High resolution chest computed tomography findings in patients with clinically suspected COVID-19 pneumonia in Uganda: a cross-sectional study

ABSTRACT

Background: The alarming spread of the COVID-19 pandemic has led to a shortage of RT-PCR kits in Uganda necessitating the use of high-resolution chest Computed Tomography to guide patient management and treatment. Main Objective: To describe the chest HRCT findings in patients with clinically suspected COVID-19 pneumonia and to compare its diagnostic accuracy to RT-PCR. . Methods: In this cross-sectional study, chest HRCT findings of 384 patients and available RT-PCR laboratory results were reviewed and recorded in the data collection form. Results: The commonest chest HRCT findings were bilateral ground glass opacities (78.2%). Out of the 31.7% patients that took the PCR test only 26.9% tested positive. 16 out of 17 patients who tested negative, were classified under CORADS 5. The sensitivity of chest HRCT was 90.4%, 95% CI (82.6-95.5), positive predictive value of 84.2%, 95% CI (75.6-90.7), and accuracy of 77.5%, 95% CI (71.5-87.1). Conclusions: HRCT was found superior to RT-PCR in diagnosing COVID-19. A patient with positive HRCT findings should be treated as COVID 19 when RT-PCR is inaccessible or results are negative. A patient with negative HRCT requires complimentary RT-PCR and possibly follow up CT scans if symptoms persist before treating for COVID 19.