Computerized tomography of the Thorax for surgical patients during the
COVID-19 pandemic: Was it useful?
Abstract
Objectives Diagnostic challenges during the COVID-19 pandemic forced the
radiology regulating body to adopt the use of CT Chest as a triage and
diagnostic tool, which was subsequently abandoned. The Royal
Wolverhampton hospital followed both protocols. Here, we investigate the
evidence behind this decision within the context of surgical admissions
during the COVID-19 peak in our hospital. Methods Retrospective data
collection and analysis of all surgical admissions between the 1st of
March to the 31st of May. Data was collected from the radiology and
electronic portal looking into patients undergoing CT chest to diagnose
the presence of C-19 as well as swab results. Results 78 patients
fulfilled our inclusion criteria. The scan either confirmed the presence
or absence (4, 63 patients) of C-19 but was sometimes inconclusive (11
patients). Comparing these to the results of the swabs; CT showed
sensitivity 42.86 %, Specificity 97.92%, and accuracy 90.91 %. In the
inconclusive CT report group, chances of having a positive swab result
were 45%: None of the scan results changed any of the surgical
planning. Lymphocyte count in the context of surgical presentation did
not have any statistical significance to predict the presence of C-19
(P=0.7). Cost implications on our cohort of patients for adding the
chest CT is estimated to be around £31,000. Conclusion CT Thorax during
the pandemic was a good negative predictor but had limited diagnostic
value and did not change patient management. Newer, faster techniques of
PCR swabs and antibody testing would be a better and cheaper
alternative. Advances in knowledge This paper provides evidence to
support the decision from the regulatory bodies not to use CT scan as a
screening tool for COVID 19 diagnosis.