Correlation Between Chest CT Findings and Clinical Features of 211 COVID-19 Suspected Patients in Wuhan, China

Songlin Song; Feihong Wu; Yiming Liu; Hongwei Jiang; Fu Xiong; Xiaopeng Guo; Hongsen Zhang; Chuansheng Zheng; Fan Yang

doi:10.1093/ofid/ofaa171

Correlation Between Chest CT Findings and Clinical Features of 211 COVID-19 Suspected Patients in Wuhan, China

Open Forum Infect Dis. 2020 May 16;7(6):ofaa171. doi: 10.1093/ofid/ofaa171. eCollection 2020 Jun.

Authors

Songlin Song^{1

2}, Feihong Wu^{1

2}, Yiming Liu^{1

2}, Hongwei Jiang³, Fu Xiong^{1

2}, Xiaopeng Guo^{1

2}, Hongsen Zhang^{1

2}, Chuansheng Zheng^{1

2}, Fan Yang^{1

2}

Affiliations

¹ Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China.
³ Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Abstract

Background: Chest computed tomography (CT) has been widely used to assess pulmonary involvement in COVID-19. We aimed to investigate the correlation between chest CT and clinical features in COVID-19 suspected patients with or without fever.

Methods: We retrospectively enrolled 211 COVID-19 suspected patients who underwent both chest CT and reverse transcription polymerase chain reaction in Wuhan, China. The performance of CT in patients with relevant onset of symptoms, with fever (n = 141) and without fever (n = 70), was assessed respectively.

Results: The sensitivity of CT for COVID-19 was 97.3%, with area under the curve (AUC) of 0.71 (95% confidence interval [CI], 0.66-0.76). There were 141 suspected patients with fever and 70 without fever. In the fever group, 4 variables were screened to establish the basic model: age, monocyte, red blood cell, and hypertension. The AUC of the basic model was 0.72 (95% CI, 0.63-0.81), while the AUC of the CT-aided model was 0.77 (95% CI, 0.68-0.85), a significant difference (P < .05). In the nonfever group, only dry cough was screened out to establish the basic model. The AUC was 0.76 (95% CI, 0.64-0.88), which was not significantly different than the CT-aided model (P = .08).

Conclusions: Chest CT has a high sensitivity in patients with COVID-19, and it can improve diagnostic accuracy for COVID-19 suspected patients with fever during the initial screen, whereas its value for nonfever patients remains questionable.

Keywords: COVID-19; polymerase chain reaction; reverse transcriptase ROC curve; tomography; x-ray computed.