New virtual tool to help the world diagnose COVID-19 in the lungs

By Dr. Liji Thomas, MDMar 31 2020

A new virtual tool helps overstressed and overworked doctors sharpen their skills at making a timely diagnosis of COVID-19 pneumonia based on the characteristic lung signs on computerized tomography (CT) of the chest.

The Sydney company, which developed the app, is now offering it free to every doctor all over the world, to help arrest the spread of the disease. Painful experience shows that the ability to pick up COVID-19 as early as possible, treating patients before advanced disease sets in, and isolating such patients, is the most significant single measure to prevent the spread of the disease.

What is the advantage of early diagnosis?

Unlike the early days of the infection, when the world still didn’t know what it was up against, today it is clear that the number of patients developing COVID-19 sickness is exploding out of all proportion to the number of healthcare staff who can diagnose the illness. The best way to reduce the mortality rate is early diagnosis and isolation of cases.

The new tool fills the niche, according to the website, allowing current healthcare workers to make correct diagnoses of COVID-19 faster while training new workers to read CT scans faster. This will be a boon, especially the ability to interpret CT scans – “required as the number of patients escalates rapidly especially in the developing world.”

CovED – hope for the future

Earlier studies have shown that CT scans of the lungs could help cut down the period to diagnose COVID-19 cases significantly.

Free virtual clinical environment that helps clinicians to become better at recognising the early CT signs of COVID-19. Image Credit: DetectEd

The company calls its online platform CovED – meant to help diagnose COVID-19 using CT chest images. CovED is a collaboration of international experts. It is described as a “powerful educational solution which contains modules that will take between 1-2 hours to complete.” It is able to offer certification and CME (continuing medical education) points from the US Accreditation Council for CME.

Earlier, the company called DetecED-X created the BREAST platform of 2010, a breast cancer screening tool, as well as the 2019 HRCT (high-resolution CT)-based solution to diagnose dust lung disease. They are offering the tool free of charge to all clinical workers.

Initially, the plan was to make CovED available to all clinicians over Australia, and the University of Sydney was in talks with the federal ministry in Australia to achieve this. However, now the tool is planned to be offered to as many doctors all over the world as possible.

Lung signs of COVID-19

Describing the tool, program co-creator Stuart Grieve says that COVID-19 shows up in CT scans of the lungs in three ways, mainly. The first thing the doctor must do is ask for a history of risk. If this is positive, the earliest CT finding of infection is the “ground-glass opacity,” where the lung looks like the view from a frosted window rather than the transparent black of the normal lung.

The second sign is termed “crazy paving” and denotes a more advanced form of the disease – patches of the lung turn white, with no obvious pattern to them. And the third is a sign of severe lung disease, with consolidation of the lung – the lung is filled with mucus and looks white because there is no air within the lung in that field.

Implications

According to medical radiation scientist Patrick Brennan who is chief executive DetectED, “It’s a tool which makes clinicians, healthcare professionals anywhere in the world able to recognize and identify the disease much more effectively than they could previously. We think it will save thousands and thousands of lives.”

At present, the interpretation of lung CT scans is left to lung radiologists – and there simply aren’t enough of them to rely on in the present crisis. The current platform aims to train thousands of healthcare providers to read lung scans, and the learning will persist even after and if COVID-19 passes into history.

Says Professor Grieve, “We’re getting to the point now where everyone's on the front line, and we don't have the amount of people to do all the tasks, people have to chip in and do everything.” A huge second advantage is that these doctors can also pick up CT lung signs of other lung diseases or conditions, which could make COVID-19 more complicated. This could allow clinicians to “start people on the road to ICU admission and treat them with something that we know is effective.” The outcome could be the slowdown of the pandemic.