Radiology findings are vital prognostic aids in the fight against COVID-19, and imaging is all but essential for elderly patients.
So suggest the authors of an expedited literature review running in the British Geriatrics Society’s Age and Ageing journal.
Combing through more than 1,100 peer-reviewed and pre-published articles, Fiona Lithander, PhD, of the University of Bristol in the U.K. and colleagues found 22 that met their criteria for COVID-19 testing, along with 15 on treatment and 13 on prognosis.
The review showed that viral polymerase chain reaction (PCR) and serology remain the initial go-to exams for COVID-19 testing, but positive diagnoses are increasingly supported by imaging exams.
In their discussion the authors emphasize that radiological changes may be absent in early disease and minimal in mild disease.
Also, patients with non-severe disease tend to have no radiological abnormality. However, on the other end of the scale, only 3% of included cases had no radiological signs of COVID.
In light of this, the authors comment, COVID-19 “cannot necessarily be ruled out on the basis of a normal CT whilst there is some evidence to suggest that the negative predictive value of CT is higher when symptom duration is more than one week.”
“Given the established association between increasing age and poor prognosis in COVID-19, we anticipate that this rapid review of the current and emergent evidence might form a basis on which future work can be established,” the authors conclude. “Exclusion of older people, particularly those with comorbidities, from clinical trials is well recognized and is potentially being perpetuated in the field of current COVID-19 research.”
The study is available in full for free. (Select PDF.)
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.