Early Chest Computed Tomography To Diagnose Covid-19 From Suspected Patients: A Multicenter Retrospective Study

AMERICAN JOURNAL OF EMERGENCY MEDICINE(2021)

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摘要
Objective: The purpose of this study was to distinguish the imaging features of COVID-19 from those of other in-fectious pulmonary diseases and evaluate the diagnostic value of chest CT for suspected COVID-19 patients.Methods: Adult patients suspected of COVID-19 aged N18 years who underwent chest CT scans and reverse -transcription polymerase chain reaction (RT-PCR) tests within 14 days of symptom onset were enrolled. The en -rolled patients were confirmed and grouped according to the results of the RT-PCR tests. The basic demographics, single chest CT features, and combined chest CT features were analyzed for the confirmed and nonconfirmed groups.Results: A total of 130 patients were enrolled, with 54 testing positive and 76 testing negative. The typical CT im-aging features of the positive group were ground glass opacities (GGOs), the crazy-paving pattern and air bronchogram. The lesions were mostly distributed bilaterally and close to the lower lungs or the pleura. When features were combined, GGOs with bilateral pulmonary distribution and GGOs with pleural distribution were more common among the positive patients, found in 31 (57.4%) and 30 patients (55.6%), respectively. The com-binations were almost all statistically significant (P b .05), except for the combination of GGOs with consolidation. Most combinations presented relatively low sensitivity but extremely high specificity. The average specificity of these combinations was approximately 90%.Conclusions: The combinations with GGOs could be useful in the identification and differential diagnosis of COVID-19, alerting clinicians to isolate patients for prompt treatment and repeat RT-PCR tests until the end of incubation.(c) 2018 Elsevier Inc. All rights reserved.
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关键词
Coronavirus infections, Viral pneumonia, Computed tomography, Sensitivity and specificity, Reverse-transcription polymerase chain reac-tion
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