Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb;31(2):795-803.
doi: 10.1007/s00330-020-07154-4. Epub 2020 Aug 19.

Chest CT for rapid triage of patients in multiple emergency departments during COVID-19 epidemic: experience report from a large French university hospital

Victoria Ducray  1 , Anna Sesilia Vlachomitrou  2 , Maude Bouscambert-Duchamp  3   4 , Salim Si-Mohamed  5   6   7 , Sylvain Gouttard  1 , Adeline Mansuy  1 , Florian Wickert  8 , Alain Sigal  9 , Alexandre Gaymard  3   4 , François Talbot  10 , Catherine Michel  10 , Thomas Perpoint  11 , Jean-Baptiste Pialat  1   8 , Olivier Rouviere  1   12 , Laurent Milot  1 , François Cotton  1   8 , Philippe Douek  1   8 , Muriel Rabilloud  13 , Loic Boussel  1   8 ; COVID-Outcomes-HCL Consortium
Collaborators, Affiliations

Chest CT for rapid triage of patients in multiple emergency departments during COVID-19 epidemic: experience report from a large French university hospital

Victoria Ducray et al. Eur Radiol. 2021 Feb.

Abstract

Objectives: To assess the diagnostic performances of chest CT for triage of patients in multiple emergency departments during COVID-19 epidemic, in comparison with reverse transcription polymerase chain reaction (RT-PCR) test.

Method: From March 3 to April 4, 2020, 694 consecutive patients from three emergency departments of a large university hospital, for which a hospitalization was planned whatever the reasons, i.e., COVID- or non-COVID-related, underwent a chest CT and one or several RT-PCR tests. Chest CTs were rated as "Surely COVID+," "Possible COVID+," or "COVID-" by experienced radiologists. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using the final RT-PCR test as standard of reference. The delays for CT reports and RT-PCR results were recorded and compared.

Results: Among the 694 patients, 287 were positive on the final RT-PCR exam. Concerning the 694 chest CT, 308 were rated as "Surely COVID+", 34 as "Possible COVID+," and 352 as "COVID-." When considering only the "Surely COVID+" CT as positive, accuracy, sensitivity, specificity, PPV, and NPV reached 88.9%, 90.2%, 88%, 84.1%, and 92.7%, respectively, with respect to final RT-PCR test. The mean delay for CT reports was three times shorter than for RT-PCR results (187 ± 148 min versus 573 ± 327 min, p < 0.0001).

Conclusion: During COVID-19 epidemic phase, chest CT is a rapid and most probably an adequately reliable tool to refer patients requiring hospitalization to the COVID+ or COVID- hospital units, when response times for virological tests are too long.

Key points: • In a large university hospital in Lyon, France, the accuracy, sensitivity, specificity, PPV, and NPV of chest CT for COVID-19 reached 88.9%, 90.2%, 88%, 84.1%, and 92.7%, respectively, using RT-PCR as standard of reference. • The mean delay for CT reports was three times shorter than for RT-PCR results (187 ± 148 min versus 573 ± 327 min, p < 0.0001). • Due to high accuracy of chest CT for COVID-19 and shorter time for CT reports than RT-PCR results, chest CT can be used to orient patients suspected to be positive towards the COVID+ unit to decrease congestion in the emergency departments.

Keywords: Coronavirus; Diagnostic imaging; Emergency medicine; Sensitivity and specificity; Tomography, X-ray.

PubMed Disclaimer

Conflict of interest statement

Anna Vlachomitrou declares relationships with the following companies: Philips.

