• Naciye Sinem Gezer, Begüm Ergan, Mustafa Mahmut Barış, Özgür Appak, Ayça Arzu Sayıner, Pınar Balcı, Ziya Kuruüzüm, Çavuş Sema Alp SA Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey., and Oğuz Kılınç.
• Department of Radiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey.
• Diagn Interv Radiol. 2020 Jul 1; 26 (4): 315-322.

PurposeBecause of the widespread use of CT in the diagnosis of COVID 19, indeterminate presentations such as single, few or unilateral lesions amount to a considerable number. We aimed to develop a new classification and structured reporting system on CT imaging (COVID-19 S) that would facilitate the diagnosis of COVID-19 in the most accurate way.MethodsOur retrospective cohort included 803 patients with a chest CT scan upon suspicion of COVID 19. The patients' history, physical examination, CT findings, RT PCR, and other laboratory test results were reviewed, and a final diagnosis was made as COVID 19 or non-COVID 19. Chest CT scans were classified according to the COVID 19 S CT diagnosis criteria. Cohen's kappa analysis was used.ResultsFinal clinical diagnosis was COVID-19 in 98 patients (12%). According to the COVID-19 S CT diagnosis criteria, the number of patients in the normal, compatible with COVID 19, indeterminate and alternative diagnosis groups were 581 (72.3%), 97 (12.1%), 16 (2.0%) and 109 (13.6%). When the indeterminate group was combined with the group compatible with COVID 19, the sensitivity and specificity of COVID-19 S were 99.0% and 87.1%, with 85.8% positive predictive value (PPV) and 99.1% negative predictive value (NPV). When the indeterminate group was combined with the alternative diagnosis group, the sensitivity and specificity of COVID-19 S were 93.9% and 96.0%, with 94.8% PPV and 95.2% NPV.ConclusionCOVID-19 S CT classification system may meet the needs of radiologists in distinguishing COVID-19 from pneumonia of other etiologies and help optimize patient management and disease control in this pandemic by the use of structured reporting.

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