RT Journal Article
SR Electronic
T1 CT Scanning in Suspected Stroke or Head Trauma: Is it Worth to go the Extra Mile and Include the Chest to Screen for COVID-19 Infection?
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A6607
A1 Kwee, R.M.
A1 Krdzalic, J.
A1 Fasen, B.A.C.M.
A1 de Jaegere, T.M.H.
A1 for the COVID-19 CT Investigators South-East Netherlands (CISEN) Study Group
YR 2020
UL http://www.ajnr.org/content/early/2020/05/21/ajnr.A6607.abstract
AB BACKGROUND AND PURPOSE: Chest CT may be used as a tool for rapid coronavirus disease 2019 (COVID-19) detection. Our aim was to investigate the value of additional chest CT for detection of coronavirus 19 (COVID-19) in patients who undergo head CT for suspected stroke or head trauma in a COVID-19-endemic region.MATERIALS AND METHODS: Our study included 27 patients (mean age, 74 years; range, 54–90 years; 20 men) who underwent head CT for suspected stroke (n = 21) or head trauma (n = 6), additional chest CT for COVID-19 detection, and real-time reverse transcriptase polymerase chain reaction testing in a COVID-19-endemic region. Sensitivity, specificity, and negative and positive predictive values of chest CT in detecting COVID-19 were calculated.RESULTS: Final neurologic diagnoses were ischemic stroke (n = 11), brain contusion (n = 5), nontraumatic intracranial hemorrhage (n = 2), brain metastasis (n = 1), and no primary neurologic disorder (n = 8). Symptoms of possible COVID-19 infection (ie, fever, cough, and/or shortness of breath) were present in 20 of 27 (74%) patients. Seven of 27 patients (26%) had real-time reverse transcriptase polymerase chain reaction confirmed–COVID-19 infection. Chest CT results were 6 true-positives, 15 true-negatives, 5 false-positives, and 1 false-negative. Diagnostic performance values of chest CT were a sensitivity of 85.7%, specificity of 75.0%, negative predictive value of 93.8%, and positive predictive value of 54.6%.CONCLUSIONS: The sensitivity of additional chest CT is fairly high. However, a negative result does not exclude COVID-19. The positive predictive value is poor. Correlation of chest CT results with epidemiologic history and clinical presentation, along with real-time reverse transcriptase polymerase chain reaction, is needed for confirmation.COVID-19coronavirus disease 2019RT-PCRreal-time reverse transcriptase polymerase chain reaction