胸部计算机断层扫描与聚合酶链反应诊断2019冠状病毒病的比较——对利比亚的黎波里大学医院1240例病例的回顾性研究

N. Shalaka, Najah Gurad, Salam Alawasi, Nuha R Mansour, Ala Ali, Khaled Elobidy, Mohamed Algumati, Hossam Swisi, Elham Elhshik, Ziyad Mukhtar, Alfitouri Abojamra
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摘要

目的:随着2019冠状病毒病(COVID-19)疑似病例在急诊科(EDs)的流行率不断上升,需要一种快速可靠的分诊工具。胸部计算机断层扫描(CT)对急诊科病例的诊断性能尚未得到验证。我们的目的是评估胸部CT与GeneXpert Xpress Xpert严重急性呼吸综合征冠状病毒2检测在急诊科出现呼吸道症状的患者中快速诊断COVID-19的诊断性能。这是一项在的黎波里大学医院进行的回顾性单中心研究,包括在2020年5月18日至8月18日期间接受胸部CT和疑似COVID-19聚合酶链反应(PCR)检测的呼吸道症状患者。结果:共纳入1240例,其中胸部CT影像学表现明显的COVID-19病例570例(46%)。PCR阳性565例(45.6%),其中胸部CT影像学表现明显的557例(97.7%)。相对于PCR结果计算的准确率为98%,灵敏度为98.5%,特异性为98%,阳性预测值为97.7%,阴性预测值为98.8%。结论:在当前疫情期间,胸部CT是急诊科快速、可靠的新冠肺炎诊断工具。
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The diagnostic performance of chest computed tomography scanning in the diagnosis of coronavirus disease 2019 compared to polymerase chain reaction: A retrospective study of 1240 cases from Tripoli University Hospital, Libya
OBJECTIVE: The increasing prevalence of suspected cases of coronavirus disease 2019 (COVID-19) presenting to emergency departments (EDs) requires a rapid and reliable triaging tool. The diagnostic performance of chest computed tomography (CT) has yet to be validated for triaging cases in the ED. We aimed to assess the diagnostic performance of chest CT compared to GeneXpert Xpress Xpert severe acute respiratory syndrome coronavirus 2 test in rapidly diagnosing COVID-19 among patients with respiratory symptoms presenting to the ED. MATERIALS AND METHODS: This was a retrospective, single-center study at Tripoli University Hospital including cases with respiratory symptoms who underwent chest CT as well as polymerase chain reaction (PCR) testing for suspected COVID-19 between May 18 and August 18, 2020. RESULTS: A total of 1240 cases were included, among whom 570 had radiologically evident COVID-19 on chest CT (46%). Five hundred and sixty-five cases had positive PCR results (45.6%), of whom 557 had radiologically evident COVID-19 on chest CT (97.7%). The calculated accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 98%, 98.5%, 98%, 97.7%, and 98.8%, respectively, in relation to the PCR results. CONCLUSION: During the current pandemic, chest CT is a quick and reliable diagnostic tool for COVID-19 in the ED.
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