Use of Chest Imaging in the Diagnosis and Management of COVID-19: A                     WHO Rapid Advice Guide

Akl, Elie A.; Blažić, Ivana; Yaacoub, Sally; Frija, G.; Chou, Roger; Appiah, John Adabie; Fatehi, Mansoor; Flor, Nicola; Hitti, Eveline; Jafri, Hussain; Jin, Zheng; Kauczor, Hans Ulrich; Kawooya, Michael; Kazerooni, Ella A.; Ko, Jane P.; Mahfouz, Rami; Muglia, Valdair Francisco; Nyabanda, Rose; Sánchez, Marcelo; Shete, Priya B.; Ulla, Marina; Zheng, Chuansheng; Deventer, Emilie van; Pérez, María del Rosario

doi:10.1148/radiol.2020203173

Cited by 142 publications

(165 citation statements)

References 25 publications

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“…Our study has depended primarily on the HRCT to screen cases with clinical and epidemiological data suspicious for COVID-19 infection even with negative or unavailable RT-PCR testing. It has met the recent WHO guidelines [14]. The current study did not depend primarily on RT-PCR.…”

Section: Discussionmentioning

confidence: 94%

COVID-19 infection: epidemiological, clinical, and radiological expression among adult population

Ragab

Mahrous

Sheikh

2020

Egypt J Radiol Nucl Med

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Background High-resolution computed tomography (HRCT) has proved to be an important diagnostic tool throughout the COVID-19 pandemic outbreaks. Increasing number of the infected personnel and shortage of real-time transcriptase polymerase chain reaction (RT-PCR) as well as its lower sensitivity made the CT a backbone in diagnosis, assessment of severity, and follow-up of the cases. Results Two hundred forty patients were evaluated retrospectively for clinical, laboratory, and radiological expression in COVID-19 infection. One hundred eighty-six non-severe cases with home isolation and outpatient treatment and 54 severe cases needed hospitalization and oxygen support. Significant difference between both groups was encountered regarding the age, male gender, > 38° fever, dyspnea, chest pain, hypertension, ≤ 93 oxygen saturation, intensive care unit (ICU) admission, elevated D-dimer, high serum ferritin and troponin levels, and high CT-severity score (CT-SS) of the severe group. CT-SS showed a negative correlation with O2 saturation and patients’ outcome (r − 0.73/p 0.001 and r − 0.56/p 0.001, respectively). Bilateral peripherally distributed ground glass opacities (GGOs) were the commonest imaging feature similar to the literature. Conclusion Older age, male gender, smoking, hypertension, low O2 saturation, increased CT score, high serum ferritin, and high D-dimer level are the most significant risk factors for severe COVID-19 pneumonia. Follow-up of the recovered severe cases is recommended to depict possible post COVID-19 lung fibrosis.

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Section: Discussionmentioning

confidence: 94%

COVID-19 infection: epidemiological, clinical, and radiological expression among adult population

Ragab

Mahrous

Sheikh

2020

Egypt J Radiol Nucl Med

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“…A total of 2018 articles were identified, and 37 records 4,5,10–44 were finally included after successive screening, including 32 guidelines 4,5,11,14–20,22,23,25–44 (86.5%) published in English language and five 10,12,13,21,24 (13.5%) in Chinese language (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Consistency of recommendations and methodological quality of guidelines for the diagnosis and treatment of COVID‐19

