Imaging evaluation of COVID-19 in the emergency department
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ORIGINAL ARTICLE
Imaging evaluation of COVID-19 in the emergency department Amir Pakray 1 Mary Coffey 1
&
David Walker 1 & Alexander Figacz 1 & Stephen Kilanowski 1 & Casey Rhodes 1 & Shashin Doshi 1 &
Received: 6 April 2020 / Accepted: 4 May 2020 # American Society of Emergency Radiology 2020
Abstract Purpose The purpose of this study is to elucidate the chest imaging findings of suspected COVID-19 patients presenting to the emergency department and the relationship with their demographics and RT-PCR testing results. Methods Patients presenting to the ED between March 12 and March 28, 2020, with symptoms suspicious for COVID-19 and subsequent CXR and/or CT exam were selected. Patients imaged for other reasons with findings suspicious for COVID-19 were also included. Demographics, laboratory test results, and history were extracted from the medical record. Descriptive statistics were used to explore the relationship between imaging and these factors. Results A total of 227 patients from the emergency department were analyzed (224 CXRs and 25 CTs). Of the 192 patients with COVID-19 results, 173 (90.1%) had COVID-19 RT-PCR (+). Abnormal imaging (CXR, 85.7% and/or CT, 100%) was noted in 155 (89.6%) of COVID-19 RT-PCR (+) cases. The most common imaging findings were mixed airspace/interstitial opacities (39.8%) on CXR and peripheral GGOs on CT (92%). The most common demographic were African Americans (76.8%). Furthermore, 97.1% of African Americans were RT-PCR (+) compared to 65.8% of Caucasians. Conclusion We found a similar spectrum of thoracic imaging findings in COVID-19 patients as previous studies. The most common demographic were African Americans (76.8%). Furthermore, 97.1% of African Americans were RT-PCR (+) compared to 65.8% of Caucasians. Both CT and CXR can accurately identify COVID-19 pneumonitis in 89.6% of RT-PCR (+) cases, 89.5% of false negatives, and 72.7% of cases with no RT-PCR result. Keywords COVID-19 . Coronavirus . Emergency radiology . Ground glass opacities . Detroit
Introduction Since the first reported outbreak of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), Coronavirus Disease 2019 (COVID-19), in Wuhan, Hubei Province, China in December 2019, a pandemic has ensued, inundating
hospitals across the globe [1]. Clinical manifestations are varied, ranging from asymptomatic to death, complicating viral spread throughout the community [2, 3]. The virus has spread all across the U.S., with Michigan harboring the third-highest number of recorded cases in the country as of this writing. In particular, the Detroit Metropolitan area, where some of this
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10140-020-01787-0) contains supplementary material, which is available to authorized users. * Amir Pakray [email protected]
Casey Rhodes [email protected] Shashin Doshi [email protected]
David Walker [email protected]
Mary Coffey [email protected]
Alexander Figacz [email protected]
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