Chest ct: A valuable tool in discrimination of covid-19 pneumonia, community acquired pneumonia and the other pathologies in slow epidemic phase

Aim: SARS-CoV-2 infection manifests like COVID-19 pneumonia, computed tomography (CT) has been reported as its valuable imaging Frequent arguments against are discussed: the problem of the possible further spread of the infection to medical staff and/or other patients, and also insufficient SARS-CoV-2 detectability based solely on CT The aim of the study was to examine the usefulness of CT for personalized, precision and predictive diagnostics of COVID-19-suspected Method: Chest CT was performed due to suspected COVID-19 pneumonia in 310 patients during slow epidemic in Czech Republic, during March and April 2020 All patients underwent sampling for RT-PCR to confirm SARS-CoV-2 viral presence When all RT-PCR tests had been completed and after one week of follow-up, the assessment of the sensitivity, specificity, positive and negative predictive value, and accuracy were calculated, a role of the discrimination using leukocytosis in suspected chest CT findings was evaluated respectively One-weekfollow-up was performed to assess the readmission of the patient, and/or the COVID-19 transmission within patients or staff Results: The overall sensitivity of 93 75%, specificity of 94 60%, positive predictive value of 66 67%, negative predictive value of 99 25%, and accuracy 94 52 were reached;adding leukocytosis in suspected cases, specificity of 99 64%, positive predictive value of 96 77%, negative predictive value of 99 28%, and accuracy 99 03% were improved respectively Only one re-admission with COVID-19 in formerly CT-negative was recorded There were no noted SARS-CoV-2 transmission neither patient-to-patient, nor patient-to-staff Conclusion: The high negative predictive value of chest CT significantly contributed to the early identification of a large group patients with low risk for COVID-19, thus allowing them to be safely admitted outside the reserved COVID-19 units, the additional strength lies in the ability to identify an alternative non-COVID-19 diagnosis to explain the patients’ clinical symptoms The CT based approach is enabling personalized, precise and predictive approach to COVID-19 pneumonia detection