Figures

Fig. 1
Fig. 1
Typical images from five different patients COVID-19 positive at virology test: ground glass opacity (a), crazy paving (b), posterior lung consolidations (c) and sub-pleural bands of consolidations (d), reversed halo sign (e)
Fig. 2
Fig. 2
Flowchart of the study
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

  • GM@mTG-V microspheres promote NP regeneration by reconstructing IVD biomechanics and inflammatory microenvironment.
    Gao R, Zhang Y, Deng B, Zhang J, Liang Z, Wei Z, Xu F, Ding T. Gao R, et al. Mater Today Bio. 2025 May 23;32:101897. doi: 10.1016/j.mtbio.2025.101897. eCollection 2025 Jun. Mater Today Bio. 2025. PMID: 40502369 Free PMC article.
  • Chest CT Imaging Features of Typical Covert COVID-19 Cases.
    Dai M, Ouyang L, Yang F, Shi H, Wang J, Han X, Alwalid O, Cao Y, Yang D, Li Y, Zhu W, Liu J. Dai M, et al. Int J Med Sci. 2021 Mar 15;18(10):2128-2136. doi: 10.7150/ijms.48614. eCollection 2021. Int J Med Sci. 2021. PMID: 33859519 Free PMC article.
  • Evaluation of Cytokines as Robust Diagnostic Biomarkers for COVID-19 Detection.
    Tamayo-Velasco Á, Peñarrubia-Ponce MJ, Álvarez FJ, Gonzalo-Benito H, de la Fuente I, Martín-Fernández M, Eiros JM, Martínez-Paz P, Miramontes-González JP, Fiz-López A, Arribas-Rodríguez E, Cal-Sabater P, Aller R, Dueñas C, Heredia-Rodríguez M, Tamayo E, Bernardo D, Gómez-Sánchez E. Tamayo-Velasco Á, et al. J Pers Med. 2021 Jul 20;11(7):681. doi: 10.3390/jpm11070681. J Pers Med. 2021. PMID: 34357148 Free PMC article.
  • Thoracic imaging tests for the diagnosis of COVID-19.
    Ebrahimzadeh S, Islam N, Dawit H, Salameh JP, Kazi S, Fabiano N, Treanor L, Absi M, Ahmad F, Rooprai P, Al Khalil A, Harper K, Kamra N, Leeflang MM, Hooft L, van der Pol CB, Prager R, Hare SS, Dennie C, Spijker R, Deeks JJ, Dinnes J, Jenniskens K, Korevaar DA, Cohen JF, Van den Bruel A, Takwoingi Y, van de Wijgert J, Wang J, Pena E, Sabongui S, McInnes MD; Cochrane COVID-19 Diagnostic Test Accuracy Group. Ebrahimzadeh S, et al. Cochrane Database Syst Rev. 2022 May 16;5(5):CD013639. doi: 10.1002/14651858.CD013639.pub5. Cochrane Database Syst Rev. 2022. PMID: 35575286 Free PMC article.
  • Efficacy of chest CT scan for COVID-19 diagnosis in a low prevalence and incidence region.
    Thomas C, Naudin M, Tasu JP, Leclerc C, Depaire L, Subervillle M, Vionnet M, Guillevin R, Herpe G. Thomas C, et al. Eur Radiol. 2021 Nov;31(11):8141-8146. doi: 10.1007/s00330-021-07863-4. Epub 2021 Apr 19. Eur Radiol. 2021. PMID: 33871709 Free PMC article.
See all "Cited by" articles

References

    1. Mareiniss DP (2020) The impending storm: COVID-19, pandemics and our overwhelmed emergency departments. Am J Emerg Med. 10.1016/j.ajem.2020.03.033 - PMC - PubMed
    1. Mitchell R, Banks C, authoring working party (2020) Emergency departments and the COVID-19 pandemic: making the most of limited resources. Emerg Med J. 10.1136/emermed-2020-209660 - PMC - PubMed
    1. Bai HX, Hsieh B, Xiong Z et al (2020) Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Radiology 200823. 10.1148/radiol.2020200823 - PMC - PubMed
    1. Ai T, Yang Z, Hou H et al (2020) Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology 200642. 10.1148/radiol.2020200642 - PMC - PubMed
    1. Fang Y, Zhang H, Xie J et al (2020) Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology 200432. 10.1148/radiol.2020200432 - PMC - PubMed