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Chest Computed Tomography Is an Efficient Method for Initial Diagnosis of COVID-19: An Observational Study
Waldonio de Brito Vieira1, Karen Margarete Vieira da Silva Franco1, Apio Ricardo Nazareth Dias1,2
1Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil.
Insights
Chest computed tomography (CT) is an effective tool for the initial diagnosis of coronavirus disease (COVID-19). This imaging method aids in the early identification and improved management of patients with COVID-19, especially when molecular tests are inconclusive.
Area of Science:
- Radiology
- Infectious Diseases
- Pulmonology
Background:
- Coronavirus disease (COVID-19) can cause severe respiratory complications, including pneumonia and acute respiratory distress syndrome.
- Accurate and timely diagnosis is crucial for effective patient management and limiting disease spread.
Purpose of the Study:
- To evaluate the diagnostic efficacy of chest computed tomography (CT) in the initial assessment of COVID-19.
- To compare CT findings with reverse transcription polymerase chain reaction (RT-PCR) results in a Brazilian cohort.
Main Methods:
- An observational, retrospective, cross-sectional study involving 259 adult patients with flu-like symptoms.
- Patients underwent clinical evaluation, blood tests, chest CT, and RT-PCR for SARS-CoV-2.
- Statistical analysis included Student's t-test, average test, and Fisher's exact test.
Main Results:
- Chest CT revealed a higher proportion of ground-glass opacity, vascular enhancement, septal thickening, crazy-paving pattern, and consolidations in COVID-19 positive individuals.
- CO-RADS categories 4 and 5 were significantly more prevalent in the COVID-19 positive group (77.25%) compared to the negative group (50%).
- Chest CT demonstrated significant differences in key imaging findings between COVID-19 positive and negative patients.
Conclusions:
- Chest CT is an efficient method for the initial diagnosis of COVID-19 when imaging is available.
- CT findings can significantly aid in differentiating COVID-19 from other respiratory conditions.
- The study supports the utility of chest CT in the early management of COVID-19 patients.
Abstract:
Coronavirus disease (COVID-19) is an infectious disease that can lead to pneumonia, pulmonary oedema, acute respiratory distress syndrome, multiple organ and system dysfunction, and death. This study aimed to verify the efficacy of chest computed tomography (CT) for the initial diagnosis of COVID-19. This observational, retrospective, cross-sectional study included 259 individuals who underwent clinical evaluation, blood collection, chest CT, and a reverse transcription polymerase chain reaction (RT-PCR) diagnostic test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during their course of treatment at a reference hospital in Belém, Pará, Brazil between April and June 2020. Inclusion criteria were flu-like symptoms in adults of both sexes. Individuals with an inconclusive COVID-19 molecular test or who had artifacts in the chest CT images were excluded. Parametric data were analyzed using Student-t-test and non-parametric data were analyzed using average test and Fisher exact test. Participants were divided into two groups: Group 1 (COVID-19 positive), n = 211 (124 males, 87 females), 51.8 ± 17.9 years old and Group 2 (COVID-19 negative), n = 48 (22 males, 26 females), 47.6 ± 18.6 years old. Most frequent symptoms were cough [Group 1 n = 199 (94%)/Group 2 n = 46 (95%)], fever [Group 1 n = 154 (72%)/Group 2 n = 28 (58%)], myalgia [Group 1 n = 172 (81%)/Group 2 n = 38 (79%)], dyspnoea [Group 1 n = 169 (80%) / Group 2 n = 37 (77%)], headache [Group 1 n = 163 (77%)/Group 2 n = 32 (66%)], and anosmia [Group 1 n = 154 (73%)/Group 2 n = 29 (60%)]. Group 1 had a higher proportion of ground-glass opacity [Group 1 n = 175 (83%)/Group 2 n = 24 (50%), 0.00], vascular enhancement sign [Group 1 n = 128 (60%)/Group 2 n = 15 (31%), 0.00], septal thickening [Group 1 n = 99 (47%)/Group 2 n = 13 (27%), 0.01], crazy-paving pattern [Group 1 n = 98 (46%) / Group 2 n = 13 (27%), 0.01], consolidations [Group 1 n = 92 (43%)/Group 2 n = 8 (16%), 0.00], and CO-RADS 4 and 5 [Group 1 n = 163 (77.25%)/Group 2 n = 24 (50%), 0.00] categories in chest CT. Chest CT, when available, was found to be an efficient method for the initial diagnosis and better management of individuals with COVID-19.
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