- Chest CT has high sensitivity for rapid COVID-19 diagnosis compared with reverse-transcription-PCR (RT-PCR) assay testing.
Why this matters
- Consider chest CT for initial COVID-19 screening, evaluation, and follow-up to ensure timely diagnosis and subsequent isolation and treatment, as needed.
- 1014 patients, mean age 51 + 15 years, 46% (467/1014) male.
- RT-PCR positive rate: 59% (56%-62%).
- Chest CT positive rate: 88% (86%-90%).
- Chest CT: 97% sensitivity (95%-98%), 25% specificity (22%-30%).
- CT chest accuracy: 68% (65%-70%).
- Positive predictive value:
- 72% in patients > 60 years (P=.001);
- 62% in those P=.009).
- Primary chest CT findings: ground-glass opacity (46%), consolidation (50%).
- 308 patients with negative RT-PCR had chest CT images suggestive of COVID-19:
- 48% were considered highly likely, 33% probable, and 19% uncertain.
- Subgroup of negative-to-positive RT-PCR results:
- 67% (10/15) of cases had positive chest CT vs negative RT-PCR;
- 93% (14/15) had imaging with typical COVID-19 features before or parallel to initial positive RT-PCR (median interval, 8 days; range, 0-21 days).
- Case investigation of diagnostic chest CT value, consistency vs initial, serial RT-PCR testing in Chinese patients, January 6-February 6, 2020.
- Funding: None.
- Potentially overestimated chest CT sensitivity, underestimated specificity.
- Limited laboratory, clinical data.