Chest CT for early detection and management of coronavirus disease (COVID-19): a report of 314 patients admitted to Emergency Department with suspected pneumonia

Abstract

Purpose The purpose of our study was to assess the potential role of chest CT in the early detection of COVID-19 pneumonia and to explore its role in patient management in an adult Italian population admitted to the Emergency Department. Methods Three hundred and fourteen patients presented with clinically suspected COVID-19, from March 3 to 23, 2020, were evaluated with PaO2/FIO2 ratio from arterial blood gas, RT-PCR assay from nasopharyngeal swab sample and chest CT. Patients were classified as COVID-19 negative and COVID-19 positive according to RT-PCR results, considered as a reference. Images were independently evaluated by two radiologists blinded to the RT-PCR results and classified as “CT positive” or “CT negative” for COVID-19, according to CT findings. Results According to RT-PCR results, 152 patients were COVID-19 negative (48%) and 162 were COVID-19 positive (52%). We found substantial agreement between RT-PCR results and CT findings ( p < 0.000001), as well as an almost perfect agreement between the two readers. Mixed GGO and consolidation pattern with peripheral and bilateral distribution, multifocal or diffuse abnormalities localized in both upper lung and lower lung, in association with interlobular septal thickening, bronchial wall thickening and air bronchogram, showed higher frequency in COVID-positive patients. We also found a significant correlation between CT findings and patient’s oxygenation status expressed by PaO2/FIO2 ratio. Conclusion Chest CT has a useful role in the early detection and in patient management of COVID-19 pneumonia in a pandemic. It helps in identifying suspected patients, cutting off the route of transmission and avoiding further spread of infection.

Why Are COVID-19 Mortality Rates by Country or Region So Different?: An Ecologic Study of Factors Associated with Mortality from Novel Coronavirus Infections by Country

“…Chest CT scans are useful in finding milder patients with pneumonia. 12 In countries with more CT scans, patients with pneumonia © 2021 Tottori University Medical Press can be found earlier, which may lead to lower mortality due to earlier initiation of treatment in patients who become more severe if treatment is delayed.…”

“…11 We also considered the number of CT scans, as a paper suggests that CT scans can lead to earlier detection of pneumonia caused by COVID-19. 12 We used ecologic studies to evaluate these candidate factors.…”

Artificial Intelligence in Predicting Clinical Outcome in COVID-19 Patients from Clinical, Biochemical and a Qualitative Chest X-Ray Scoring System

“…Warren et al 44 have demonstrated, in acute respiratory distress syndrome (ARDS), that a higher CXR severity score was independently associated with a lower P/F ratio and a worse survival. In Covid-19 patients, a significant correlation was found between CT findings and P/F ratio 45 and Pan et al 46 showed that SpO2 ≤ 89% was an independent risk factor of death.…”

Impact of coronavirus disease 2019 (COVID-19) outbreak on radiology research: An Italian survey

“…5,10 Over the last few months, a huge amount of papers concerning diagnostic and prognostic value of imaging of COVID-19 has been published. [11][12][13][14][15][16][17][18][19][20][21] This proves that radiology research has not stopped during COVID-19 pandemic and that this emergency has become a main topic of several trials and research activities. Nevertheless, the impact of COVID-19 outbreak on radiology research has been scarcely considered.…”