Could CT scans substitute for coronavirus testing?

CT scans are far more expensive, they expose patients to a low dose of radiation, and the Centers for Disease Control and Prevention and some medical groups recommend against using them to diagnose Covid-19. But they were widely used in China to identify cases, and their reliability there is fueling growing interest in adding chest CT to the diagnostic arsenal in the U.S.

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The scans detect hazy, patchy, “ground glass” white spots in the lung, a telltale sign of Covid-19. In one recent study of 1,014 patients, published in the journal Radiology, scientists in China reported that chest CT found 97% of Covid-19 infections. In comparison, the study found that 48% of patients who had negative results on the swab test, which detect the coronavirus’s genome, in fact had the disease.

“Once you’re a couple of days into infection, chest CT scans don’t miss,” said an emergency medicine physician in Louisiana who asked not to named. With the swab test missing 30% to 50% of cases, physicians in China called for the diagnostic use of CT early in the outbreak there, and “fever clinics” set up in Wuhan and elsewhere began routinely using them.

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