DALLAS, Oct. 29, 2020 — Computed tomography angiogram (CTA) scans may offer fast and early detection of COVID-19 in acute ischemic stroke (AIS) patients, according to new research published today in Stroke, a journal of the American Stroke Association, a division of the American Heart Association.
The study, titled “The Utility of Apical Lung Assessment on CTA as a COVID-19 Screen in Acute Stroke,” found that in addition to patient-reported COVID-19 symptoms, routine or standard care CTA scans were an accurate screening method for faster detection of COVID-19 since they include imaging of the upper portion of the lungs.
Researchers conducted a retrospective analysis of patients treated for AIS at three hospitals in the Bronx from March 1 to April 30, 2020, the height of the COVID-19 surge in New York City. A total of 57 patients who received a CTA scan within 24 hours of hospitalization for AIS were included in the study. Researchers used CTA scans to evaluate the lung apices (the upper area of the lungs) for signs of COVID-19 pneumonia. They then analyzed the accuracy of using CTA scans for COVID-19 diagnosis alone as well as in combination with patient-reported symptoms, such as cough and/or shortness of breath.
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“Every second counts when treating a person experiencing a stroke,” said Charles Esenwa, M.D., M.S., lead author of the study, an assistant professor and a stroke neurologist at the Albert Einstein College of Medicine in the Bronx, New York City. “Conducting a CTA is already part of the stroke management process, and these scans provide an opportunity to assess the lungs for signs suggestive of COVID-19. Our team sought to determine if this already necessary scan could have a secondary use of identifying potential COVID-19 patients more quickly than a standard nasal swab COVID-19 test.”
The study defined confirmed COVID-19 positive cases from nasal swab PCR-test results, which are the standard required by the U.S. Food and Drug Administration (FDA) for COVID-19 testing, and it can take several days for results. Of the 57 study participants, three were diagnosed with COVID-19 prior to the date when a nasal swab COVID-19 test was administered.
Researchers found that:
CTA scans in combination with patient feedback to COVID-19 symptom questions were able to diagnose COVID-19 with 83% accuracy before results were received from traditional nasal swab tests in AIS patients.
30 of the 57 patients included in the study were COVID-19 positive.
20 of the COVID-19 positive patients and 2 of the COVID-19 negative patients had findings highly suspicious for COVID-19 pneumonia on their CTA lung scans.