CT Scans Provide COVID-19 Insight

Article

A new study explores the relation between patient chest CT scan findings and the clinical conditions of COVID-19 pneumonia.

As cases of the novel coronavirus (COVID-19) have risen over the last week, US media outlets have focused on spread within the country.

But, the COVID-19 outbreak is also a global phenomenon. In China, there is cautious optimism as new cases detected in the nation are on the decline, however, new cases are still popping up around the world.

A new study out of China may offer insight on the clinical characteristics of COVID-19 to health care providers globally. The study, published in the American Journal of Roentgenology, explores the relationship between patient chest CT scan findings and the clinical conditions of COVID-19 pneumonia.

The investigators retrospectively collected records of 101 patients with confirmed COVID-19 infection from the Radiology Quality Control Center in Hunan, China.

“We described 4 distributions: craniocaudal, transverse, lung region, and scattered. A CT score system was used to evaluate the extent of disease,” the study authors wrote.

Of the 101 patients, 87 were nonemergency and 14 were emergency cases. Most patients (70.2%) in the study group were between 21-50 years old.

There were 17 patients who denied a history of travel to Wuhan or exposure to people with a travel history, suggestive of possible community transmission. Five patients were associated with family outbreaks.

The onset symptom was fever for 78.2% of patients. Cough was the second most common onset symptom, occurring in 62.4% of patients.

CT results revealed patients with COVID-19 pneumonia had imaging features like ground-glass opacities, mixed ground-glass opacities and consolidation, vascular enlargement in the lesion, and traction bronchiectasis.

Lesions detected by CT imagery were more likely to feature bilateral involvement, peripheral distribution, to be lower lung predominant, and to be multifocal.

“Patients in the emergency group were older than those in the non-emergency group. Architectural distortion, traction bronchiectasis, and CT involvement score aided in evaluation of the severity and extent of the disease,” the study authors wrote.

The imaging features identified could be helpful for screening suspected cases of COVID-19 as well as evaluating disease severity. The investigators highlighted the usefulness of an alternative to diagnostic screening in their discussion of the results.

“Laboratory testing has become the standard for the diagnosis of COVID-19 pneumonia, but the supply of laboratory kits cannot meet the demand of the increasing number of suspected cases. At the same time, the problem of false-negative results of the laboratory test has been discussed by clinicians in China. As of February 17, 2020, 6242 suspected cases of COVID-19 were waiting for final diagnosis,” the authors wrote.

Diagnostics, then, may have to be supplemented by other methods. Regardless of the availability of diagnostic tests, the study demonstrates that CT scans can offer key insight into disease severity.

For the most recent case counts in the COVID-19 outbreak, check out the Contagion® Outbreak Monitor.

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Paul Tambyah, MD, president of ISID
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