COVID-19: mobilising CT as a frontline management tool

Abstract

As the COVID-19 pandemic has spread across the globe, questions have arisen about the approach healthcare systems should adopt in order to optimally manage patient influx. With a focus on the impact of COVID-19 on the NHS, we describe the frontline experience of a severely affected hospital in close proximity to London. We highlight a protocol-driven approach, incorporating the use of CT in the rapid triage, assessment and cohorting of patients, in an environment where there was a lack of readily available, onsite RT-PCR testing facilities. Furthermore, the effects of the protocol on the effective streamlining of patient flow within the hospital are discussed, as are the resultant improvements in clinical management decisions within the acute care service. This model may help other healthcare systems in managing this pandemic whilst assessing their own needs and resources.

Chest radiography as a predictor of prognosis in COVID-19

“…In the group with a normal CXR on admission there was a significantly lower RT PCR test positivity rate compared to those with an abnormal CXR. However this does not simply reflect low rates of infection in this group as RT PCR sensitivity at the time was a low as 71% [3], and the hospital was using CT scanning on admission to augment CXR and RT PCR in the cohorting of patients [4]. In those patients who had a negative RT PCR swab and a normal CXR on admission, and had a CT chest undertaken in the first 24 hours of admission, 22.2% had changes consistent with COVID-19 infection.…”