Performance of CO-RADS in the diagnosis of COVID-19 in hemodialysis patients.

Pervin Ozkan Kurtgoz, Fatih Sackan, Meral Buyukterzi, Ibrahim Guney
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Abstract

Introduction: Different data systems have been used to reach a common decision in the interpretation of chest computed tomography (CT) scans for the detection of COVID-19 infection. The aim of our study was to determine the usefulness of the COVID-19 Reporting and Data System (CO-RADS) for COVID-19 in patients undergoing hemodialysis.

Methods: We included 90 hemodialysis patients who underwent chest CT and had samples available for real-time reverse transcription-polymerase chain reaction (RT-PCR). The files of the patients were retrospectively reviewed and the data were recorded. Image interpretation and CO-RADS staging were performed retrospectively by two radiologists experienced in COVID-19 patients, blinded to the RT-PCR results. The RT-PCR results were then compared with the CO-RADS stages obtained. The success of CO-RADS in diagnosing COVID-19 was evaluated according to its prediction of a positive RT-PCR result. At the same time, the relationship between CO-RADS stages and prognosis was also evaluated.

Results: Patients were divided into two groups according to the RT-PCR results, of which 38 (42.2%) had positive results. Validity tests of CO-RADS were performed according to the RT-PCR test. While 71.1% of patients with CO-RADS ≥4 were RT-PCR (+), 13.2% of patients with CO-RADS ≤2 were RT-PCR (+) (p < 0.001). CO-RADS ≥4 detected COVID-19 with 71.1% sensitivity and 51.9% specificity. ROC analysis confirmed the diagnostic performance of CO-RADS for predicting RT-PCR positivity with AUC = 0.73 (95% CI: 0.63-0.84). The relationship between CO-RADS stages and mortality was not significant (p = 0.21).

Conclusion: CO-RADS is moderately sensitive and poorly specific for the diagnosis of COVID-19 in hemodialysis patients. In these patients, CO-RADS would be more useful to exclude other infections than to diagnose COVID-19.

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CO-RADS 在血液透析患者 COVID-19 诊断中的表现。
导言:在解释胸部计算机断层扫描(CT)以检测 COVID-19 感染时,不同的数据系统被用于达成共同的决定。我们的研究旨在确定 COVID-19 报告和数据系统(COVID-19 Reporting and Data System,CO-RADS)对血液透析患者 COVID-19 的有用性:我们纳入了 90 名接受过胸部 CT 并有样本可用于实时逆转录聚合酶链反应 (RT-PCR) 的血液透析患者。我们对患者的档案进行了回顾性审查,并记录了相关数据。图像解读和 CO-RADS 分期由两名对 COVID-19 患者有经验的放射科医生进行回顾性分析,RT-PCR 结果为盲法。然后将 RT-PCR 结果与 CO-RADS 分期结果进行比较。根据 CO-RADS 对 RT-PCR 阳性结果的预测,评估 CO-RADS 诊断 COVID-19 的成功率。同时,还评估了 CO-RADS 分期与预后之间的关系:根据 RT-PCR 结果将患者分为两组,其中 38 人(42.2%)为阳性结果。根据 RT-PCR 检测结果对 CO-RADS 进行了有效性测试。CO-RADS≥4的患者中71.1%为RT-PCR(+),而CO-RADS≤2的患者中13.2%为RT-PCR(+)(P 结论:CO-RADS的灵敏度为中度:CO-RADS 对血液透析患者 COVID-19 诊断的敏感性一般,特异性较差。在这些患者中,CO-RADS 对于排除其他感染比诊断 COVID-19 更有用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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