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The role of CT imaging for management of COVID-19 in epidemic area

Journal Contribution - Journal Article

Subtitle:early experience from a University Hospital

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.

Journal: Insights Imaging
ISSN: 1869-4101
Issue: 1
Volume: 12
Keywords:COVID-19, Chest CT, RT-PCR
  • WoS Id: 000613482200001
  • DOI: https://doi.org/10.1186/s13244-020-00957-5
  • Scopus Id: 85100100978
  • PubMed Id: PMC7844558
  • ORCID: /0000-0003-2830-6899/work/87950980
  • ORCID: /0000-0003-0924-4557/work/87951311
  • ORCID: /0000-0002-3601-3212/work/91494537
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