Diagnostic accuracy of infrared thermal imaging for detecting COVID-19 infection in minimally symptomatic patients

Introduction Despite being widely used as a screening tool, a rigorous scientific evaluation of infrared thermography for the diagnosis of minimally symptomatic patients suspected of having COVID-19 infection has not been performed. Methods A consecutive sample of 60 adult individuals with a history of close contact with COVID-19 infected individuals and mild respiratory symptoms for less than 7 days and 20 confirmed COVID-19 negative healthy volunteers were enrolled in the study. Infrared thermograms of the face were obtained with a mobile camera, and RT-PCR was used as the reference standard test to diagnose COVID-19 infection. Temperature values and distribution of the face of healthy volunteers and patients with and without COVID-19 infection were then compared. Results Thirty-four patients had an RT-PCR confirmed diagnosis of COVID-19 and 26 had negative test results. The temperature asymmetry between the lacrimal caruncles and the forehead was significantly higher in COVID-19 positive individuals. Through a random forest analysis, a cut-off value of 0.55 degrees C was found to discriminate with an 82% accuracy between patients with and without COVID-19 confirmed infection. Conclusions Among adults with a history of COVID-19 exposure and mild respiratory symptoms, a temperature asymmetry of >= 0.55 degrees C between the lacrimal caruncle and the forehead is highly suggestive of COVID-19 infection. This finding questions the widespread use of the measurement of absolute temperature values of the forehead as a COVID-19 screening tool.

Automated summary

This study indicates that temperature asymmetry between the lacrimal caruncles and the forehead can be an important indicator in the diagnosis of COVID-19 suspected cases, with potential clinical application value.