Lung Cancer Diagnosed by Artificial Intelligence, But It Was Actually COVID-19: A Descriptive Study

Introduction: COVID-19 showed certain characteristic features of multiple signs in bilateral lungs. COVID-19 with a solitary pulmonary nodule (SPN) also occurs, which is easily misdiagnosed as lung cancer.Methods: In this single-center retrospective study, patients with SPN hospitalized General hospital of central theater command of the People's Liberation Army during COVID-19 outbreak (from 22 January, 2020, to 15 March, 2020) were included in the study. Their clinical data including epidemiology, imaging characteristics, clinical symptoms, laboratory data, clinical characteristics, Artificial Intelligence (AI) reports, and outcomes was obtained after reviewing all the patients’ clinical records and patients’ telephone interview.Result: As an COVID-19 designated center, altogether 21 inpatients were diagnosed SPN by chest computed tomography in this outbreak. Imaging characteristics included: burr sign (76.2%), lobulated sign (61.9%), pleural indentation (42.9%), smooth edges (23.8%), cavity (14.3%). However, lesions from 16 cases (76.2%) were considered as high-risk patients of lung cancer rather than inflammation by the AI system. After distinguishing by clinicians and laboratory tests, they were received a correct diagnosis as COVID-19.Interpretation: COVID-19 patients with SPN are easy to be misdiagnosed by the AI system. In our study, we found the general pattern of COVID-19 with SPN: younger ages, asymptomatic, without underlying disease. During the COVID-19 epidemic, the diagnosis in patients with SPN should be combined with RT-PCR results and epidemiological history comprehensively.Funding Statement: None.Declaration of Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Ethics Approval Statement: The institutional review board of the general hospital of Central Theater Command of the People's Liberation Army approved the study.