Background Although typical and atypical CT image findings of COVID-19 are reported in current studies, the CT image features of COVID-19 overlap with those of viral pneumonia and other respiratory diseases. Hence, it is difficult to make an exclusive diagnosis. Methods Thirty confirmed cases of COVID-19 and forty-three cases of other aetiology or clinically confirmed non-COVID-19 in a general hospital were included. The clinical data including age, sex, exposure history, laboratory parameters and aetiological diagnosis of all patients were collected. Seven positive signs (posterior part/lower lobe predilection, bilateral involvement, rounded GGO, subpleural bandlike GGO, crazy-paving pattern, peripheral distribution, and GGO +/− consolidation) from significant COVID-19 CT image features and four negative signs (only one lobe involvement, only central distribution, tree-in-bud sign, and bronchial wall thickening) from other non-COVID-19 pneumonia were used. The scoring analysis of CT features was compared between the two groups (COVID-19 and non-COVID-19). Results Older age, symptoms of diarrhoea, exposure history related to Wuhan, and a lower white blood cell and lymphocyte count were significantly suggestive of COVID-19 rather than non-COVID-19 ( p < 0.05). The receiver operating characteristic (ROC) curve of the combined CT image features analysis revealed that the area under the curve (AUC) of the scoring system was 0.854. These cut-off values yielded a sensitivity of 56.67% and a specificity of 95.35% for a score > 4, a sensitivity of 100% and a specificity of 23.26% for a score > 0, and a sensitivity of 86.67% and a specificity of 67.44% for a score > 2. Conclusions With a simple and practical scoring system based on CT imaging features, we can make a hierarchical diagnosis of COVID-19 and non-COVID-19 with different management suggestions.
【저자키워드】 Pneumonia, Coronavirus infections, Lung diseases, Tomography, X-Ray Computed, 【초록키워드】 COVID-19, hospital, Diagnosis, Sex, Symptom, respiratory diseases, Viral pneumonia, Lymphocyte count, sensitivity, specificity, ROC, Features, White blood cell, management, Wuhan, Patient, age, GGO, distribution, characteristic, consolidation, Analysis, Atypical, AUC, diarrhoea, scoring system, confirmed case, Hierarchical, Non-COVID-19, overlap, crazy-paving pattern, Clinical data, cut-off value, positive, aetiology, feature, laboratory parameter, Result, collected, significantly, reported, clinically, were used, two group, diagnosis of COVID-19, subpleural, 【제목키워드】 COVID-19, symptomatic, differential diagnosis, Non-COVID-19,