High Resolution CHEST CT(HRCT) Evaluation in Patients Hospitalized with COVID-19 Infection

Patel, M.; Chowdhury, Junad; Zheng, Matthew; Abramian, Osheen; Verga, S.; Zhao, Huaqing; Patlakh, N.; Fleece, David; Montecalvo, Nicholas; Cohen, Gary; Kumaran, Maruti; Dass, Chandra; Criner, Gerard J.

doi:10.1101/2020.05.26.20114082

Cited by 3 publications

(2 citation statements)

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“…The search strategy and cross-referencing searches yielded 395 results. After duplicate screening of title and abstract 70 references were selected for full text review of which 30 met selection criteria and were included: 11 systematic reviews (5,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) and 19 primary diagnostic accuracy studies (12,(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49).…”

Section: Search Resultsmentioning

confidence: 99%

An Umbrella Review With Meta-Analysis of Chest Computed Tomography for Diagnosis of COVID-19: Considerations for Trauma Patient Management

et al. 2022

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BackgroundRT-PCR testing is the standard for diagnosis of COVID-19, although it has its suboptimal sensitivity. Chest computed tomography (CT) has been proposed as an additional tool with diagnostic value, and several reports from primary and secondary studies that assessed its diagnostic accuracy are already available. To inform recommendations and practice regarding the use of chest CT in the in the trauma setting, we sought to identify, appraise, and summarize the available evidence on the diagnostic accuracy of chest CT for diagnosis of COVID-19, and its application in emergency trauma surgery patients; overcoming limitations of previous reports regarding chest CT accuracy and discussing important considerations regarding its role in this setting.MethodsWe conducted an umbrella review using Living Overview of Evidence platform for COVID-19, which performs regular automated searches in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and more than 30 other sources. The review was conducted following the JBI methodology for systematic reviews. The Grading of Recommendations, Assessment, Development, and Evaluation approach for grading the certainty of the evidence is reported (registered in International Prospective Register of Systematic Reviews, CRD42020198267).ResultsThirty studies that fulfilled selection criteria were included; 19 primary studies provided estimates of sensitivity (0.91, 95%CI = [0.88–0.93]) and specificity (0.73, 95%CI = [0.61; 0.82]) of chest CT for COVID-19. No correlation was found between sensitivities and specificities (ρ = 0.22, IC95% [–0.33; 0.66]). Diagnostic odds ratio was estimated at: DOR = 27.5, 95%CI (14.7; 48.5). Evidence for sensitivity estimates was graded as MODERATE, and for specificity estimates it was graded as LOW.ConclusionThe value of chest CT appears to be that of an additional screening tool that can easily detect PCR false negatives, which are reportedly highly frequent. Upon the absence of PCR testing and impossibility to perform RT-PCR in trauma patients, chest CT can serve as a substitute with increased value and easy implementation.Systematic Review Registration[www.crd.york.ac.uk/prospero], identifier [CRD42020198267].

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Section: Search Resultsmentioning

confidence: 99%

An Umbrella Review With Meta-Analysis of Chest Computed Tomography for Diagnosis of COVID-19: Considerations for Trauma Patient Management

et al. 2022

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“…In another study done by Patel and his colleagues on 324 patients with fever and acute respiratory symptoms suggesting COVID-19 infection, high-resolution CT (HRCT) was done in addition to RT-PCR and laboratory tests. They observed that ferritin, CRP, and LDH were significantly higher in patients with COVID-19 whose CT showed distinct multifocal pneumonia and extensive ground glass opacity (GGO) while platelet and ALC were significantly low [31]. Also, Abdelmoty et al found significant validity of lymphopenia, increased D-dimer, LDH, CRP, and serum ferritin to predict severity of COVID-19 infection [32].…”

