Performance of Low-Dose Chest CT as a Triage Tool for Suspected COVID-19 Patients.

IF 2 4区 医学 Q4 Medicine Journal of the Belgian Society of Radiology Pub Date : 2021-02-16 DOI:10.5334/jbsr.2319
Jeroen Desmet, Charlotte Biebaû, Walter De Wever, Lesley Cockmartin, Verbraeken Viktor, Johan Coolen, Johny Verschakelen, Adriana Dubbeldam
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Abstract

Purpose: To investigate the role of low-dose chest computed tomography (CT) imaging in the triage of patients suspected of coronavirus disease 2019 (COVID-19) in an emergency setting.

Materials and methods: Data from 610 patients admitted to our emergency unit from March 20, 2020, until April 11, 2020, with suspicion of COVID-19 were collected. Diagnostic values of low-dose chest CT for COVID-19 were calculated using consecutive reverse-transcription polymerase chain reaction (RT-PCR) tests and bronchoalveolar lavage (BAL) as reference. Comparative analysis of the 199 COVID-19 positive versus 411 COVID-19 negative patients was done with identification of risk factors and predictors of worse outcome.

Results: Sensitivity and specificity of low-dose CT for the diagnosis of COVID-19 respectively ranged from 75% (150/199) to 88% (175/199) and 94% (386/411) to 99% (386/389), depending on the inclusion of inconclusive results. On multivariate analysis, a higher body mass index (BMI), fever, and dyspnea on admission were risk factors for COVID-19 (all p-values < 0.05). The mortality rate was 12.6% (25/199). Higher age and high levels of C-reactive protein (CRP) and D-dimers were predictors of worse outcome (all p-values < 0.05).

Conclusion: Low-dose chest CT has a high specificity and a moderate to high sensitivity in symptomatic patients with suspicion of COVID-19 and could be used as an effective tool in setting of triage in high-prevalence areas.

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低剂量胸部 CT 作为疑似 COVID-19 患者的分诊工具的性能。
目的:研究低剂量胸部计算机断层扫描(CT)成像在急诊疑似冠状病毒病2019(COVID-19)患者分诊中的作用:收集2020年3月20日至2020年4月11日期间我院急诊科收治的610名疑似COVID-19患者的数据。以连续的反转录聚合酶链反应(RT-PCR)检测和支气管肺泡灌洗(BAL)为参考,计算低剂量胸部 CT 对 COVID-19 的诊断价值。对199例COVID-19阳性和411例COVID-19阴性患者进行了比较分析,并确定了风险因素和预示不良结局的因素:结果:低剂量CT诊断COVID-19的敏感性和特异性分别为75%(150/199)至88%(175/199)和94%(386/411)至99%(386/389),取决于是否纳入不确定结果。多变量分析显示,较高的体重指数(BMI)、发热和入院时呼吸困难是COVID-19的风险因素(所有P值均小于0.05)。死亡率为 12.6%(25/199)。高年龄、高水平的 C 反应蛋白 (CRP) 和 D 二聚体是预示较差预后的因素(所有 p 值均小于 0.05):结论:低剂量胸部 CT 对怀疑 COVID-19 的无症状患者具有较高的特异性和中高灵敏度,可作为高发地区分诊的有效工具。
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来源期刊
Journal of the Belgian Society of Radiology
Journal of the Belgian Society of Radiology Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
0.60
自引率
5.00%
发文量
0
审稿时长
6-12 weeks
期刊介绍: The purpose of the Journal of the Belgian Society of Radiology is the publication of articles dealing with diagnostic and interventional radiology, related imaging techniques, allied sciences, and continuing education.
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