Table 4.
Time and manner of COVID-19 diagnosis according to presence of symptoms at onset of disease
| Chest CT screening | No symptoms, n (%) | Actual or history of symptoms, n (%) | Total, n (%) | Chest CT screening direct benefit, n (%) | |
|---|---|---|---|---|---|
| Screening detected (RT-PCR or chest CT) | CO-RADS score 1-3 | 3 patients, including 2 with false-negative chest CT scans (no false-negative RT-PCR): - 1 patient first had a positive RT-PCR 1 wk before CT simulation, but at the time of the chest CT screening both RT-PCR and CT were negative |
2 patients, including 1 with false-negative chest CT: - 1 had initial false-negative RT-PCR; however, repeated tests motivated by a history of symptoms enabled patient diagnosis - 1 developed COVID-19 during RT (systematic RT-PCR performed before concomitant chemotherapy 1 mo after the start of RT. No diagnostic chest CT was performed at the time of the diagnosis). |
5 (19.2) | 0 (0) |
| CO-RADS score 4-5 | 3 (no false-negative RT-PCR) | 8 patients: - 4 had initial false-negative RT-PCR but repeated tests enabled diagnosis - 1 had no positive RT-PCR (1 test performed) - 1 refused the RT-PCR test |
11 (42.3) | 6 (23.1) | |
| Total | 6 (23.1) | 10 (38.5) | 16 (61.5) | ||
| COVID-19 infection known before RT management | CO-RADS score 1-3 | 0 | 1 false-negative chest CT | 1 (3.8) | 0 |
| CO-RADS score 4-5 | 0 | 7 patients: - 1 had a past infection of RT-PCR–confirmed COVID-19 1 mo before CT simulation. Two negative RT-PCR tests allowed planning of RT; however, suspicious images on chest CT screening led to a third RT-PCR test, which was positive) |
7 (26.9) | 1 (3.8) | |
| Total | 8 (30.8) | 8 (30.8) | |||
| Revealed by symptoms, n (%) | CO-RADS score 1-3 | 0 | 1 patient had negative chest CT screening: - symptoms of COVID-19 infection occurred during RT 1 mo after, with positive diagnostic chest CT. RT-PCR was negative, but patient was considered clinically positive. |
1 (3.8) | 0 (0)∗ |
| CO-RADS score 4-5 | 0 | 1 patient, no false-negative RT-PCR | 1 (3.8) | 0 | |
| Total | 0 (0) | 2 (7.7) | 2 (7.7) | ||
| TOTAL | 6 (23.1) | 20 (76.9) | 26 (100) | 7 (26.9) |
Abbreviations: CO-RADS = COVID-2019 Reporting and Data System classification; CT = computed tomography; RT = radiation therapy; RT-PCR = reverse-transcription polymerase chain reaction.
∗
A diagnostic chest CT scan allowed for a diagnosis, despite a negative RT-PCR test result.