COVID-19 impact assessment on the French radiological centers: a nationwide survey

Abstract

Purpose To determine the impact of the COVID-19 on the CT activities in French radiological centers during the epidemic peak. Materials and methods A cross-sectional prospective CT scan survey was conducted between March 16 and April 12, 2020, in accordance with the local IRB. Seven hundred nine radiology centers were invited to participate in a weekly online survey. Numbers of CT examinations related to COVID-19 including at least chest (CT covid) and whole chest CT scan activities (CT chest) were recorded each week. A sub-analysis on French departments was performed during the 4 weeks of the study. The impact of the number of RT-PCRs (reverse transcriptase polymerase chain reactions) on the CT workflow was tested using two-sample t test and Pearson's test. Results Five hundred seventy-seven structures finally registered (78%) with mean response numbers of 336 ± 18.9 (323; 351). Mean CT chest activity per radiologic structure ranged from 75.8 ± 133 (0-1444) on week 12 to 99.3 ± 138.6 (0-1147) on week 13. Mean ratio of CT covid on CT chest varied from 0.36 to 0.59 on week 12 and week 14 respectively. There was a significant relationship between the number of RT-PCR performed and the number of CT covid (r = 0.73, p = 3.10 −16) but no link with the number of positive RT-PCR results. Conclusion In case of local high density COVID-19, CT workflow is strongly modified and redirected to the management of these specific patients. Key Points • Over the 4-week survey period, 117,686 chest CT (CT total) were performed among the responding centers, including 61,784 (52%) CT performed for COVID-19 (CT covid). • Across the country, the ratio CT covid /CT total varied from 0.36 to 0.59 and depended significantly on the local epidemic density (p = 0.003). • In clinical practice, in a context of growing epidemic, in France, chest CT was used as a surrogate to RT-PCR for patient triage.

Efficacy of Chest CT for COVID-19 Pneumonia Diagnosis in France

“…In this study, we hypothesized that chest CT has been effective as a primary diagnosis tool in clinical practice given the perceived higher sensitivity of Chest CT compared to the first RT-PCR test during the workup for the first hospital admission. To demonstrate that point, we launched a French national observational survey ( 11 ) to determine the efficacy of chest CT for the diagnosis of COVID 19 pneumonia. The final discharge diagnosis based on a multi-parametric item including clinical findings, RT-PCR testing, chest CT imaging, risk level of exposure, local estimated prevalence and biological data, was used as reference standard.…”

The impact of COVID-19 upon student radiographers and clinical training

“…Several papers have documented these changes in practice and currently, the focus is on how to best address radiology waiting lists at a time when a second COVID-19 wave is anticipated and as some countries are still dealing with the initial wave. 7 , 8 , 9 , 10 , 11 , 12…”

“…Patients awaiting medical imaging procedures have been significantly affected and there is substantial concern that many pathologies are not being diagnosed in an optimal period due to imaging delays and the publics’ reticence to attend general practitioner appointments or hospital appointments during the lockdown phases applied to reduce the impact of the COVID-19 pandemic. 7 , 8 , 9 , 10 , 11 , 12 Also, there is evidence that the morbidity arising from the virus is significant and will require ongoing monitoring of chronic illness. 13 , 14 A further impact of the disruption to radiology services is to radiography training as well as radiology residency training.…”

Ultra-low-dose chest CT performance for the detection of viral pneumonia patterns during the COVID-19 outbreak period: a monocentric experience

“…Altogether, CT-scanning seems to have an important role to play in these viral pneumonia outbreak periods with rapid detection of lung damage, which can help to control potential transmission early on. Due to limited access to RT-PCR tests and their moderate sensitivity, many patients are addressed to the emergency department for a CT-scan (14). Its widespread implementation warrants a critical review of the radiation dose.…”