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10.1371/journal.pone.0235844

http://scihub22266oqcxt.onion/10.1371/journal.pone.0235844
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32645053!7347219!32645053
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suck abstract from ncbi


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pmid32645053      PLoS+One 2020 ; 15 (7): e0235844
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  • CT in relation to RT-PCR in diagnosing COVID-19 in The Netherlands: A prospective study #MMPMID32645053
  • Gietema HA; Zelis N; Nobel JM; Lambriks LJG; van Alphen LB; Oude Lashof AML; Wildberger JE; Nelissen IC; Stassen PM
  • PLoS One 2020[]; 15 (7): e0235844 PMID32645053show ga
  • INTRODUCTION: Early differentiation between emergency department (ED) patients with and without corona virus disease (COVID-19) is very important. Chest CT scan may be helpful in early diagnosing of COVID-19. We investigated the diagnostic accuracy of CT using RT-PCR for SARS-CoV-2 as reference standard and investigated reasons for discordant results between the two tests. METHODS: In this prospective single centre study in the Netherlands, all adult symptomatic ED patients had both a CT scan and a RT-PCR upon arrival at the ED. CT results were compared with PCR test(s). Diagnostic accuracy was calculated. Discordant results were investigated using discharge diagnoses. RESULTS: Between March 13th and March 24th 2020, 193 symptomatic ED patients were included. In total, 43.0% of patients had a positive PCR and 56.5% a positive CT, resulting in a sensitivity of 89.2%, specificity 68.2%, likelihood ratio (LR)+ 2.81 and LR- 0.16. Sensitivity was higher in patients with high risk pneumonia (CURB-65 score >/=3; n = 17, 100%) and with sepsis (SOFA score >/=2; n = 137, 95.5%). Of the 35 patients (31.8%) with a suspicious CT and a negative RT-PCR, 9 had another respiratory viral pathogen, and in 7 patients, COVID-19 was considered likely. One of nine patients with a non-suspicious CT and a positive PCR had developed symptoms within 48 hours before scanning. DISCUSSION: The accuracy of chest CT in symptomatic ED patients is high, but used as a single diagnostic test, CT can not safely diagnose or exclude COVID-19. However, CT can be used as a quick tool to categorize patients into "probably positive" and "probably negative" cohorts.
  • |Adult[MESH]
  • |Aged[MESH]
  • |COVID-19[MESH]
  • |COVID-19 Testing[MESH]
  • |Clinical Laboratory Techniques[MESH]
  • |Coronavirus Infections/*diagnosis/diagnostic imaging/epidemiology[MESH]
  • |Emergency Service, Hospital[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Likelihood Functions[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Netherlands/epidemiology[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/*diagnosis/diagnostic imaging/epidemiology[MESH]
  • |Prospective Studies[MESH]
  • |Reverse Transcriptase Polymerase Chain Reaction[MESH]


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