Archives of Academic Emergency Medicine. 2020; 8(1): e31 LE T T E R TO ED I TO R Incidentally Diagnosed COVID-19 Infection in Trauma Pa- tients; a Clinical Experience Mehdi Khazaei1, Reyhaneh Asgari1, Ehsan Zarei1, Yashar Moharramzad1, Hamidreza Haghighatkhah1, Morteza Sanei Taheri1∗ 1. Department of Radiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Received: March 2020; Accepted: March 2020; Published online: 23 March 2020 Cite this article as: Khazaei M, Asgari R, Zarei E, Moharramzad Y, Haghighatkhah H, Sanei Taheri M.Incidentally Diagnosed COVID-19 In- fection in Trauma Patients; a Clinical Experience. Arch Acad Emerg Med. 2020; 8(1): e31. Dear Editor, The novel coronavirus disease (COVID-19) has rapidly spread across the world and caused a pandemic, and still continues to evolve. In Iran, the first cases of COVID-19 were officially announced between February 19 and 23, 2020 and it soon be- came clear that Iran is one of the countries that is worst-hit by COVID-19 outbreak (1, 2). It is now evident that most cases of COVID-19 disease de- velop mild respiratory and constitutional symptoms (3), while some cases are asymptomatic (3, 4). Involvement of other organs, including liver and kidneys has been reported in patients with COVID-19 (5). Many questions remain unan- swered about associations and presentations of COVID-19. Shohada-e-Tajrish Hospital, a university hospital located in Tehran, Iran, was designated as one of the main centers pro- viding diagnostic and healthcare services for patients sus- pected to be infected with the new virus. Here, we share our experience regarding computed tomography (CT) find- ings suggestive of COVID-19 disease among patients who un- derwent radiologic investigation due to traumatic injuries. Several trauma patients had findings on their chest and/or abdominal CT scans, which were suggestive or highly sug- gestive of COVID-19 (1). The findings were noted in the lung bases that were visible on an abdominal CT scan or on a clini- cally indicated spiral CT scan of the chest. The most frequent mechanisms of injury were fall and car accident. Conscious patients did not report dizziness or loss of consciousness be- fore the trauma and most of them did not have any symp- toms related to COVID-19 (e.g., fever, shortness of breath). To our knowledge, there is no study or report about the pos- sible association between COVID-19 and trauma in the lit- ∗Corresponding Author: Morteza Sanei Taheri; Department of Radiology, Shohada Hospital, Tajrish Sq., Tehran, Iran. Postal code: 1445613131, Phone: 00982122739200, Email: saneim@gmail.com erature. So, the mentioned observations could be just a co- incidence, but this association could still be proposed as a research objective. The importance of this finding is that CT characteristics of COVID-19 could be seen in patients who were admitted to the hospitals not due to COVID-19 related symptoms, but because of chest and abdominal trauma. This issue should be considered by health care workers serving trauma patients and it should be kept in mind that during an outbreak of respiratory infections, in particular COVID-19 disease, every attempt should be made to protect the health and safety of the staff even when providing care for trauma patients. 1. Declarations 1.1. Acknowledgements None. 1.2. Author’s contribution MST developed the concept. MKh, RA, EZ, YM, and HH prepared the draft of the letter. MST revised the letter. Authors ORCIDs Mehdi Khazaei: 0000-0001-7852-7951 Reyhaneh Asgari: 0000-0002-2052-2987 Ehsan Zarei1 ORCID: 0000-0001-8529 Yashar Moharramzad: 0000-0002-5986-3754 Hamidreza Haghighatkhah: 0000-0001-5411-0609 Morteza Sanei Taheri: 0000-0002-8881-9058 1.3. Conflict of interest None. 1.4. Funding and support No fund was received to prepare this letter. This open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0). Downloaded from: http://journals.sbmu.ac.ir/aaem M. Khazaei et al. 2 References 1. Mahdavi A, Khalili N, Davarpanah AH, Faghihi T, Mahdavi A, Haseli S, et al. Radiologic Management of COVID-19: Preliminary Experience of the Iranian Society of Radiol- ogy COVID-19 Consultant Group (ISRCC). Iranian Journal of Radiology. (In Press). 2. National Committee on COVID-19 Epidemiology. Daily Situation Report on Coronavirus disease (COVID-19) in Iran; March 13, 2020. Archives of Academic Emergency Medicine. 2020;8(1):e23. 3. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Preven- tion. Jama. 2020. 4. Hu Z, Song C, Xu C, Jin G, Chen Y, Xu X, et al. Clinical char- acteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China. Science China Life Sciences. 2020:1-6. 5. Zhang C, Shi L, Wang F-S. Liver injury in COVID-19: man- agement and challenges. The Lancet Gastroenterology & Hepatology. 2020. This open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0). Downloaded from: http://journals.sbmu.ac.ir/aaem Declarations References