Diagnostic Accuracy of Chest CT Scans for Suspected Patients with COVID-19 in a Retrospective Cohort Study

Link to article at PubMed

JMIR Public Health Surveill. 2020 Sep 9. doi: 10.2196/19424. Online ahead of print.


BACKGROUND: CT scans are increasingly available in clinical care globally. They enable a rapid and detailed assessment of tissue and organ involvement in disease processes that are relevant to diagnosis and management, particularly since the coronavirus outbreak in the world.

OBJECTIVE: We wanted to compare CT scan findings of patients that were COVID-19 positive (confirmed via nucleic acid testing) to patients who were confirmed COVID-19 negative.

METHODS: A retrospective cohort study was proposed to compare patient clinical characteristics and CT scan findings in suspected COVID-19 cases. A multivariable logistic model with LASSO selection for variables was used to identify the good predictors from all available predictors. The area under the curve (AUC) with 95% confidence interval was calculated for each of the selected predictors and these combined selected key predictors.

RESULTS: A total of 94 (56%) patients were confirmed positive for COVID-19 from the suspected 167 patients. We found that elderly people were more likely to be infected by COVID-19. Among the 94 confirmed positive patients, 2 (2%) patients were admitted to an intensive care unit, and 0 (0%) patients died during the study period. We found that the presence, distribution, and location of CT lesions was associated with the presence of COVID-19. White blood cell counts, cough, and a contact history of Wuhan also were the top predictors for COVID-19. The overall AUC of these selected predictors is 0.97 (0.93, 1.00).

CONCLUSIONS: Taken together with nucleic acid testing, we find that CT scans can allow for the rapid diagnosis of COVID-19. This study suggests that chest CT scans should be more broadly adopted along with nucleic acid testing in the initial assessment of suspected COVID-19 cases, especially for patients with non-specific symptoms.

PMID:33001830 | DOI:10.2196/19424

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