Significance of High-Resolution Computed Tomography (HRCT) Chest in Screening Hospital Admissions for Coronavirus Disease (COVID-19) in Preoperative and Non-COVID-19 Clinical Settings

Background: Early diagnosis of Coronavirus disease-19 (COVID-19) can help in triaging and surgical decision making for admitted patients referred for non-COVID-19 symptoms. The study was performed to evaluate the diagnostic accuracy of HRCT chest and its correlation with Reverse transcriptase-polymerase chain reaction (RT-PCR). Methods: A hospital-based prospective study was conducted on 548 patients as a part of COVID-19 screening between March to June 2020. HRCT findings were classified based on COVID-19 Reporting and Data System (CORADS) grading and were analysed and corroborated with RT-PCR and clinical parameters. Results: 2.91% of cases had HRCT findings as highly suspicious or suspicious for COVID-19 (2% with CORADS-5 and 0.91% with CORADS-4 features, respectively. Amongst these patients, 37.5 % were RT-PCR positive. CORADS-3 features were seen in 4.74% of patients. A false-negative rate of HRCT was found to be 1.9% of patients with CORADS-1 features and RT-PCR positivity. Overall RT-PCR positivity in our study cohort was 3.28%. HRCT and RT-PCR results helped in deferring 7/266 (2.63%) elective surgeries, out of these 0.75% (2/266) were deferred based on HRCT findings alone thereby preventing postoperative morbidity. In a few CORADS 3, 4 and 5 patients, clinical and laboratory correlation helped to distinguish COVID-19 from other diseases. Conclusions: HRCT chest came out to be a robust faster screening tool to diagnose COVID-19, although RT-PCR is considered the gold standard. It played a key role in triaging and isolating patients before the availability of RT-PCR results and also helped in reducing morbidity, mortality and cross infection.