Goel Shiv, Kipp Julia, Kipp Adam, Jain Shelly, Goel Nirmit
Public Health, Saint Louis University, St. Louis, USA.
Medicine, St. Ignatius College Prep, Chicago, USA.
Cureus. 2024 Dec 11;16(12):e75536. doi: 10.7759/cureus.75536. eCollection 2024 Dec.
Introduction In the emergency department (ED), COVID-19 and influenza are two common viral diseases. They cause similar symptoms in the respiratory system, and most patients' symptoms are relatively mild. We have reported previously that COVID-19 and influenza infections cause similar abnormalities in chest X-ray readings in the ED. Chest X-ray is a convenient, cost-effective, and useful tool, but it is not as sensitive as computed tomography (CT) scans and does not reveal a high level of detail. To assist physicians in obtaining the most advantageous and specific data to guide the diagnosis and treatment of these diseases, this study aimed to compare the degree of abnormalities on chest CT scans between COVID-19 and influenza patients when they were evaluated in the ED. Methods From a general diagnostic radiologist's teaching files, 87 chest CT scans of COVID-19 patients and 87 chest CT scans of influenza patients were collected. Based on our initial review, four severity categories of lung abnormalities were established. These four categories were normal, mildly abnormal, moderately abnormal, and severely abnormal. Each CT scan was categorized into one of these four categories after being evaluated by two independent raters. The number of CT scans in each category was then counted for the COVID-19 and influenza groups. The resulting number was also divided by the total number of CT scans in each disease group to obtain the percentage within each category. Finally, the results were compared between the COVID-19 and influenza groups. Results In the COVID-19 group, the number and percentage of CT scans in each of the four categories were 10 (11.5%) normal, 44 (50.6%) mildly abnormal, 19 (21.8%) moderately abnormal, and 14 (16.1%) severely abnormal. In the influenza group, there were 13 (14.9%) normal, 48 (55.2%) mildly abnormal, 15 (17.3%) moderately abnormal, and 11 (12.6%) severely abnormal. Chi-square tests revealed no significant difference in these two groups' chest CT abnormalities severity levels. Conclusion Our results indicate that most COVID-19 and influenza patients had mild to moderate abnormalities on their chest CT scans at the time of their ED visits, and the overall severity levels of chest CT abnormalities were similar in both groups of patients.
引言 在急诊科，新型冠状病毒肺炎（COVID-19）和流感是两种常见的病毒性疾病。它们在呼吸系统引起相似的症状，且大多数患者症状相对较轻。我们之前曾报道，COVID-19和流感感染在急诊科胸部X线检查结果中会导致相似的异常表现。胸部X线是一种便捷、经济高效且有用的工具，但它不如计算机断层扫描（CT）敏感，且显示的细节程度不高。为帮助医生获取最有利且具特异性的数据以指导这些疾病的诊断和治疗，本研究旨在比较COVID-19患者和流感患者在急诊科接受评估时胸部CT扫描的异常程度。
方法 从一位普通诊断放射科医生的教学档案中，收集了87例COVID-19患者的胸部CT扫描图像和87例流感患者的胸部CT扫描图像。基于我们的初步审查，确定了肺部异常的四个严重程度类别。这四个类别分别为正常、轻度异常、中度异常和重度异常。在由两名独立评估人员进行评估后，将每张CT扫描图像归入这四个类别之一。然后统计COVID-19组和流感组中每个类别的CT扫描图像数量。所得数量也除以每个疾病组的CT扫描图像总数，以获得每个类别中的百分比。最后，比较COVID-19组和流感组的结果。
结果 在COVID-19组中，表示正常的CT扫描图像数量及百分比为10例（11.5%），轻度异常44例（50.6%），中度异常19例（21.8%），重度异常14例（16.1%）。在流感组中，正常的有13例（14.9%），轻度异常48例（55.2%），中度异常15例（17.3%），重度异常11例（12.6%）。卡方检验显示，这两组患者胸部CT异常严重程度水平无显著差异。
结论 我们的结果表明，大多数COVID-19和流感患者在急诊科就诊时胸部CT扫描有轻度至中度异常，且两组患者胸部CT异常的总体严重程度水平相似。
