• Geoffrey D Rubin, Christopher J Ryerson, Linda B Haramati, Nicola Sverzellati, Jeffrey P Kanne, Suhail Raoof, Neil W Schluger, Annalisa Volpi, Jae-Joon Yim, Martin Ian B K IBK From the Department of Radiology, Duke University School of Medicine, Box 3808, Durham, NC 27705 (G.D.R.); Department of Medicine, University of Britis, Deverick J Anderson, Christina Kong, Talissa Altes, Andrew Bush, Sujal R Desai, Onathan Goldin, Jin Mo Goo, Marc Humbert, Yoshikazu Inoue, Hans-Ulrich Kauczor, Fengming Luo, Peter J Mazzone, Mathias Prokop, Martine Remy-Jardin, Luca Richeldi, Cornelia M Schaefer-Prokop, Noriyuki Tomiyama, Athol U Wells, and Ann N Leung.
• From the Department of Radiology, Duke University School of Medicine, Box 3808, Durham, NC 27705 (G.D.R.); Department of Medicine, University of British Columbia, Vancouver, Canada (C.J.R.); Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (L.B.H.); Department of Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (N.S.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (J.P.K.); Division of Pulmonary, Critical Care & Sleep Medicine, Lenox Hill Hospital, New York, NY (S.R.); Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University Irving Medical Center, New York, NY (N.W.S.); 1st Anesthesia and Intensive Care Unit, University Hospital of Parma, Parma, Italy (A.V.); Division of Pulmonary and Critical Medicine, Seoul National University College of Medicine, Seoul, South Korea (J.J.Y.); Department of Emergency Medicine, The Medical College of Wisconsin School of Medicine, Milwaukee, Wis (I.B.K.M.); Director, Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University Medical Center, Durham, NC (D.J.A.); Medical Director of Pathology and Clinical Laboratory Medicine, Stanford University Medical Center, Stanford, Calif (C.K.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.); Department of Paediatrics and Paediatric Respirology, Royal Brompton Hospital, London, England (A.B.); Department of Radiology, Royal Brompton & Harefield NHS Foundation Trust, London, England (S.R.D.); National Heart and Lung Institute, Imperial College, London, England (S.R.D.); Department of Radiology, David Geffen School of Medline at University of California Los Angeles, Los Angeles, Calif (J.G.); Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea (J.M.G.); Department of Respiratory and Intensive Care Medicine, Université Paris-Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France (M.H.); Department of Pathology, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan (Y.I.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (H.U.K.); Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan, China (F.L.); Respiratory Institute, Cleveland Clinic, Cleveland,Ohio (P.J.M.); Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands (M.P.); Department of Thoracic Imaging-Hospital Calmette, University Centre of Lille, Lille, France (M.R.J.); Divisionof Pulmonary Medicine, Università Cattolica del Sacro Cuore, Rome, Italy (L.R.); Department of Radiology and Nuclear Medicine, Meander Medical Centre, Amersfoort, the Netherlands (C.M.S.P.); Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan (N.T.); Department of Pulmonary Medicine, Royal Brompton Hospital, London, England (A.U.W.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (A.N.L.).
• Radiology. 2020 Jul 1; 296 (1): 172-180.

AbstractWith more than 900 000 confirmed cases worldwide and nearly 50 000 deaths during the first 3 months of 2020, the coronavirus disease 2019 (COVID-19) pandemic has emerged as an unprecedented health care crisis. The spread of COVID-19 has been heterogeneous, resulting in some regions having sporadic transmission and relatively few hospitalized patients with COVID-19 and others having community transmission that has led to overwhelming numbers of severe cases. For these regions, health care delivery has been disrupted and compromised by critical resource constraints in diagnostic testing, hospital beds, ventilators, and health care workers who have fallen ill to the virus exacerbated by shortages of personal protective equipment. Although mild cases mimic common upper respiratory viral infections, respiratory dysfunction becomes the principal source of morbidity and mortality as the disease advances. Thoracic imaging with chest radiography and CT are key tools for pulmonary disease diagnosis and management, but their role in the management of COVID-19 has not been considered within the multivariable context of the severity of respiratory disease, pretest probability, risk factors for disease progression, and critical resource constraints. To address this deficit, a multidisciplinary panel comprised principally of radiologists and pulmonologists from 10 countries with experience managing patients with COVID-19 across a spectrum of health care environments evaluated the utility of imaging within three scenarios representing varying risk factors, community conditions, and resource constraints. Fourteen key questions, corresponding to 11 decision points within the three scenarios and three additional clinical situations, were rated by the panel based on the anticipated value of the information that thoracic imaging would be expected to provide. The results were aggregated, resulting in five main and three additional recommendations intended to guide medical practitioners in the use of chest radiography and CT in the management of COVID-19.© RSNA, 2020; American College of Chest Physicians, published by Elsevier Inc.Editor's note: This article is being simultaneously published in.

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