Diagnostic performance of chest computed tomography in coronavirus disease 2019 infection and its correlation with disease severity

Hafez, Mona A.F.; El Hinnawy, Yasmine H.; Nabil, Dina M.; Tadros, Sally F.

doi:10.4103/kamj.kamj_23_21

Diagnostic performance of chest computed tomography in coronavirus disease 2019 infection and its correlation with disease severity

Authors

Abstract

Introduction
Coronavirus disease 2019 (COVID-19) pneumonia is a recently diagnosed rapidly spreading acute respiratory syndrome. Real-time reverse-transcription (RT-PCR) testing for COVID-19 pneumonia is the standard for diagnostic confirmation. Because of low sensitivity rates of RT-PCR and the need for rapid diagnosis, noncontrast computed tomography (CT) of the chest has been regularly used in the current pandemic situation.
Aim
The aim of this study was to assess the diagnostic performance of CT chest and to grade the severity of lung involvement in COVID-19 infection.
Results
With RT-PCR serving as a reference standard, sensitivity, specificity, and accuracy of chest CT in COVID-19 pneumonia were 98.8, 58, and 72%, respectively. According to CT severity score, 66.7% of patients were mild cases, whereas 33.3% were severe. The most frequent CT chest finding was ground-glass opacities (98.9%). Most of the cases presented with bilateral and lower lobe involvement with peripheral distribution (88.9%). However, both peripheral and central distributions showed significant correlation with disease severity (<0.1). Moreover, a significant correlation was found between CT severity score and crazy paving pattern, as it was present in 76.7% of severe cases (<0.1).
Conclusion
CT of the chest is a valid imaging method for assessing the extent and severity of COVID-19 pneumonia and can be used as a standard method in early management of patients.

Keywords