Radiological management of COVID-19: structure your diagnostic path to guarantee a safe path

Abstract

The current COVID-19 outbreak is requiring a tremendous effort not only regarding the diagnostic and therapeutic approach but also in terms of global management of the delivered care. Hospital administrations had to provide a prompt response to a rapidly evolving emergency characterized by the necessity of giving access to an enormous number of infected patients, guaranteeing appropriate care to patients in need of other types of treatment, and simultaneously preserving the well-being of healthcare providers. To optimize the diagnostic pathway during the current COVID-19 outbreak, the hospital administration of our tertiary center applied a highly structured framework assigning specific tasks to the different units composing the Department of Imaging. In particular, since the beginning of the pandemic, a mobile CT scanner in a truck was rented and became operative for all patients with a confirmed diagnosis of COVID-19 and another CT was assigned for all suspected cases. The success and efficacy of the management applied by our administration is demonstrated by the fact that during the outbreak, the radiological workflow was never interrupted. In fact, despite the national lockdown only a 29.3% decrease of CT scans occurred compared to the previous year. Moreover, none of the healthcare providers of the Department contracted the infection at work. Thus, according to the experience gained in our center, we recommend to all hospital administrations facing the COVID-19 outbreak to promptly adapt their resources, creating precise and safe pathways for their diagnostic units.

Keywords: COVID-19; Emergency; Management; Radiology; Safety.

Fig. 1

Graphic representation of the radiological pathway established in our tertiary center to face the COVID-19 outbreak. All patients with a confirmed diagnosis of COVID-19 are scanned in a mobile CT scanner (i.e., represented in red), which is available since the early phase of the outbreak in our region. All suspect COVID-19 patients requiring an urgent CT are scanned with the device of the academic radiological unit (i.e., represented in orange). All other CTs of the hospital (i.e., represented in green) are used for COVID-19-negative patients. In case of extremely critical patients, the nearest CT room is used and then disinfected and locked according to the guidelines. [Only the main buildings of the hospital where COVID-19 are currently admitted and the radiological units are pictured. Other units such as the women care center with patients in need of radiological examinations will follow the same pathway for suspected and confirmed COVID-19 patients and use the nearest CT room for COVID-19-negative patients. #safe transport with Individual Protection Devices; *COVID-19 only elevators. ICU: Intensive Care Unit; CT: Computed Tomography]