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Radiographic coronavirus rule out?

Disasters   (419 Views | 2 Replies)

MunoRN has 10 years experience as a RN and specializes in Critical Care.

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Is anybody else using only a chest CT to rule out coronavirus?

Supposedly, there are only about 200 test kits for about 10 million people in my region so they are picky about who gets tested.

We've been testing for the respiratory bugs we do have the ability to test for and if one of those is positive then we assume it's that, and not coronavirus, including rhinovirus in a patient that returned from a coronavirus hotspot 5 days prior.  The explanation we were given is that they were ruled out by CT.  While I get there are some radiographic findings common to coronavirus, they dont seem specific enough to definitively rule it out.

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NRSKarenRN has 40 years experience as a BSN, RN and specializes in Vents, Telemetry, Home Care, Home infusion.

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Heard about this retrospective study on MSNBC today;

Chest CT Findings in Coronavirus Disease-19 (COVID-19 ...

https://pubs.rsna.org/doi/10.1148/radiol.2020200463

Quote

In this retrospective study, chest CTs of 121 symptomatic patients infected with coronavirus disease-19 (COVID-19) from four centers in China from January 18, 2020 to February 2, 2020 were reviewed for common CT findings in relationship to the time between symptom onset and the initial CT scan (I.e. early, 0-2 days (36 patients), intermediate 3-5 days (33 patients), late 6-12 days (25 patients)). The hallmarks of COVID-19 infection on imaging were bilateral and peripheral ground-glass and consolidative pulmonary opacities. Notably, 20/36 (56%) of early patients had a normal CT. With a longer time after the onset of symptoms, CT findings were more frequent, including consolidation, bilateral and peripheral disease, greater total lung involvement, linear opacities, “crazy-paving” pattern and the “reverse halo” sign. Bilateral lung involvement was observed in 10/36 early patients (28%), 25/33 intermediate patients (76%), and 22/25 late patients (88%).

 

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twinmommy+2 has 15 years experience as a ADN, BSN, MSN and specializes in ED.

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15 minutes ago, NRSKarenRN said:

Heard about this retrospective study on MSNBC today;

Chest CT Findings in Coronavirus Disease-19 (COVID-19 ...

https://pubs.rsna.org/doi/10.1148/radiol.2020200463

 

That would mean that a patient would have to be sick for quite a while, infecting many people before something would show up on a CT. We really need more testing kits.

 

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