Asymptomatic COVID-19 infection in multiple trauma patients: incidence and implications

Background: Some studies show a chest CT scan to be superior to reverse transcription-polymerase chain reaction (RT-PCR) studies for diagnosis of COVID-19. Objectives: This study was designed to assess the prevalence of COVID-19-related lung involvement in patients admitted to our trauma center. Methods: In this retrospective study, data from a referral trauma center were reviewed from February 21, 2020, to April 10, 2020. All patients admitted to the hospital for whom a chest CT scan was performed for any reason during the study period were included. Trained physicians screened all CT scans for findings suggestive of COVID-19. Next, blinded radiologists selected CT scans with findings highly suggestive of COVID-19 involvement. The clinical course and outcome and the results of PCR for SARS-CoV-2 were recorded and assessed. Results: A total of 4200 chest CT scans were reviewed. After multiple rounds of exclusion, 24 patients with highly- suggestive findings were reviewed. Only three patients developed COVID-19 symptoms during the course of admission. PCR results were positive in 22 patients (92.6%). Conclusion: We recommend chest CT scans in trauma patients at a high risk of COVID-19 infection, as well as those requiring extensive surgical interventions. Also, a thorough review of the available CT scans before invasive procedures, preferably with the help of an expert radiologist, is highly recommended, even when the results of the COVID-19 laboratory tests are negative.