Can chest computed tomography be useful to emergency residents in the diagnosis of COVID-19 pneumonia?

Abstract

Aim: During the novel coronavirus disease (COVID-19) pandemic, the workload of emergency department residents (ER) has increased since emergency departments (EDs) are among the first health units to which patients apply. The aim of this study was to investigate the diagnostic value of chest computed tomography (CT) interpretations of emergency department residents in the diagnosis of COVID-19 pneumonia. Material and methods: Patients who admitted to the tertiary ED between 30.03.2020 and 30.12.2020 with suspected COVID-19 pneumonia and underwent chest CT imaging were retrospectively analyzed. Chest CT images previously reported by the radiologist were reinterpreted by the ER and the diagnostic performance of the ER for COVID-19 pneumonia was calculated. Results: The study included 2045 patients with suspected COVID-19 pneumonia. Chest CT images of all patients were interpreted and compared by a radiologist and the ER In this study, interpretation by a radiologist was considered as the gold standard. In all patients, the diagnostic performance capacity of ER for COVID-19 pneumonia included a low sensitivity of 66%, a high specificity of 92%, a positive predictive value (PPV) of 83% and a negative predictive value (NPV) of 82%. When patients with positive COVID-19 RT-PCR test results were analyzed, the highest sensitivity, specificity, PPV and NPV of ER were 96%, 82%, 95%, 95% and 86%, respectively. Conclusion: ER detected COVID-19 pneumonia in COVID-19 (+) patients with high diagnostic value and excluded inconsistent findings. Chest CT interpretation in the ER has a high diagnostic value. It is as important as any other radiologist in outbreak management in the ED.

Keywords

• Chest computed tomography
• emergency department
• emergency resident interpret