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

Figure 1.

Flowchart for patient inclusion. Abbreviations: COVID-19, coronavirus disease 2019; CT, computed tomography; RT-PCR, real-time reverse transcription polymerase chain reaction.

Figure 2.

Chest computed tomography (CT) images of COVID-19 confirmed patients. A–C, Fifty-six-year-old male presenting with fever. Axial CT image (A, B) demonstrates bilateral, diffuse distribution of ground glass opacities in a lobular configuration with interlobular septal thickening; coronal reformatted CT image (C) shows bilateral, lower lung predominance ground glass opacities with consolidations. D, Forty-nine-year-old female, a family member of the reverse transcription polymerase chain reaction (RT-PCR)–positive patient, presenting with dry cough for 2 days. Her RT-PCR proved positive. The chest CT shows no obvious abnormality in the bilateral lungs.

Figure 3.

The receiver operating characteristic (ROC) curve of COVID-19 suspected patients. A, The ROC curve for all 211 COVID-19 suspected patients. B, The ROC curve for COVID-19 suspected patients with fever. C, The ROC curve for COVID-19 suspected patients without fever.