Diagnostic efficacy of chest computed tomography for Coronavirus Disease 2019

A significant discrepancy between the results of previous studies is identified regarding the diagnostic efficacy of chest computed tomography (CT) for coronavirus disease 2019 (COVID‑19). We aimed to evaluate the diagnostic efficacy of chest CT for COVID‑19.

Suspected cases of COVID‑19 with fever, cough, dyspnea, and evidence of pneumonia on chest CT scan were enrolled in the study. The accuracy, sensitivity, and specificity of chest CT were determined according to real‑time reverse transcriptase‑polymerase chain reaction (RT‑PCR) results as the gold standard method.

The study population comprised 356 suspected cases of COVID‑19 (174 men and 182 women; age range 3–96 years; mean age ± standard deviation, 55.21 ± 18.38 years). COVID‑19 patients were diagnosed using chest CT with 89.8% sensitivity, 78.1% accuracy, 21.3% specificity, 84.7% positive predictive value, and 30.23% negative predictive value. The odds ratio was 2.39 (95% confidence interval, 1.16–4.91). Typical CT manifestations of COVID‑19 were observed in 48 (13.5%) patients with negative RT‑PCR results and 30 (8.4%) patients with confirmed positive RT‑PCR results had no radiological manifestations. Kappa coefficient of chest CT for diagnosis of COVID‑19 was 0.78.

The results show that when RT‑PCR results are negative, chest CT could be considered as a complementary diagnostic method for the diagnosis of COVID‑19 patients. A more comprehensive diagnostic method could be established by combining the chest CT examination, clinical symptoms, and RT‑PCR assay.