The relationship between diagnostic value of chest computed tomography imaging and symptom duration in COVID infection

Ann Thorac Med. Jul-Sep 2020;15(3):151-154. doi: 10.4103/atm.ATM_165_20. Epub 2020 Jun 18.

Abstract

Objectives: Severe acute respiratory syndrome-coronovirus-2 is a global public health problem, in which early diagnosis is required to prevent the spread of infection. In this study, we aimed to reveal the diagnostic value of chest computed tomography (CT) imaging with respect to symptom duration.

Methods: This retrospective study involved patients from five centers, who were admitted with typical COVID-19 symptoms and found to be positive for COVID-19 real-time reverse transcription-polymerase chain reaction (rtRT-PCR) test.

Results: One hundred and five patients with positive COVID-19 rtRT-PCR test were involved in the study. Sixty percent of these patients had chest CT imaging findings consistent with COVID-19 pneumonia. The most common chest CT finding was bilateral and subpleural ground-glass opacity in middle-lower lobes of the lungs. Chest CT findings were detected in 85.1% of the patients with a symptom duration of more than 2 days. In receiver operating characteristic analysis of this parameter, area under the curve (AUC) was 0.869, while sensitivity and specificity were 90.5% and 76.2%, respectively. It was notable that chest CT findings were 7.17 times more common among the patients aged 60 years and older, with AUC, specificity, and positive predictive value of 0.768, 88.1%, and 84.8%, respectively.

Conclusion: Chest CT imaging is a quite valuable tool in patients with longer than 2 days' duration of symptoms, in whom clinical and epidemiological data support the diagnosis of COVID-19 infection. We suggest that the diagnosis of COVID-19 pneumonia should be made with chest CT imaging when rtRT-PCR test cannot be performed or gives a negative result, which is important for public health and to prevent the spread of infection.

Keywords: COVID-19; Chest computed tomography; symptom duration.