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COVID-19 and Crimean-Congo Hemorrhagic Fever: Is there any Similarity in Chest Radiology?
Derya Yapar1, Özlem Akdoğan1, Hilal Boyacı2
1Department of Infectious Diseases and Clinical Microbiology, Hitit University School of Medicine, Çorum, Turkey.
Insights
Crimean-Congo hemorrhagic fever (CCHF) rarely causes lung involvement on CT scans, unlike COVID-19. Most CCHF patients showed no lung abnormalities, suggesting COVID-19 should be prioritized if CT findings are similar.
Area of Science:
- Medical Imaging
- Infectious Diseases
- Radiology
Background:
- The COVID-19 pandemic overlapped with CCHF season, causing diagnostic challenges.
- Some Crimean-Congo hemorrhagic fever (CCHF) patients presented with CT findings mimicking COVID-19.
- Respiratory symptoms are not always prominent in CCHF, complicating differential diagnosis.
Purpose of the Study:
- To compare chest CT findings, clinical symptoms, and demographics of CCHF and COVID-19 patients.
- To investigate the prevalence and characteristics of lung involvement in CCHF during the COVID-19 pandemic.
- To differentiate CCHF from COVID-19 based on imaging and clinical presentation.
Main Methods:
- Retrospective comparison of chest CT scans, clinical data, and demographics.
- Study included 77 COVID-19 and 25 CCHF patients presenting with suspected COVID-19.
- Data collected from emergency department patients in spring/summer 2020.
Main Results:
- CCHF patients had higher rates of myalgia, headache, diarrhea, nausea, and vomiting (p<0.05).
- COVID-19 patients showed a significantly higher incidence of cough (p=0.034).
- Ground-glass opacity was common in CCHF, but most CCHF cases had no lung involvement (p=0.001); COVID-19 showed diverse findings like consolidation and vascularization.
Conclusions:
- Most Crimean-Congo hemorrhagic fever cases exhibited no pathological thoracic CT findings.
- Lung involvement on CT in patients with similar symptoms should primarily suggest COVID-19.
- Differentiating CCHF from COVID-19 is crucial, especially during overlapping endemic and pandemic periods.
Objective:
While the coronavirus disease 2019 (COVID-19) pandemic was continuing at full speed, patients with Crimean-Congo hemorrhagic fever (CCHF), which is endemic in our region, apply to the emergency department simultaneously. The presence of computed tomography (CT) lesions suggesting COVID-19 in some CCHF patients has brought to our mind the question of whether there is CCHF lung involvement even though respiratory symptoms are not at the forefront.
Methods:
In this study, the findings of chest CT, demographic data and clinical symptoms of cases who had thorax tomography scan with suspicion of COVID-19 in the emergency department in the spring and summer of 2020 and were diagnosed with CCHF as a result of the evaluation and followed up in our clinic were compared with the findings of COVID-19 cases that were hospitalized and treated in the same period.
Results:
Seventy-seven COVID-19 and 25 CCHF cases were included in the study. Myalgia, headache, diarrhea, nausea and vomiting were significantly higher in CCHF patients ( p<0.05). Cough was significantly more common in COVID-19 patients ( p=0.034). Ground-glass opacity (GGO) was the most common tomography finding in CCHF, and cases without lung involvement were significantly higher (p=0.001). GGO, consolidation, vascularization, atelectasis band, reverse halo, air-bubble, nodule were significantly high in COVID-19 patients.
Conclusion:
During the epidemic period, no pathological finding was found in thoracic CT in most of the CCHF cases, and the presence of involvement in the lung tomography in cases with similar clinical and laboratory findings should primarily suggest the diagnosis of COVID-19.
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