Display options
Cite
Axiaq A, Almohtadi A, Massias SA, et al. The role of computed tomography scan in the diagnosis of COVID-19 pneumonia. Curr Opin Pulm Med. 2021;27(3):163-168doi: 10.1097/MCP.0000000000000765.
Axiaq, A., Almohtadi, A., Massias, S. A., Ngemoh, D., & Harky, A. (2021). The role of computed tomography scan in the diagnosis of COVID-19 pneumonia. Current opinion in pulmonary medicine, 27(3), 163-168. https://doi.org/10.1097/MCP.0000000000000765
Axiaq, Ariana, et al. "The role of computed tomography scan in the diagnosis of COVID-19 pneumonia." Current opinion in pulmonary medicine vol. 27,3 (2021): 163-168. doi: https://doi.org/10.1097/MCP.0000000000000765
Axiaq A, Almohtadi A, Massias SA, Ngemoh D, Harky A. The role of computed tomography scan in the diagnosis of COVID-19 pneumonia. Curr Opin Pulm Med. 2021 May 01;27(3):163-168. doi: 10.1097/MCP.0000000000000765. PMID: 33560673.
Copy Download .nbib Format: NLM
Share it on

Curr Opin Pulm Med. 2021 May 01;27(3):163-168. doi: 10.1097/MCP.0000000000000765.

The role of computed tomography scan in the diagnosis of COVID-19 pneumonia.

Current opinion in pulmonary medicine

Ariana Axiaq, Ahmad Almohtadi, Samuel A Massias, Dorette Ngemoh, Amer Harky

Affiliations

  1. School of Medicine, Queen's University Belfast, Belfast.
  2. Medical School, St George's University of London, London.
  3. Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital.
  4. Department of Cardiac Surgery, Alder Hey Children Hospital, Liverpool, UK.

PMID: 33560673 DOI: 10.1097/MCP.0000000000000765

Abstract

PURPOSE OF REVIEW: To summarize current literature evidence on the role of computed tomography (CT) scan in the diagnosis and assessment of coronavirus disease 2019 (COVID-19) pneumonia.

RECENT FINDINGS: Recent guidelines on the use of CT scans in COVID-19 vary between countries. However, the consensus is that it should not be used as the first line; a notion supported by the WHO. Currently, several investigations are being used including reverse transcription PCR testing, chest radiographs, and ultrasound scans, and CT scans. They are ideally performed later during the disease process as the sensitivity and specificity are highest by that time. Typical COVID-19 features on CT scans vary but include vascular enlargement, ground-glass opacities, and ground glass opacification together with consolidation.

SUMMARY: Since COVID-19 was declared as a global pandemic, there was a push towards identifying appropriate diagnostic tests that are both reliable and effective. There is a general agreement that CT scans have a high sensitivity but low specificity in diagnosing COVID-19. However, the quality of available studies is not optimal, so this must always be interpreted with the clinical context in mind. Clinicians must aim to weigh up the practicalities and drawbacks of CT scans when considering their use for a patient. The ease and speed of use of CT scans must be balanced with their high radiation doses, and infection control considerations.

