CT differential diagnosis of COVID-19 and non-COVID-19 in symptomatic suspects: a practical scoring method

CT differential diagnosis of COVID-19 and non-COVID-19 in symptomatic suspects: a practical scoring method

Lin Luo, Yizhen Jia, Zhendong Luo, Xinping Shen, Jianlong He, Cuiping Zhou, Jianxun Lyu

Abstract Background Although typical and atypical CT image findings of COVID-19 are reported in current studies, the CT image features of COVID-19 overlap with those of viral pneumonia and other respiratory diseases. Hence, it is difficult to make an exclusive diagnosis. Methods Thirty confirmed cases of COVID-19 and forty-three cases of other aetiology or clinically confirmed non-COVID-19 in a general hospital were included. The clinical data including age, sex, exposure history, laboratory parameters and aetiological diagnosis of all patients were collected. Seven positive signs (posterior part/lower lobe predilection, bilateral involvement, rounded GGO, subpleural bandlike GGO, crazy-paving pattern, peripheral distribution, and GGO +/− consolidation) from significant COVID-19 CT image features and four negative signs (only one lobe involvement, only central distribution, tree-in-bud sign, and bronchial wall thickening) from other non-COVID-19 pneumonia were used. The scoring analysis of CT features was compared between the two groups (COVID-19 and non-COVID-19). Results Older age, symptoms of diarrhoea, exposure history related to Wuhan, and a lower white blood cell and lymphocyte count were significantly suggestive of COVID-19 rather than non-COVID-19 (p  4, a sensitivity of 100% and a specificity of 23.26% for a score > 0, and a sensitivity of 86.67% and a specificity of 67.44% for a score >  2. Conclusions With a simple and practical scoring system based on CT imaging features, we can make a hierarchical diagnosis of COVID-19 and non-COVID-19 with different management suggestions.

2020

Tomography, X-Ray Computed, Pneumonia, Lung diseases, coronavirus infections

DOI: 10.1186/s12890-020-1170-6

BMC Pulmonary Medicine

BMC

Diseases of the respiratory system