Abstract Details

Title Value Of Chest Computed Tomographic Scan Added To Acute Stroke Neuroimaging Protocol For Identifying Coronavirus Disease 2019: A Critical Assessment Of A Prospective Protocol

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 028

Objective We report our experience of incorporating chest CT scan in the initial neuroimaging protocol for evaluation of acute stroke patients.

Background Coronavirus Disease 2019 (COVID-19) is associated with an increased risk for acute ischemic stroke but screening for COVID-19 based on clinical criteria or laboratory testing may be difficult in acute stroke evaluation. Chest computed tomographic (CT) scan may be another time-sensitive option for identification. of COVID-19 in such patients.

Design/Methods All acute stroke patients underwent chest CT scan concurrent to CT head, CT angiogram of head and neck and CT perfusion for 4 months. We identified patients who had chest CT scan findings that were suggestive of COVID-19 including bilateral, multilobar ground glass opacification with a peripheral or posterior distribution, and/or consolidation (mainly in the lower lobes). All patients subsequently underwent polymerase chain reaction (PCR) testing of nasopharyngeal swab with contact isolation until COVID-19 could be excluded.

Results A total of 224 consecutive patients (mean age 62.12 years±SD; 15.3) underwent acute stroke evaluation with a concurrent chest CT scan. The chest CT identified findings suggestive of COVID-19 in 11 (4.9%) patients. Subsequent PCR testing did not confirm the diagnosis of COVID-19 in any of the patient. Another 99 patients (44%) without any findings suggestive of COVID-19 on chest CT scan underwent PCR testing. PCR testing did not confirm the diagnosis of COVID-19 in any of the patients. Four patients (4.3%) with chest CT scan findings suggestive of COVID-19 were found to have an ischemic stroke while 7 patients (5.9%) with chest CT scan findings suggestive of COVID-19 did not have any ischemic stroke (stroke mimic).

Conclusions We found a very low yield for identifying COVID-19 in acute stroke patients by performing chest CT scan concurrent to standard acute stroke neuroimaging protocol.

Authors/Disclosures
Muhammad F. Ishfaq, MD PRESENTER	Dr. Ishfaq has nothing to disclose.
Sachin M. Bhagavan, MD	Dr. Bhagavan has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Brandi R. French, MD (University of Missouri)	Dr. French has nothing to disclose.
Farhan Siddiq, MD	Dr. Siddiq has nothing to disclose.
Camilo R. Gomez, MD, F�鶹��ýӳ�� (University of Missouri)	Dr. Gomez has nothing to disclose.
Hamza I. Maqsood, MD (Dept of Neurology)	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.

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