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

References

  1. Gattinoni L, Caironi P, Valenza F, Carlesso E. The role of CT-scan studies for the diagnosis and therapy of acute respiratory distress syndrome. Clin Chest Med 2006; 27:559–570. - PubMed
  2. Ai T, Yang Z, Hou H, et al. Correlation of chest CT and RT-PCR testing for coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology 2020; 296:E32–E40. - PubMed
  3. Manna S, Wruble J, Maron S, et al. COVID-19: a multimodality review of radiologic techniques, clinical utility, and imaging features. Radiology: Cardiothoracic imaging 2020; 2:e200210. - PubMed
  4. World Health Organisation. Clinical management of COVID-19. 2020; Geneva: World Health Organisation, 21 Available from: https://www.who.int/publications/i/item/clinical-management-of-covid-19. [Accessed 20 October 2020]. - PubMed
  5. World Health Organization. Use of chest imaging in COVID-19. 2020; Geneva: World Health Organization, 1–2, Available from: https://www.who.int/publications/i/item/use-of-chest-imaging-in-covid-19. [Accessed 20 October 2020]. - PubMed
  6. El Homsi M, Chung M, Bernheim A, et al. Review of chest CT manifestations of COVID-19 infection. Eur J Radiol Open 2020; 7:100239. - PubMed
  7. Xing C, Li Q, Du H, et al. Lung ultrasound findings in patients with COVID-19 pneumonia. Crit Care 2020; 24:174. - PubMed
  8. Salameh J, Leeflang M, Hooft L, et al. Thoracic imaging tests for the diagnosis of COVID-19. Cochrane Database Syst Rev 2020; 11:CD013639. - PubMed
  9. Bernheim A, Mei X, Huang M, et al. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology 2020; 295:200463. - PubMed
  10. The Royal College of Radiologists. The role of CT in patients suspected with COVID-19 infection. 2020; London United Kingdom: The Royal College of Radiologists, Available from: https://www.rcr.ac.uk/college/coronavirus-covid-19-what-rcr-doing/clinical-information/role-ct-chest/role-ct-patients. [Accessed 20 October 2020]. - PubMed
  11. American College of Radiology. ACR recommendations for the use of chest radiography and computed tomography (CT) for suspected COVID-19 infection. 2020; Philadelphia United States: American College of Radiology, Available from: https://www.acr.org/Advocacy-and-Economics/ACR-Position-Statements/Recommendations-for-Chest-Radiography-and-CT-for-Suspected-COVID19-Infection. [Accessed 20 October 2020]. - PubMed
  12. World Health Organization. Use of chest imaging in COVID-19. 2020; Geneva: World Health Organisation, 10–22, Available from: https://www.who.int/publications/i/item/use-of-chest-imaging-in-covid-19. [Accessed 20 October 2020]. - PubMed
  13. Harahwa TA, Lai Yau TH, Lim-Cooke MS, et al. The optimal diagnostic methods for COVID-19. Diagnosis 2020; 7:349–356. - PubMed
  14. Ye Z, Zhang Y, Wang Y, et al. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol 2020; 30:4381–4389. - PubMed
  15. Pan Y, Guan H, Zhou S, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. Eur Radiol 2020; 30:3306–3309. - PubMed
  16. Shao JM, Ayuso SA, Deerenberg EB, et al. A systematic review of CT chest in COVID-19 diagnosis and its potential application in a surgical setting. Colorectal Dis 2020; 22:993–1001. - PubMed
  17. Ding X, Xu J, Zhou J, Long Q. Chest CT findings of COVID-19 pneumonia by duration of symptoms. Eur J Radiol 2020; 127:109009. - PubMed
  18. Kang Z, Li X, Zhou S. Recommendation of low-dose CT in the detection and management of COVID-19. Eur Radiol 2020; 30:4356–4357. - PubMed
  19. Wang H, Wei R, Rao G, et al. Characteristic CT findings distinguishing 2019 novel coronavirus disease (COVID-19) from influenza pneumonia. Eur Radiol 2020; 30:4910–4917. - PubMed
  20. Stogiannos N, Fotopoulos D, Woznitza N, Malamateniou C. COVID-19 in the radiology department: what radiographers need to know. Radiography 2020; 26:254–263. - PubMed
  21. Zhao W, Zhong Z, Xie X, et al. Relation between chest CT findings and clinical conditions of coronavirus disease (COVID-19) pneumonia: a multicenter study. AJR Am J Roentgenol 2020; 214:1072–1077. - PubMed
