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Chest CT for early detection and management of coronavirus disease (COVID-19): a report of 314 patients admitted to Emergency Department with suspected pneumonia.
Radiol Med. 2020 Oct; 125(10):931-942.RM

Abstract

PURPOSE

The purpose of our study was to assess the potential role of chest CT in the early detection of COVID-19 pneumonia and to explore its role in patient management in an adult Italian population admitted to the Emergency Department.

METHODS

Three hundred and fourteen patients presented with clinically suspected COVID-19, from March 3 to 23, 2020, were evaluated with PaO2/FIO2 ratio from arterial blood gas, RT-PCR assay from nasopharyngeal swab sample and chest CT. Patients were classified as COVID-19 negative and COVID-19 positive according to RT-PCR results, considered as a reference. Images were independently evaluated by two radiologists blinded to the RT-PCR results and classified as "CT positive" or "CT negative" for COVID-19, according to CT findings.

RESULTS

According to RT-PCR results, 152 patients were COVID-19 negative (48%) and 162 were COVID-19 positive (52%). We found substantial agreement between RT-PCR results and CT findings (p < 0.000001), as well as an almost perfect agreement between the two readers. Mixed GGO and consolidation pattern with peripheral and bilateral distribution, multifocal or diffuse abnormalities localized in both upper lung and lower lung, in association with interlobular septal thickening, bronchial wall thickening and air bronchogram, showed higher frequency in COVID-positive patients. We also found a significant correlation between CT findings and patient's oxygenation status expressed by PaO2/FIO2 ratio.

CONCLUSION

Chest CT has a useful role in the early detection and in patient management of COVID-19 pneumonia in a pandemic. It helps in identifying suspected patients, cutting off the route of transmission and avoiding further spread of infection.

Authors+Show Affiliations

Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy. gaia.cartocci@uniroma1.it.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Department of Psychology, Sapienza University of Rome, Rome, Italy.Unit of Radiology "A", Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32729028

Citation

Gaia, Cartocci, et al. "Chest CT for Early Detection and Management of Coronavirus Disease (COVID-19): a Report of 314 Patients Admitted to Emergency Department With Suspected Pneumonia." La Radiologia Medica, vol. 125, no. 10, 2020, pp. 931-942.
Gaia C, Maria Chiara C, Silvia L, et al. Chest CT for early detection and management of coronavirus disease (COVID-19): a report of 314 patients admitted to Emergency Department with suspected pneumonia. Radiol Med. 2020;125(10):931-942.
Gaia, C., Maria Chiara, C., Silvia, L., Chiara, A., Maria Luisa, C., Giulia, B., Silvia, P., Lucia, C., Alessandra, T., Annarita, S., Cristina, V., Maria, A., Maria Rosaria, D., Giacinta, A., Riccardo, G., Zaher, K., Andrea, L., Maddalena, B., Catalano, C., & Paolo, R. (2020). Chest CT for early detection and management of coronavirus disease (COVID-19): a report of 314 patients admitted to Emergency Department with suspected pneumonia. La Radiologia Medica, 125(10), 931-942. https://doi.org/10.1007/s11547-020-01256-1
Gaia C, et al. Chest CT for Early Detection and Management of Coronavirus Disease (COVID-19): a Report of 314 Patients Admitted to Emergency Department With Suspected Pneumonia. Radiol Med. 2020;125(10):931-942. PubMed PMID: 32729028.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chest CT for early detection and management of coronavirus disease (COVID-19): a report of 314 patients admitted to Emergency Department with suspected pneumonia. AU - Gaia,Cartocci, AU - Maria Chiara,Colaiacomo, AU - Silvia,Lanciotti, AU - Chiara,Andreoli, AU - Maria Luisa,De Cicco, AU - Giulia,Brachetti, AU - Silvia,Pugliese, AU - Lucia,Capoccia, AU - Alessandra,Tortora, AU - Annarita,Scala, AU - Cristina,Valentini, AU - Maria,Almberger, AU - Maria Rosaria,D'Aprile, AU - Giacinta,Avventurieri, AU - Riccardo,Giura, AU - Zaher,Kharrub, AU - Andrea,Leonardi, AU - Maddalena,Boccia, AU - Catalano,Carlo, AU - Paolo,Ricci, Y1 - 2020/07/29/ PY - 2020/04/16/received PY - 2020/07/19/accepted PY - 2020/7/31/pubmed PY - 2020/9/10/medline PY - 2020/7/31/entrez KW - COVID-19 KW - Chest CT KW - Emergency radiology KW - Pandemic KW - Pneumonia SP - 931 EP - 942 JF - La Radiologia medica JO - Radiol Med VL - 125 IS - 10 N2 - PURPOSE: The purpose of our study was to assess the potential role of chest CT in the early detection of COVID-19 pneumonia and to explore its role in patient management in an adult Italian population admitted to the Emergency Department. METHODS: Three hundred and fourteen patients presented with clinically suspected COVID-19, from March 3 to 23, 2020, were evaluated with PaO2/FIO2 ratio from arterial blood gas, RT-PCR assay from nasopharyngeal swab sample and chest CT. Patients were classified as COVID-19 negative and COVID-19 positive according to RT-PCR results, considered as a reference. Images were independently evaluated by two radiologists blinded to the RT-PCR results and classified as "CT positive" or "CT negative" for COVID-19, according to CT findings. RESULTS: According to RT-PCR results, 152 patients were COVID-19 negative (48%) and 162 were COVID-19 positive (52%). We found substantial agreement between RT-PCR results and CT findings (p < 0.000001), as well as an almost perfect agreement between the two readers. Mixed GGO and consolidation pattern with peripheral and bilateral distribution, multifocal or diffuse abnormalities localized in both upper lung and lower lung, in association with interlobular septal thickening, bronchial wall thickening and air bronchogram, showed higher frequency in COVID-positive patients. We also found a significant correlation between CT findings and patient's oxygenation status expressed by PaO2/FIO2 ratio. CONCLUSION: Chest CT has a useful role in the early detection and in patient management of COVID-19 pneumonia in a pandemic. It helps in identifying suspected patients, cutting off the route of transmission and avoiding further spread of infection. SN - 1826-6983 UR - https://www.unboundmedicine.com/medline/citation/32729028/Chest_CT_for_early_detection_and_management_of_coronavirus_disease__COVID_19_:_a_report_of_314_patients_admitted_to_Emergency_Department_with_suspected_pneumonia_ L2 - https://dx.doi.org/10.1007/s11547-020-01256-1 DB - PRIME DP - Unbound Medicine ER -