Abstract
Purpose: To summarize the imaging results of COVID-19 pneumonia and develop a computerized tomography (CT) screening procedure for patients at our institution with malignant tumors.Methods: Following epidemiological investigation, 1,429 patients preparing to undergo anti-tumor-treatment underwent CT scans between February 17 and April 16, 2020. When CT findings showed suspected COVID-19 pneumonia after the supervisor radiologist and the thoracic experience radiologist had double-read the initial CT images, radiologists would report the result to our hospital infection control staff. Further necessary examinations, including the RT-PCR test, in the assigned hospital was strongly recommended for patients with positive CT results. The CT examination room would perform sterilization for 30 min to 1 h. If the negative results of any suspected COVID-19 pneumonia CT findings were identified, the radiologists would upload the results to our Hospital Information Systems and inform clinicians within 2 h.Results: Fifty (0.35%, 50/1,429) suspected pneumonia cases, including 29 males and 21 females (median age: 59.5 years old; age range 27–79 years), were identified. A total of 34.0% (17/50) of the patients had a history of lung cancer and 54.0 (27/50) underwent chemotherapy or targeted therapy. Forty-six patients (92.0%) had prior CT scans, and 35 patients (76.1%) with suspected pneumonia were newly seen (median interval time: 62 days). Sub-pleura small patchy or strip-like lesions most likely due to fibrosis or hypostatic pneumonia and cluster of nodular lesions were the two main signs of suspected cases on CT images (34, 68.0%). Twenty-seven patients (54.0%) had, at least once, follow-up CT scan (median interval time: 18.0 days). Only one patient had an increase in size (interval time: 8 days), the immediately RT-PCR test result was negative.Conclusion: CT may be useful as a screening tool for COVID-19 based on imaging features. But the differential diagnosis between COVID-19 and other pulmonary infection and/or non-infectious disease is very difficult due to its overlapping imaging features.The confirmed diagnosis of the COVID-19 infection should be based on the etiologic eventually. The cancer patients at a low-incidence area would continue treatment by screening carefully before admission.
Highlights
Since December 2019, the Novel Coronavirus (COVID-19) has caused an outbreak of pneumonia and has rapidly spread across the globe
computerized tomography (CT) may be useful as a screening tool for COVID-19 based on imaging features
The differential diagnosis between COVID-19 and other pulmonary infection and/or non-infectious disease is very difficult due to its overlapping imaging features.The confirmed diagnosis of the COVID-19 infection should be based on the etiologic
Summary
Since December 2019, the Novel Coronavirus (COVID-19) has caused an outbreak of pneumonia and has rapidly spread across the globe. As of 2:10 p.m. CET, 13 March 2021, there have been 118,754,336 confirmed cases of COVID19, including 2,634,370 deaths, reported to WHO. On March 19, China reported no new domestic cases for the first time, and the first prevailing peak period of the pandemic was over. Thanks to the efforts of the Chinese government, numerous measures such as preventing the spread and import of the infection, strict restrictions on the gathering of large numbers of people, disinfecting public areas, and taking charge of symptomatic people (such as those with fever and/or cough) has led to Beijing, the capital of China, maintaining its status up until mid-April, 2020 as a low-incidence area of COVID-19 infections during the period of outbreak in China
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