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Chest CT Features of COVID-19 in Rome, Italy.
Radiology. 2020 08; 296(2):E79-E85.R

Abstract

Background The standard for diagnosis of severe acute respiratory syndrome coronavirus 2 is a reverse transcription polymerase chain reaction (RT-PCR) test, but chest CT may play a complimentary role in the early detection of Coronavirus Disease 2019 (COVID-19) pneumonia. Purpose To investigate CT features of patients with COVID-19 in Rome, Italy, and to compare the accuracy of CT with that of RT-PCR. Materials and Methods In this prospective study from March 4, 2020, until March 19, 2020, consecutive patients suspected of having COVID-19 infection and respiratory symptoms were enrolled. Exclusion criteria were contrast material-enhanced chest CT performed for vascular indications, patients who refused chest CT or hospitalization, and severe CT motion artifact. All patients underwent RT-PCR and chest CT. Diagnostic performance of CT was calculated using RT-PCR as the reference standard. Chest CT features were calculated in a subgroup of patients with positive RT-PCR and CT findings. CT features of hospitalized patients and patients in home isolation were compared using the Pearson χ2 test. Results The study population included 158 consecutive participants (83 male, 75 female; mean age, 57 years ± 17 [standard deviation]). Of the 158 participants, fever was observed in 97 (61%), cough was observed in 88 (56%), dyspnea was observed in 52 (33%), lymphocytopenia was observed in 95 (60%), increased C-reactive protein level was observed in 139 (88%), and elevated lactate dehydrogenase level was observed in 128 (81%). Sensitivity, specificity, and accuracy of CT were 97% (95% confidence interval [CI]: 88%, 99%) (60 of 62), 56% (95% CI: 45%, 66%) (54 of 96), and 72% (95% CI: 64%, 78%) (114 of 158), respectively. In the subgroup of 58 participants with positive RT-PCR and CT findings, ground-glass opacities were present in all 58 (100%), both multilobe and posterior involvement were present in 54 (93%), bilateral pneumonia was present in 53 (91%), and subsegmental vessel enlargement (>3 mm) was present in 52 (89%). Conclusion The typical pattern of COVID-19 pneumonia in Rome, Italy, was peripheral ground-glass opacities with multilobe and posterior involvement, bilateral distribution, and subsegmental vessel enlargement (>3 mm). Chest CT had high sensitivity (97%) but lower specificity (56%). © RSNA, 2020.

Authors+Show Affiliations

From the Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome-Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy.From the Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome-Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy.From the Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome-Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy.From the Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome-Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy.From the Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome-Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy.From the Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome-Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy.From the Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome-Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy.From the Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome-Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy.From the Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome-Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy.From the Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome-Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32243238

Citation

Caruso, Damiano, et al. "Chest CT Features of COVID-19 in Rome, Italy." Radiology, vol. 296, no. 2, 2020, pp. E79-E85.
Caruso D, Zerunian M, Polici M, et al. Chest CT Features of COVID-19 in Rome, Italy. Radiology. 2020;296(2):E79-E85.
Caruso, D., Zerunian, M., Polici, M., Pucciarelli, F., Polidori, T., Rucci, C., Guido, G., Bracci, B., De Dominicis, C., & Laghi, A. (2020). Chest CT Features of COVID-19 in Rome, Italy. Radiology, 296(2), E79-E85. https://doi.org/10.1148/radiol.2020201237
Caruso D, et al. Chest CT Features of COVID-19 in Rome, Italy. Radiology. 2020;296(2):E79-E85. PubMed PMID: 32243238.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chest CT Features of COVID-19 in Rome, Italy. AU - Caruso,Damiano, AU - Zerunian,Marta, AU - Polici,Michela, AU - Pucciarelli,Francesco, AU - Polidori,Tiziano, AU - Rucci,Carlotta, AU - Guido,Gisella, AU - Bracci,Benedetta, AU - De Dominicis,Chiara, AU - Laghi,Andrea, Y1 - 2020/04/03/ PY - 2020/4/4/pubmed PY - 2020/8/1/medline PY - 2020/4/4/entrez SP - E79 EP - E85 JF - Radiology JO - Radiology VL - 296 IS - 2 N2 - Background The standard for diagnosis of severe acute respiratory syndrome coronavirus 2 is a reverse transcription polymerase chain reaction (RT-PCR) test, but chest CT may play a complimentary role in the early detection of Coronavirus Disease 2019 (COVID-19) pneumonia. Purpose To investigate CT features of patients with COVID-19 in Rome, Italy, and to compare the accuracy of CT with that of RT-PCR. Materials and Methods In this prospective study from March 4, 2020, until March 19, 2020, consecutive patients suspected of having COVID-19 infection and respiratory symptoms were enrolled. Exclusion criteria were contrast material-enhanced chest CT performed for vascular indications, patients who refused chest CT or hospitalization, and severe CT motion artifact. All patients underwent RT-PCR and chest CT. Diagnostic performance of CT was calculated using RT-PCR as the reference standard. Chest CT features were calculated in a subgroup of patients with positive RT-PCR and CT findings. CT features of hospitalized patients and patients in home isolation were compared using the Pearson χ2 test. Results The study population included 158 consecutive participants (83 male, 75 female; mean age, 57 years ± 17 [standard deviation]). Of the 158 participants, fever was observed in 97 (61%), cough was observed in 88 (56%), dyspnea was observed in 52 (33%), lymphocytopenia was observed in 95 (60%), increased C-reactive protein level was observed in 139 (88%), and elevated lactate dehydrogenase level was observed in 128 (81%). Sensitivity, specificity, and accuracy of CT were 97% (95% confidence interval [CI]: 88%, 99%) (60 of 62), 56% (95% CI: 45%, 66%) (54 of 96), and 72% (95% CI: 64%, 78%) (114 of 158), respectively. In the subgroup of 58 participants with positive RT-PCR and CT findings, ground-glass opacities were present in all 58 (100%), both multilobe and posterior involvement were present in 54 (93%), bilateral pneumonia was present in 53 (91%), and subsegmental vessel enlargement (>3 mm) was present in 52 (89%). Conclusion The typical pattern of COVID-19 pneumonia in Rome, Italy, was peripheral ground-glass opacities with multilobe and posterior involvement, bilateral distribution, and subsegmental vessel enlargement (>3 mm). Chest CT had high sensitivity (97%) but lower specificity (56%). © RSNA, 2020. SN - 1527-1315 UR - https://www.unboundmedicine.com/medline/citation/32243238/Chest_CT_Features_of_COVID_19_in_Rome_Italy_ L2 - https://pubs.rsna.org/doi/10.1148/radiol.2020201237?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -