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{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7160614","sourcedb":"PMC","sourceid":"7160614","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7160614","text":"Introduction\nOn January 30, 2020, the World Health Organization (WHO) has declared the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak as a global health emergency of international concern. This outbreak has infected all provinces of China and rapidly spread to the rest of the world. At the time of writing this article (March 16, 2020), there have been more than 158 countries and territories affected [1]. Whole-genome sequencing and phylogenetic analysis reveal that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is similar to some beta coronaviruses detected in bats, but it is distinct from severe acute respiratory syndrome coronavirus (SARS-Cov) and Middle East respiratory syndrome coronavirus (MERS-CoV) [2].\nPatients with COVID-19 develop pneumonia with associated symptoms of fever (98%), cough (76%), and myalgia or fatigue (44%) [3]. CT imaging plays a critical role in the diagnosis and the monitoring of disease progression [4–6]. The latest research studies described the characteristic imaging manifestations of COVID-19, including ground-glass opacities (GGO) (57 to 88%), bilateral involvement (76 to 88%), and peripheral distribution (33 to 85%) [7–10]. Other imaging features such as consolidation, cavitation, and interlobular septal thickening are also reported in some patients [11–13]. However, these imaging manifestations of COVID-19 are nonspecific and are difficult to distinguish from other pneumonia. To our knowledge, there have been no studies explicitly comparing imaging and clinical characteristics between pneumonia patients with and without COVID-19.\nThe current diagnostic criterion for COVID-19 is the positive result of a nucleic acid test by real-time reverse transcription polymerase chain reaction (RT-PCR) or next-generation sequencing [14]. However, false-negative results caused by unstable specimen processing are relatively high in clinical practice, which has worsened the spread of the outbreak [15–18]. Moreover, laboratory testing for SARS-CoV-2 requires a rigorous platform, which is not assembled in all hospitals. Thus, this requires specimen transfer, which may delay diagnosis for days. Early and accurate diagnosis is crucial, particularly for critically ill patients who need emergency surgery, and with pneumonia complications. To solve these problems, we hypothesize that a diagnostic model can be developed based on CT imaging and clinical manifestations alone, independent of the nucleic acid test.\nIn this study, we identify the differences in imaging and clinical manifestations between patients with and without COVID-19. We also develop and validate a model for COVID-19 diagnosis based on radiological semantic and clinical 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