Luo

Liu

Ren

et al. 2021

J Evidence Based Medicine

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Objective Since the beginning of the COVID‐19 epidemic, a large number of guidelines on diagnosis and treatment of COVID‐19 have been developed, but the quality of those guidelines and the consistency of recommendations are unclear. The objective of this study is to evaluate the quality of the diagnosis and treatment guidelines on COVID‐19 and analyze the consistency of the recommendations of these guidelines. Methods We searched for guidelines on diagnosis and/or treatment of COVID‐19 through PubMed, CBM, CNKI, and WanFang Data, from January 1, 2020 to August 31, 2020. In addition, we also searched official websites of the US CDC, European CDC and WHO, and some guideline collection databases. We included diagnosis and/or treatment guidelines for COVID‐19, including rapid advice guidelines and interim guidelines. Two trained researchers independently extracted data and four trained researchers evaluated the quality of the guidelines using the AGREE II instruments. We extracted information on the basic characteristics of the guidelines, guideline development process, and the recommendations. We described the consistency of the direction of recommendations for treatment and diagnosis of COVID‐19 across the included guidelines. Results A total of 37 guidelines were included. Most included guidelines were assessed as low quality, with only one of the six domains of AGREE II (clarity of presentation) having a mean score above 50%. The mean scores of three domains (stakeholder involvement, the rigor of development and applicability) were all below 30%. The recommendations on diagnosis and treatment were to some extent consistent between the included guidelines. Computed tomography (CT), X‐rays, lung ultrasound, RT‐PCR, and routine blood tests were the most commonly recommended methods for COVID‐19 diagnosis. Thirty guidelines were on the treatment of COVID‐19. The recommended forms of treatment included supportive care, antiviral therapy, glucocorticoid therapy, antibiotics, immunoglobulin, extracorporeal membrane oxygenation (ECMO), convalescent plasma, and psychotherapy. Conclusions The methodological quality of currently available diagnosis and treatment guidelines for COVID‐19 is low. The diagnosis and treatment recommendations between the included guidelines are highly consistent. The main diagnostic methods for COVID‐19 are RT‐PCR and CT, with ultrasound as a potential diagnostic tool. As there is no effective treatment against COVID‐19 yet, supportive therapy is at the moment the most important treatment option.

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“…Although not routinely recommended, chest computed tomography (CT) is still the cornerstone of the radiologic evaluation which aids in the detection of equivocal cases, follow-up of clinically deteriorating confirmed cases, predicting mortality and early detection of complications [2][3][4][5]. Cross-sectional imaging is recommended for patients with higher risk for complication, those with comorbidities, not responding to supportive treatment and presenting with acute clinical deterioration, per WHO rapid advice guide [6]. Chest CT imaging features of COVID-19 has been well described in the literature.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging features of coronavirus disease 2019 (COVID-19) pneumonia: The first preliminary case series

et al. 2021

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Rationale and objectives: There is a rising onus on understanding the common features of COVID-19 pneumonia on different imaging modalities. In this study, we aimed to review and depict the common MRI features of COVID-19 pneumonia in our laboratory confirmed case series, the first comprehensive reported cohort in the literature. Materials and methods: Upon IRB approval, eight laboratory confirmed COVID-19 patients who presented to our outpatient imaging clinic underwent chest CT and, once various features of COVID-19 pneumonia were identified, a dedicated multisequence chest MRI was performed on the same day with an institutional protocol. Demographic data and the morphology, laterality and location of the lesions were recorded for each case. Results: Five males and three females with the mean age of 40.63 ± 12.64 years old were present in this case series. Five cases had typical CT features with ground glass opacities and consolidations, readily visible on different MRI sequences. Three cases had indeterminate or atypical features which were also easily seen on MRI. The comprehensive review of MRI features for each case and representative images have been illustrated. Conclusion: Becoming familiar with typical findings of COVID-19 pneumonia in MRI is crucial for every radiologist. Although MRI is not the modality of choice for evaluation of pulmonary opacities, it has similar capabilities in detection of COVID-19 pneumonia when compared to chest CT.

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Use of Chest Imaging in the Diagnosis and Management of COVID-19: A WHO Rapid Advice Guide

Cited by 142 publications

References 25 publications

COVID-19 infection: epidemiological, clinical, and radiological expression among adult population

COVID-19 infection: epidemiological, clinical, and radiological expression among adult population

Consistency of recommendations and methodological quality of guidelines for the diagnosis and treatment of COVID‐19

Magnetic resonance imaging features of coronavirus disease 2019 (COVID-19) pneumonia: The first preliminary case series

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