The role of CT imaging for management of COVID-19 in epidemic area: early experience from a University Hospital

Abstract

Background To evaluate the clinical value of the chest CT scan compared to the reference standard real-time polymerase chain reaction (RT-PCR) in COVID-19 patients. Methods From March 29th to April 15th of 2020, a total of 240 patients with respiratory distress underwent both a low-dose chest CT scan and RT-PCR tests. The performance of chest CT in diagnosing COVID-19 was assessed with reference to the RT-PCR result. Two board-certified radiologists (mean 24 years of experience chest CT), blinded for the RT-PCR result, reviewed all scans and decided positive or negative chest CT findings by consensus. Results Out of 240 patients, 60% (144/240) had positive RT-PCR results and 89% (213/240) had a positive chest CT scans. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of chest CT in suggesting COVID-19 were 100% (95% CI: 97–100%, 144/240), 28% (95% CI: 19–38%, 27/240), 68% (95% CI: 65–70%) and 100%, respectively. The diagnostic accuracy of the chest CT suggesting COVID-19 was 71% (95% CI: 65–77%). Thirty-three patients with positive chest CT scan and negative RT-PCR test at baseline underwent repeat RT-PCR assay. In this subgroup, 21.2% (7/33) cases became RT-PCR positive. Conclusion Chest CT imaging has high sensitivity and high NPV for diagnosing COVID-19 and can be considered as an alternative primary screening tool for COVID-19 in epidemic areas. In addition, a negative RT-PCR test, but positive CT findings can still be suggestive of COVID-19 infection.

Role of High Resolution Computed Tomography chest in the diagnosis and evaluation of COVID -19 patients -A systematic review and meta-analysis

“…Chest CT is found to have high sensitivity and high negative predictive value as compared RT-PCR and can be used as an alternative tool for primary screening of COVID-19 patients. [69] In conclusion COVID-19 is a novel disease that has affected millions of people across the country. The early detection of the disease is very important in controlling the spread of the disease and in this regard, the role of the thoracic computed tomography is very important based on the representation of radological features of the infection.…”

COVI3D: Automatic COVID-19 CT Image-Based Classification and Visualization Platform Utilizing Virtual and Augmented Reality Technologies

“…However, it is time-consuming and may provide both false-negative (FN) and false-positive (FP) rates [7]. Since COVID-19 causes lung complications, such as pneumonia, computed tomography (CT) of the scan is the most frequently used diagnostic tool [8][9][10]. In Algeria, CT scans have been widely used and show good clinical diagnostics [11].…”

The correlation between severity scores in computed tomography lung scans and viral load in the severity of novel coronavirus 2019 progression

“…A time window exists to help prevent patients infected with COVID‐19 from deteriorating by providing clinical interventions. Changes are observable via computed tomography (CT) imaging as it serves as an important tool for evaluating the severity of COVID‐19 6,7 . The CT lung scan results of patients may vary over time.…”

“…Changes are observable via computed tomography (CT) imaging as it serves as an important tool for evaluating the severity of COVID‐19. 6 , 7 The CT lung scan results of patients may vary over time. For example, ground‐glass opacity (GGO) is often observed at the initial stage, a crazy‐paving pattern at the progressive stage and consolidation at the peak stage, as well as at the recovery stage when consolidation is gradually absorbed and fibrotic changes arise.…”