The role of computed tomography scan in the diagnosis of COVID-19 pneumonia

Curr Opin Pulm Med. 2021 May 1;27(3):163-168. doi: 10.1097/MCP.0000000000000765.

Abstract

Purpose of review: To summarize current literature evidence on the role of computed tomography (CT) scan in the diagnosis and assessment of coronavirus disease 2019 (COVID-19) pneumonia.

Recent findings: Recent guidelines on the use of CT scans in COVID-19 vary between countries. However, the consensus is that it should not be used as the first line; a notion supported by the WHO. Currently, several investigations are being used including reverse transcription PCR testing, chest radiographs, and ultrasound scans, and CT scans. They are ideally performed later during the disease process as the sensitivity and specificity are highest by that time. Typical COVID-19 features on CT scans vary but include vascular enlargement, ground-glass opacities, and ground glass opacification together with consolidation.

Summary: Since COVID-19 was declared as a global pandemic, there was a push towards identifying appropriate diagnostic tests that are both reliable and effective. There is a general agreement that CT scans have a high sensitivity but low specificity in diagnosing COVID-19. However, the quality of available studies is not optimal, so this must always be interpreted with the clinical context in mind. Clinicians must aim to weigh up the practicalities and drawbacks of CT scans when considering their use for a patient. The ease and speed of use of CT scans must be balanced with their high radiation doses, and infection control considerations.

Publication types

  • Review

MeSH terms

  • COVID-19 / diagnosis*
  • COVID-19 / epidemiology
  • COVID-19 / prevention & control
  • Humans
  • Infection Control / methods
  • Lung / diagnostic imaging*
  • Radiologic Health / methods
  • SARS-CoV-2
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / methods*