Emergence of Incidentalomas Following Chest CT Screening for COVID-19 Infection: A Multicenter Cross-Sectional Study

Background The COVID-19 pandemic has raised several questions about its potential long-term impacts. During the pandemic, computed tomography (CT) chest scans were frequently employed for the diagnosis of COVID-19 pneumonia. The increased utilization of CT scans as a diagnostic tool has facilitated the detection of subtle abnormalities that may not have been easily discernible previously. Aim The primary objective of the present study was to investigate the prevalence of non-COVID-19 lung incidental pathologies in chest CT scans performed to screen for COVID-19, with a focus on autoimmune conditions related to interstitial lung disease (ILD) following COVID-19 infection, as determined by positive chest CT results. Methods This retrospective observational study included all adult patients (aged ≥ 16 years) in Al Ain, a city in the United Arab Emirates, between June 2020 and June 2021. Patients who underwent high-resolution computed tomography (HRCT) or chest CT during this timeframe and exhibited lung pathologies beyond the typical changes associated with COVID-19 infection followed by at least one pulmonary consultation were eligible for inclusion while all typical COVID-19-related changes reported in lung pathologies were excluded from consideration in this study. The hospital's electronic medical system was used to obtain patient information and subsequent management approaches. Results Among a total of 3,000 CT scan reports, 318 individuals fit our inclusion criteria. Their mean age was 63 years, and 52% were female (n = 165). Of the patients, 12% (n = 38) were smokers and 17% (n = 54) were ex-smokers. A total of 231 (72.6%) of the patients exhibited incidental lung nodules while 87 (27.4%) displayed lung pathologies other than lung nodules, with 75 (23.6%) being diagnosed with pleural effusion, 63 (19.8%) with bronchiectasis, and 19 (5.9%) with emphysema. Furthermore, three patients (0.9%) had cavitary lung lesions and one was diagnosed with tuberculosis while two others were undergoing surveillance follow-up. Only one patient (0.3%) was identified with a lung mass, which was attributed to primary lung adenocarcinoma. The remaining eight patients (2.5%) had ILD findings (two had non-specific interstitial pneumonia, five had usual interstitial pneumonia, and one had hypersensitivity pneumonitis). All of the patients with ILD findings underwent investigations for autoimmune-related ILD; however, no cases of autoimmune-related conditions were identified during the subsequent follow-up. Conclusions This cross-sectional chest CT-based study provides insights into incidental lung abnormalities. A small percentage (10.6%) of the participants exhibited lung incidentalomas.