Abstract Introduction: Currently the main diagnostic modality for COVID-19 (Coronavirus disease-2019) is reverse transcriptase polymerase chain reaction (RT-PCR) via nasopharyngeal swab which has high false negative rates. We evaluated the performance of high-resolution computed tomography (HRCT) imaging in the diagnosis of suspected COVID-19 infection compared to RT-PCR nasopharyngeal swab alone in patients hospitalized for suspected COVID-19 infection. Methods: This was a retrospective analysis of 324 consecutive patients admitted to Temple University Hospital. All hospitalized patients who had RT-PCR testing and HRCT were included in the study. HRCTs were classified as Category 1, 2 or 3. Patients were then divided into four groups based on HRCT category and RT-PCR swab results for analysis. Results: The average age of patients was 59.4 (+15.2) years and 123 (38.9%) were female. Predominant ethnicity was African American 148 (46.11%). 161 patients tested positive by RT-PCR, while 41 tested positive by HRCT. 167 (52.02%) had category 1 scan, 63 (19.63%) had category 2 scan and 91 (28.35%) had category 3 HRCT scans. There was substantial agreement between our radiologists for HRCT classification (κ = 0.64). Sensitivity and specificity of HRCT classification system was 77.6 and 73.7 respectively. Ferritin, LDH, AST and ALT were higher in Group 1 and D-dimers levels was higher in Group 3; differences however were not statistically significant. Conclusion: Due to its high infectivity and asymptomatic transmission, until a highly sensitive and specific COVID-19 test is developed, HRCT should be incorporated into the assessment of patients who are hospitalized with suspected COVID-19.

中文翻译：

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住院COVID-19感染患者的高分辨率CHEST CT（HRCT）评估

摘要简介：目前，对COVID-19（冠状病毒病-2019）的主要诊断方式是通过鼻咽拭子进行逆转录酶聚合酶链反应（RT-PCR），其假阴性率很高。与仅RT-PCR鼻咽拭子相比，对于因怀疑COVID-19感染住院的患者，我们评估了高分辨率计算机断层扫描（HRCT）成像在诊断可疑COVID-19感染中的性能。方法：这是对324例坦普尔大学医院住院患者的回顾性分析。所有接受过RT-PCR检测和HRCT的住院患者均纳入研究。HRCT分为1类，2类或3类。然后根据HRCT类别和RT-PCR拭子结果将患者分为四组进行分析。结果：患者的平均年龄为59.4（+15。2）岁，女性为123岁（38.9％）。主要种族是非裔美国人148（46.11％）。RT-PCR检测到161例患者阳性，而HRCT检测到41例患者阳性。1类扫描为167（52.02％），2类扫描为63（19.63％），而3类HRCT扫描为91（28.35％）。我们的放射科医师之间对于HRCT分类存在实质性共识（κ= 0.64）。HRCT分类系统的敏感性和特异性分别为77.6和73.7。第一组的铁蛋白，LDH，AST和ALT较高，第三组的D-二聚体水平较高；但是差异没有统计学意义。结论：由于其高传染性和无症状传播，在开发出高度敏感和特异的COVID-19测试之前，应将HRCT纳入评估怀疑COVID-19住院的患者。