicating COVID-19 diagnosis.
• Pulmonary chest tomography (CT) is crucial for evaluating lung conditions in ESKD patients undergoing renal replacement therapy (RRT).

Purpose of the Study:

• To describe and analyze pulmonary CT findings in hospitalized ESKD patients with suspected COVID-19.
• To assess the diagnostic utility of CT patterns in differentiating COVID-19 in ESKD patients on RRT.

Main Methods:

• Retrospective analysis of 109 hospitalized ESKD patients (age >18) with suspected COVID-19.
• Classification of pulmonary CT findings into typical, indeterminate, atypical, or negative patterns.
• Comparison of CT patterns between COVID-19-positive and COVID-19-negative groups.

Main Results:

• The study included 109 patients, with 62.3% testing positive for COVID-19; the most common CT finding was ground glass opacities.
• Typical CT patterns were significantly more prevalent in COVID-19-positive patients (61%) compared to negative patients (0%, p < 0.001).
• Atypical CT patterns were more frequent in COVID-19-negative patients (56%), while typical patterns had 60.61% sensitivity and 100% specificity.

Conclusions:

• Atypical chest CT patterns in hospitalized ESKD patients on RRT do not exclude a COVID-19 diagnosis.
• The study underscores the complexity of diagnosing COVID-19 in ESKD patients, necessitating careful clinical correlation with imaging findings.