Effectiveness of Computed Tomography in the Diagnosis of Novel Coronavirus-2019

Abstract

Coronaviruses (CoV) belong to the coronavirus genus of the coronaviridae family. All CoVs are pleomorphic RNA viruses containing crown-like peplomers of 80-160 nm in size. This virus is a zoonotic pathogen seen with a wide range of clinical features from asymptomatic state to intensive care in humans. So far, seven human coronaviruses have been identified with the last one being Coronavirus-2019 (COVID-19). These pathogens typically lead to mild disease, but SARS and MERS type coronaviruses have caused severe respiratory disease and even mortality within the last 20 years. COVID-19 virus has rapidly spread worldwide after China and is continuing to cause huge economical and social impacts. Given the scarcity of resources including healthcare staff, hospital capacities, test kits, etc., timely diagnosis and treatment of this virus are of paramount importance. However, there is no vaccination or drug developed for the treatment of this disease up to today. Because the spreading rate of the virus is very high worldwide and there is no definitive treatment, diagnosis becomes even more important. The objective of this review is to evaluate the use of chest computed tomography, one of the commonly used radiologic imaging modalities, in the diagnosis of COVID-19 in light with the current literatüre.

Keywords: computed tomography; coronavirus disease; covid-2019; novel coronavirus.

Figure 1. A 39-year-old male patient: PCR (+) for COVID-19

Upper left and peripheral localized lesion of ground-glass density, which is hardly noticeable on cross-sectional CT is clearly seen on 3D reconstruction. CT, computed tomography; PCR, polymerase chain reaction

Figure 2. At the same examination, a lesion of gross ground density in the lower left lobe is well visualized on the sectional view, but it cannot be distinguished in the bronchovascularization on 3D reconstruction

Figure 3. CT examination of the same patient 2 days later

The upper left lesion is enlarged and the lower left lesion is visible. CT, computed tomography

Figure 4. CT examination of the same patients 12 days later

Air bronchograms and fibrosis were developed. Bilateral milimetric central aeration areas on 3D image. Sectional routine image better shows lesion details, and 3D images better depict involvement area in the lung. CT, computed tomography