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The relationship between diagnostic value of chest computed tomography imaging and symptom duration in COVID infection.
Annals of Thoracic Medicine ( IF 2.3 ) Pub Date : 2020-07-01 , DOI: 10.4103/atm.atm_165_20 Aydın Kant 1 , Uğur Kostakoğlu 2 , Serhat Atalar 3 , Şükrü Erensoy 4 , Tolgahan Sevimli 5 , Barış Ertunç 6 , Enes Dalmanoğlu 2 , İsmail Yılmaz 7 , Ayşe Ertürk 2 , Gürdal Yilmaz 8
OBJECTIVES: Severe acute respiratory syndrome-coronovirus-2 is a global public health problem, in which early diagnosis is required to prevent the spread of infection. In this study, we aimed to reveal the diagnostic value of chest computed tomography (CT) imaging with respect to symptom duration.
METHODS: This retrospective study involved patients from five centers, who were admitted with typical COVID-19 symptoms and found to be positive for COVID-19 real-time reverse transcription-polymerase chain reaction (rtRT-PCR) test.
RESULTS: One hundred and five patients with positive COVID-19 rtRT-PCR test were involved in the study. Sixty percent of these patients had chest CT imaging findings consistent with COVID-19 pneumonia. The most common chest CT finding was bilateral and subpleural ground-glass opacity in middle-lower lobes of the lungs. Chest CT findings were detected in 85.1% of the patients with a symptom duration of more than 2 days. In receiver operating characteristic analysis of this parameter, area under the curve (AUC) was 0.869, while sensitivity and specificity were 90.5% and 76.2%, respectively. It was notable that chest CT findings were 7.17 times more common among the patients aged 60 years and older, with AUC, specificity, and positive predictive value of 0.768, 88.1%, and 84.8%, respectively.
CONCLUSION: Chest CT imaging is a quite valuable tool in patients with longer than 2 days' duration of symptoms, in whom clinical and epidemiological data support the diagnosis of COVID-19 infection. We suggest that the diagnosis of COVID-19 pneumonia should be made with chest CT imaging when rtRT-PCR test cannot be performed or gives a negative result, which is important for public health and to prevent the spread of infection.
中文翻译：
COVID感染中胸部计算机断层扫描成像的诊断价值与症状持续时间的关系。
目的：严重急性呼吸综合征-冠状病毒-2是一个全球性公共卫生问题，需要早期诊断以防止感染传播。在这项研究中，我们的目的是揭示胸部计算机断层扫描 (CT) 成像对症状持续时间的诊断价值。
方法：这项回顾性研究涉及来自五个中心的患者，这些患者因典型的 COVID-19 症状而入院，并发现 COVID-19 实时逆转录聚合酶链反应 (rtRT-PCR) 检测呈阳性。
结果： 105 名 COVID-19 rtRT-PCR 检测呈阳性的患者参与了该研究。这些患者中 60% 的胸部 CT 成像结果与 COVID-19 肺炎一致。最常见的胸部 CT 发现是肺中下叶双侧和胸膜下磨玻璃样混浊。85.1%的症状持续时间超过2天的患者检测到胸部CT结果。该参数的受试者工作特征分析中，曲线下面积（AUC）为0.869，敏感性和特异性分别为90.5%和76.2%。值得注意的是，60 岁及以上患者的胸部 CT 发现常见率是 7.17 倍，AUC、特异性和阳性预测值分别为 0.768、88.1% 和 84.8%。
结论：胸部 CT 成像对于症状持续时间超过 2 天的患者来说是一个非常有价值的工具，其中临床和流行病学数据支持 COVID-19 感染的诊断。我们建议，当无法进行rtRT-PCR检测或得到阴性结果时，应通过胸部CT影像诊断COVID-19肺炎，这对公共卫生和防止感染传播很重要。
更新日期：2020-07-01
Annals of Thoracic Medicine ( IF 2.3 ) Pub Date : 2020-07-01 , DOI: 10.4103/atm.atm_165_20 Aydın Kant 1 , Uğur Kostakoğlu 2 , Serhat Atalar 3 , Şükrü Erensoy 4 , Tolgahan Sevimli 5 , Barış Ertunç 6 , Enes Dalmanoğlu 2 , İsmail Yılmaz 7 , Ayşe Ertürk 2 , Gürdal Yilmaz 8
Affiliation
OBJECTIVES: Severe acute respiratory syndrome-coronovirus-2 is a global public health problem, in which early diagnosis is required to prevent the spread of infection. In this study, we aimed to reveal the diagnostic value of chest computed tomography (CT) imaging with respect to symptom duration.
METHODS: This retrospective study involved patients from five centers, who were admitted with typical COVID-19 symptoms and found to be positive for COVID-19 real-time reverse transcription-polymerase chain reaction (rtRT-PCR) test.
RESULTS: One hundred and five patients with positive COVID-19 rtRT-PCR test were involved in the study. Sixty percent of these patients had chest CT imaging findings consistent with COVID-19 pneumonia. The most common chest CT finding was bilateral and subpleural ground-glass opacity in middle-lower lobes of the lungs. Chest CT findings were detected in 85.1% of the patients with a symptom duration of more than 2 days. In receiver operating characteristic analysis of this parameter, area under the curve (AUC) was 0.869, while sensitivity and specificity were 90.5% and 76.2%, respectively. It was notable that chest CT findings were 7.17 times more common among the patients aged 60 years and older, with AUC, specificity, and positive predictive value of 0.768, 88.1%, and 84.8%, respectively.
CONCLUSION: Chest CT imaging is a quite valuable tool in patients with longer than 2 days' duration of symptoms, in whom clinical and epidemiological data support the diagnosis of COVID-19 infection. We suggest that the diagnosis of COVID-19 pneumonia should be made with chest CT imaging when rtRT-PCR test cannot be performed or gives a negative result, which is important for public health and to prevent the spread of infection.
中文翻译：
COVID感染中胸部计算机断层扫描成像的诊断价值与症状持续时间的关系。
目的：严重急性呼吸综合征-冠状病毒-2是一个全球性公共卫生问题，需要早期诊断以防止感染传播。在这项研究中，我们的目的是揭示胸部计算机断层扫描 (CT) 成像对症状持续时间的诊断价值。
方法：这项回顾性研究涉及来自五个中心的患者，这些患者因典型的 COVID-19 症状而入院，并发现 COVID-19 实时逆转录聚合酶链反应 (rtRT-PCR) 检测呈阳性。
结果： 105 名 COVID-19 rtRT-PCR 检测呈阳性的患者参与了该研究。这些患者中 60% 的胸部 CT 成像结果与 COVID-19 肺炎一致。最常见的胸部 CT 发现是肺中下叶双侧和胸膜下磨玻璃样混浊。85.1%的症状持续时间超过2天的患者检测到胸部CT结果。该参数的受试者工作特征分析中，曲线下面积（AUC）为0.869，敏感性和特异性分别为90.5%和76.2%。值得注意的是，60 岁及以上患者的胸部 CT 发现常见率是 7.17 倍，AUC、特异性和阳性预测值分别为 0.768、88.1% 和 84.8%。
结论：胸部 CT 成像对于症状持续时间超过 2 天的患者来说是一个非常有价值的工具，其中临床和流行病学数据支持 COVID-19 感染的诊断。我们建议，当无法进行rtRT-PCR检测或得到阴性结果时，应通过胸部CT影像诊断COVID-19肺炎，这对公共卫生和防止感染传播很重要。
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