The Role of Computed Tomography in the Management of Hospitalized Patients With COVID-19

The emergence of SARS-CoV-2 at the end of 2019 sparked the beginning of the COVID-19 pandemic. Even though it was a novel virus, the workup of suspected COVID-19 included standard protocols used for the investigation of similar respiratory infections and pneumonia. One of the most important diagnostic tests in this regard is computed tomography (CT). CT scans have a high sensitivity in diagnosing COVID-19, and many of the characteristic imaging findings of COVID-19 are used in its diagnosis. The role of CT in COVID-19 management is expanding as more and more hospital practices adopt regular CT use in both the initial workup and continued care of COVID-19 patients. CT has helped hospitalists diagnose complications such as pulmonary embolism, subcutaneous emphysema, pneumomediastinum, pneumothoraces, and nosocomial pneumonia. Although mainly used as a diagnostic tool, the prognostic role of CT in COVID-19 patients is developing. In this review, we explore the role of CT in the management of hospitalized patients with COVID-19, specifically elucidating its use as a diagnostic and prognostic modality, as well as its ability to guide hospital decision-making regarding complex cases. We will highlight important time points when CT scans are used: the initial encounter, the time at admission, and during hospitalization.