COVID-19 associated pulmonary cavitary lesions - A single center observational study

<b>Introduction:</b> Cavitary lesions are rarely associated with COVID-19 and have been very rarely reported. We conducted a retrospective analysis of the COVID-19 patients admitted in our center in South India and attempted to study the distribution and etiology of cavitary lesions in COVID-19. <b>Materials and methods:</b> All inpatients in pulmonology department over a period of 14 months who were diagnosed to have COVID-19 and were found to have cavity on thoracic imaging were included in the study. patient with pre existing cavity were excluded. Patient demographics, comorbid conditions, treatment details, length of hospital stay, and outcomes were examined. The details of the cavitary lesions including their number, the time of detection and lobe of involvement, and the etiology of the cavity were described. <b>Results:</b> 602 patients with COVID-19 were admitted during the study period.&nbsp;A total of 9 patients were included in this report with an incidence of cavitation in hospitalised COVID-19 patients being 1.5%. 55.5% patients had evidence of Aspergillus infection confirmed by serology or isolation of Aspergillus from respiratory specimen. Two (22.2%) patients had tuberculosis. The mortality rate of COVID-19 patients with Aspergillus lesions was 44.4%. Majority were detected to have cavity in the third week of illness. Left lower lobe was the most common involved site. <b>Results:</b> The incidence of cavitary lesions in patients hospitalised with COVID-19 was 1.5% in this study most common etiology of these cavities was fungal followed by TB. These patients had a very high mortality rate of around 45% in this study. Early identification and treatment may improve clinical outcomes in these patients.