Radiography cannot accurately determine the severity of lung involvement.
Timely diagnosis of COVID-19 is a crucial factor in the disease’s progression. Our biggest fear remains the virus’s impact on the lungs, which can lead to reduced oxygen levels and the need for oxygen therapy. The CT scan is the best diagnostic tool to determine if the coronavirus has reached the lungs. But when is a lung CT scan recommended? In an interview with ‘Gazeta Shqiptare,’ radiologist Almir Skana explains the three stages of COVID-19 diagnosis where imaging evaluation follows laboratory tests. He adds that CT scanning is recommended from the 5th to the 13th day of clinical symptom onset. Performing a CT scan from the first to the fourth day might result in a false negative since the lungs may not yet be affected, despite infection by COVID-19. Regarding the risks of CT scanning, Skana emphasizes that despite ionizing radiation, the diagnostic benefits outweigh the potential harms.
Current pandemic situation in Albania:
After a year of the global pandemic, Albania has reported 114,840 infected cases, with 35,356 active cases. Unfortunately, 17 deaths within the last 24 hours have occurred in the 22-89 age group. Currently, 649 patients are hospitalized, with 43 in intensive care and 15 intubated. Sadly, 1,986 patients have lost their lives, while 77,498 have recovered. COVID-19 now affects all ages, with the youngest confirmed case being 2 months old and the oldest 94 years old.
How is COVID-19 diagnosed?
COVID-19 diagnosis has three stages: The first is when a person suspects infection, where the swab test is crucial for confirming the virus in the upper respiratory tract. The second stage is during the disease’s development, involving biochemical tests like PCR, D-Dimer, and blood tests to monitor the body’s response. Imaging exams determine lung involvement. The third stage is over three weeks post-illness, where serological tests confirm antibody development.
How important is imaging in diagnosing the disease?
The value of imaging during the disease’s development is indisputable for determining lung involvement severity, directly influencing personalized therapeutic protocols.
What are the imaging modalities for COVID-19?
There are three imaging modalities for diagnosing lung involvement: Computed Tomography (CT scan), radiography, and ultrasound.
When do you recommend a CT scan and why?
CT scanning is recommended from the 5th to the 13th day of clinical symptom onset. Scanning from the first to the fourth day might result in a false negative because the lungs may not yet be affected despite COVID-19 infection.
What symptoms indicate lung involvement by COVID-19?
Symptoms include fever, chills, cough, and difficulty breathing.
Can radiography replace CT scanning for lung examination?
Both modalities can evaluate lung involvement, but radiography has disadvantages. Early lung lesions might not be visible on radiography but are detectable with a CT scan. Radiography cannot determine the severity of lung involvement as accurately as a CT scan, which also tracks the progression of lesions from initial stages to peak disease and recovery.
Are there cases of unnecessary CT scanning?
Examinations should be recommended by specialists based on diagnostic criteria. Any examination conducted without medical advice can be considered abusive.
How harmful is the CT scan, and can a patient with COVID-19 undergo more than one scan?
CT scanning involves ionizing radiation, but the diagnostic benefits outweigh the potential harms. There’s no fixed dose at which ionizing radiation causes damage. Multiple scans may be conducted if necessary.
How challenging has this situation been for you as a radiologist?
This has been a challenge for the entire healthcare system. Over the past year, I have conducted over 3,000 physical or online imaging consultations. I feel gratified to share my expertise with colleagues for accurate patient treatment.
For more information reach out to Skana Clinic in Tirana, Albania.
