Comparison of the Degree of Chest CT Scan Abnormalities in COVID-19 and Influenza Patients

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.