Diagnostic Utility of Chest CT versus Radiography in COVID-19

Abstract

Background: Coronavirus Disease-2019 (COVID-19) is considered an acute infectious disease mainly involving the respiratory system. The diagnosis depends on a reverse transcription-polymerase chain reaction. However, these methods are time-consuming do not allow assessing the disease severity and may give false negative results. Aim: The present study was conducted to identify the role of CT chest findings and chest radiography in the diagnosis, severity, and prognosis of the disease. Patients and Methods: This cross-sectional study included 105 patients with PCR-confirmed COVID-19 infection from Suez Canal University Hospital, Ismailia City, Egypt. All patients were subjected to history taking, chest X-ray, and CT. Results: A review of the chest X-ray of the study subjects revealed that 21.9% of the study patients had positive chest X-ray findings and 78.1% had negative findings. Those chest x-ray findings were unilateral in 13.0% and bilateral in 87.0% of the 23 positive patients. About 18.1% of the study patients had subtle CT findings, 15.2% had mild-moderate findings, 18.1% had extensive findings, 8.6% had very severe findings, and 40.0% had negative findings. This is compared to only 21.9% positive cases by the chest X-ray. Compared to the 63 subjects with positive findings in the CT scan (60 %), the chest X-ray imaging interpretation findings were much less (only 23 subjects comprising 21.9 % of all subjects). Conclusion: CT is the modality of choice while X-Ray has a very limited role in COVID Imaging. Further larger longitudinal studies are needed to confirm the results of our study.