July 30, 2020 -- The World Health Organization (WHO) published rapid guidance on July 30 in Radiology regarding the use of chest imaging for the diagnosis and management of patients with COVID-19.
An international team of authors developed the guide over two months using online meetings and a process of rapid systematic reviews to assess the acceptability, feasibility, and impact of chest radiography, chest CT, and lung ultrasound for COVID-19 imaging.
The guide includes three recommendations for COVID-19 diagnosis:Chest imaging is not suggested to diagnose COVID-19 in asymptomatic patients. Chest imaging is not suggested to diagnose COVID-19 in symptomatic patients when reverse transcription polymerase chain reaction (RT-PCR) testing is available and timely. Chest imaging is suggested to diagnose COVID-19 in symptomatic patients when RT-PCR testing is not available or has delayed results, or when an initial RT-PCR test is negative but there is still high clinical suspicion of COVID-19.
The guidance also contains four recommendations for using imaging for patient management:Chest imaging is suggested to help clinicians decide whether to admit or discharge patients with mild COVID-19 symptoms. Chest imaging is suggested to help clinicians decide whether to admit patients with moderate-to-severe COVID-19 symptoms to a regular ward or to an intensive care unit. Chest imaging is suggested to help inform the therapeutic management of hospitalized patients with moderate-to-severe COVID-19 symptoms. Chest imaging is not suggested to help inform discharge decisions for hospitalized patients whose symptoms have resolved.
The authors cautioned the recommendations are conditional and based on expert opinions and low or very low certainty evidence from 28 studies. The recommendations are also for chest imaging in general -- not for specific modalities.
"While there is accumulating evidence about typical findings with each imaging modality, evidence about comparative diagnostic and prognostic value of the different modalities is still lacking," the authors wrote.
Ultrasound correlates with COVID-19 severity, duration
Findings on lung ultrasound scans were correlated with COVID-19 severity and duration in a study published on July 23 in the American Journal of Roentgenology....
CT radiomics can predict COVID-19 pneumonia outcomes
Radiomics features on noncontrast-enhanced chest CT exams can help to identify which patients with COVID-19 pneumonia will need to be admitted to the...
4 imaging features that define severe COVID-19
Although novel coronavirus disease (COVID-19) pneumonia tends to have typical imaging features, the presence of four features in particular may indicate...
WHO ups coronavirus mortality rate to 3.4%
The World Health Organization (WHO) has raised its estimate of the mortality rate of patients infected with the novel coronavirus to 3.4% globally, up...
WHO officially names coronavirus disease COVID-19
The World Health Organization (WHO) on February 11 announced an official designation for the disease caused by the novel coronavirus (2019-nCoV), naming...
Last Updated bc 7/31/2020 6:15:14 AM