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confidence: 99%

CO-RADS score and its correlation with clinical and laboratory parameters in patients with COVID-19

et al. 2023

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Background Polymerase chain reaction (PCR) based SARS-CoV-2 RNA detection and serological antibody tests give a proof of Coronavirus Disease 2019 (COVID-19) infection. Several variables can influence the consequences of these tests. Inflammatory markers among mild and severe patients of COVID-19 showed dissimilarity in inflammatory markers while computed tomography (CT) in patients infected with COVID-19 used to evaluate infection severity. The aim of this study is to investigate the application of the COVID-19 Reporting and Data System (CO-RADS) classification in COVID-19 patients and its relation to clinical and laboratory finding. Results One hundred patients suspected to have COVID-19 infection were involved. Their age was 49.6 ± 14.7. Fever and cough were the frequent presenting symptoms. Patients with positive PCR were significantly associated with dyspnea and higher inflammatory markers. Lymphopenia had sensitivity of 63.6% and specificity of 91.7%. Combination of PCR and lymphopenia increased both sensitivity and specificity. CT findings in relation to PCR showed sensitivity of 90.5% and specificity of 25%. CO-RADS score showed positive correlation with age and inflammatory biomarkers and negative correlation with absolute lymphocyte count (ALC). Conclusions CT finding was more prominent in older patients with COVID-19 and associated with higher inflammatory biomarkers and lower ALC which were correlated with CO-RADS score. Patients with positive PCR had more symptoms and inflammatory marker. Combination of PCR with either lymphopenia or CT finding had more sensitivity, specificity and accuracy in diagnosis

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Thoracic imaging tests for the diagnosis of COVID-19

Ebrahimzadeh,

Islam,

Dawit

et al. 2022

Cochrane Database of Systematic Reviews

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Background Our March 2021 edition of this review showed thoracic imaging computed tomography (CT) to be sensitive and moderately specific in diagnosing COVID‐19 pneumonia. This new edition is an update of the review. Objectives Our objectives were to evaluate the diagnostic accuracy of thoracic imaging in people with suspected COVID‐19; assess the rate of positive imaging in people who had an initial reverse transcriptase polymerase chain reaction (RT‐PCR) negative result and a positive RT‐PCR result on follow‐up; and evaluate the accuracy of thoracic imaging for screening COVID‐19 in asymptomatic individuals. The secondary objective was to assess threshold effects of index test positivity on accuracy. Search methods We searched the COVID‐19 Living Evidence Database from the University of Bern, the Cochrane COVID‐19 Study Register, The Stephen B. Thacker CDC Library, and repositories of COVID‐19 publications through to 17 February 2021. We did not apply any language restrictions. Selection criteria We included diagnostic accuracy studies of all designs, except for case‐control, that recruited participants of any age group suspected to have COVID‐19. Studies had to assess chest CT, chest X‐ray, or ultrasound of the lungs for the diagnosis of COVID‐19, use a reference standard that included RT‐PCR, and report estimates of test accuracy or provide data from which we could compute estimates. We excluded studies that used imaging as part of the reference standard and studies that excluded participants with normal index test results. Data collection and analysis The review authors independently and in duplicate screened articles, extracted data and assessed risk of bias and applicability concerns using QUADAS‐2. We presented sensitivity and specificity per study on paired forest plots, and summarized pooled estimates in tables. We used a bivariate meta‐analysis model where appropriate. Main results We included 98 studies in this review. Of these, 94 were included for evaluating the diagnostic accuracy of thoracic imaging in the evaluation of people with suspected COVID‐19. Eight studies were included for assessing the rate of positive imaging in individuals with initial RT‐PCR negative results and positive RT‐PCR results on follow‐up, and 10 studies were included for evaluating the accuracy of thoracic imaging for imagining asymptomatic individuals. For all 98 included studies, risk of bias was high or unclear in 52 (53%) studies with respect to participant selection, in 64 (65%) studies with respect to reference standard, in 46 (47%) studies with respect to index test, and in 48 (49%) studies with respect to flow and timing. Concerns about the applicability of the evidence to: participants were high or unclear in eight (8%) studies; index test were high or unclear in seven (7%) studies; and reference standard were high or uncle...

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High Resolution CHEST CT(HRCT) Evaluation in Patients Hospitalized with COVID-19 Infection

Cited by 3 publications

References 15 publications

An Umbrella Review With Meta-Analysis of Chest Computed Tomography for Diagnosis of COVID-19: Considerations for Trauma Patient Management

An Umbrella Review With Meta-Analysis of Chest Computed Tomography for Diagnosis of COVID-19: Considerations for Trauma Patient Management

CO-RADS score and its correlation with clinical and laboratory parameters in patients with COVID-19

Thoracic imaging tests for the diagnosis of COVID-19

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