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Recommendations Issued for Use of Imaging in Adults With COVID-19

Imaging not indicated for suspected COVID-19, mild clinical features unless patient at risk for progression

MONDAY, April 13, 2020 (HealthDay News) -- In a multinational consensus statement from the Fleischner Society, published online April 7 in Radiology, recommendations are presented for use of imaging in patients with coronavirus disease 2019 (COVID-19).

Geoffrey D. Rubin, M.D., from the Duke University School of Medicine in Durham, North Carolina, and colleagues examined the utility of chest radiography (CXR) and computed tomography (CT) imaging within three scenarios representing varying risk factors, community conditions, and resource constraints. Fourteen key questions were rated by a multidisciplinary panel; the results were aggregated, yielding five main recommendations and three additional recommendations.

According to the statement, for asymptomatic individuals, imaging is not routinely indicated as a screening test; in addition, imaging is not recommended for patients with mild features of COVID-19 unless they are at risk for progression of disease. For patients with moderate-to-severe features of COVID-19, imaging is indicated, regardless of COVID-19 test results. For patients with COVID-19 and evidence of worsening respiratory status, imaging is indicated. CXR may be preferred for patients with COVID-19 in a resource-constrained environment, unless features of respiratory worsening warrant CT use. In stable intubated patients with COVID-19, daily chest radiographs are not indicated. In patients with functional impairment and/or hypoxemia after recovery from COVID-19, CT is indicated. In patients incidentally found to have signs suggestive of COVID-19 on a CT scan, COVID-19 testing is indicated.

"As effective treatments are developed, thoracic imaging may find new roles by establishing treatment response or characterizing patients as likely responders to novel therapies," Rubin said in a statement.

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