COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

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Diagnosis Van Berkel B, Vandevenne J, Coursier K, et al. Chest CT Diagnosis of COVID-19: Accuracy using CO-RADS and CT-Involvement Scoring. J Belg Soc Radiol. 2021 Apr 5;105(1):17. doi: 10.5334/jbsr.2342.

Objectives: Both Reporting and Data System (CO-RADS) and CT-involvement scores (CTIS) have been proposed for evaluation of COVID-19 on chest CT. The purpose of this single-center, retrospective study was to evaluate both scoring systems to diagnose COVID-19 infection in a high-prevalence area.

Materials and Methods: Chest CT datasets (n = 200) and available reverse transcription polymerase chain reaction (RT-PCR) on nasopharyngeal swab were included. CT scans were assigned to four 'imaging groups' after scoring for both CO-RADS and CTIS. Diagnostic accuracy of chest CT was calculated respectively using RT-PCR and clinical diagnosis as gold standards: False-negatives and false-positives of chest CT regarding RT-PCR were studied in more depth using the medical files.

Results: The 'imaging group' including CO-RADS 4/5 scores reached the highest diagnostic values for COVID-19 considering either the initial RT-PCR or the final clinical diagnosis as the standard of reference: accuracies of 172/200 (86%) to 181/200 (90.5%), sensitivities of 60/80 (88.2%) to 70/79 (88.6%), specificities of 112/132 (84.9%) to 111/121 (91.7%), negative predictive values (NPV) of 112/120 (93.3%) to 111/120 (92.5%), respectively. False-negative CTs regarding RT-PCR were mainly explained by imaging very early in the disease course (5 out of 8 cases) or COVID-19 infection with no/minor respiratory symptoms (3 out of 8 cases).

Conclusion: Assessing chest CT using CO-RADS is a valuable diagnostic approach for COVID-19 infection in a high-prevalence area, with a higher accuracy than CTIS.

Discipline / Specialty Area Score
Hospital Doctor/Hospitalists
Internal Medicine
Infectious Disease
Emergency Medicine
Comments from MORE raters

Emergency Medicine rater

This is valuable information for all healthcare professionals in this ongoing pandemic. It's worthy to draw conclusions to make precise decisions.