  22. Zhang MQ, Wang XH, Chen YL, et al. Clinical features of 2019 novel coronavirus pneumonia in the early stage from a fever clinic in Beijing. Zhonghua Jie He He Hu Xi Za Zhi 2020; 43:E013. - PubMed
  23. Song F, Shi N, Shan F, et al. Emerging coronavirus 2019-nCoV pneumonia. Radiology 2020; 295:210–217. - PubMed
  24. Wu J, Wu X, Zeng W, et al. Chest CT Findings in patients with corona virus disease 2019 and its relationship with clinical features. Invest Radiol 2020; 55:257–261. - PubMed
  25. Shi H, Han X, Jiang N, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis 2020; 20:425–434. - PubMed
  26. Wang J, Liu J, Wang Y, et al. Dynamic changes of chest CT imaging in patients with corona virus disease-19 (COVID-19). Zhejiang Da Xue Xue Bao Yi Xue Ban 2020; 49:191–197. - PubMed
  27. Xu YH, Dong JH, An WM, et al. Clinical and computed tomographic imaging features of novel coronavirus pneumonia caused by SARSCoV-2. J Infect 2020; 80:394–400. - PubMed
  28. Zhang JJ, Dong X, Cao YY, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy 2020; 75:1730–1741. - PubMed
  29. Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382:1708–1720. - PubMed
  30. Wu J, Liu J, Zhao X, et al. Clinical characteristics of imported cases of COVID-19 in Jiangsu Province: a multicenter descriptive study. Clin Infect Dis 2020; 71:706–712. - PubMed
  31. Xu X, Yu C, Qu J, et al. Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2. Eur J Nucl Med Mol Imaging 2020; 47:1275–1280. - PubMed
  32. Ojha V, Mani A, Pandey NN, et al. CT in coronavirus disease 2019 (COVID-19): a systematic review of chest CT findings in 4410 adult patients. Eur Radiol 2020; 30:6129–6138. - PubMed
  33. Bao C, Liu X, Zhang H, et al. Coronavirus disease 2019 (COVID-19) CT findings: a systematic review and meta-analysis. J Am Coll Radiol 2020; 17:701–709. - PubMed
  34. Tsikala Vafea M, Atalla E, Kalligeros M, et al. Chest CT findings in asymptomatic cases with COVID-19: a systematic review and meta-analysis. Clin Radiol 2020; 75:876.e33–876.e39. - PubMed
  35. Pan Y, Yu X, Du X, et al. Epidemiological and clinical characteristics of 26 asymptomatic SARS-CoV-2 carriers. J Infect Dis 2020; 221:1940–1947. - PubMed
  36. Xiao N, Abboud S, McCarthy DM, et al. Incidentally discovered COVID-19 in low-suspicion patients – a threat to front line healthcare workers. Emerg Radiol 2020; 27:589–595. - PubMed
  37. Adams HJA, Kwee TC, Yakar D, et al. Chest CT imaging signature of coronavirus disease 2019 infection: in pursuit of the scientific evidence. Chest 2020; 158:1885–1895. - PubMed
  38. Fang Y, Zhang H, Xie J, et al. Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology 2020; 296:E115–E117. - PubMed
  39. Xu B, Xing Y, Peng J, et al. Chest CT for detecting COVID-19: a systematic review and meta-analysis of diagnostic accuracy. Eur Radiol 2020; 30:5720–5727. - PubMed
  40. Song S, Wu F, Liu Y, et al. Correlation between chest CT findings and clinical features of 211 COVID-19 suspected patients in Wuhan, China. Open Forum Infect Dis 2020; 7:ofaa171. - PubMed
  41. Garvey CJ, Hanlon R. Computed tomography in clinical practice. BMJ 2002; 324:1077–1080. - PubMed
  42. Bellolio MF, Heien HC, Sangaralingham LR, et al. Increased computed tomography utilization in the emergency department and its association with hospital admission. West J Emerg Med 2017; 18:835–845. - PubMed
  43. Nakajima K, Kato H, Yamashiro T, et al. COVID-19 pneumonia: infection control protocol inside computed tomography suites. Jpn J Radiol 2020; 38:391–393. - PubMed
  44. Tofighi S, Najafi S, Johnston SK, Gholamrezanezhad A. Low-dose CT in COVID-19 outbreak: radiation safety, image wisely, and image gently pledge. Emerg Radiol 2020; 27:601–605. - PubMed
  45. Fred HL. Drawbacks and limitations of computed tomography: views from a medical educator. Tex Heart Inst J 2004; 31:345–348. - PubMed
  46. Yan C, Lin J, Xu Y. Recommendations for coronavirus disease 2019 (COVID-19) prevention and infection control in the radiology department: Chinese experience. Clin Imaging 2020; 69:33–36. - PubMed

MeSH terms

Publication Types