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10.1007/s00330-020-07050-x

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suck abstract from ncbi


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pmid32666316      Eur+Radiol 2020 ; 30 (12): 6818-6827
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  • Accuracy of CT in a cohort of symptomatic patients with suspected COVID-19 pneumonia during the outbreak peak in Italy #MMPMID32666316
  • Besutti G; Giorgi Rossi P; Iotti V; Spaggiari L; Bonacini R; Nitrosi A; Ottone M; Bonelli E; Fasano T; Canovi S; Colla R; Massari M; Lattuada IM; Trabucco L; Pattacini P
  • Eur Radiol 2020[Dec]; 30 (12): 6818-6827 PMID32666316show ga
  • OBJECTIVE: To assess sensitivity/specificity of CT vs RT-PCR for the diagnosis of COVID-19 pneumonia in a prospective Italian cohort of symptomatic patients during the outbreak peak. METHODS: In this cross-sectional study, we included all consecutive patients who presented to the ER between March 13 and 23 for suspected COVID-19 and underwent CT and RT-PCR within 3 days. Using a structured report, radiologists prospectively classified CTs in highly suggestive, suggestive, and non-suggestive of COVID-19 pneumonia. Ground-glass, consolidation, and visual extension of parenchymal changes were collected. Three different RT-PCR-based reference standard definitions were used. Oxygen saturation level, CRP, LDH, and blood cell counts were collected and compared between CT/RT-PCR classes. RESULTS: The study included 696 patients (41.4% women; age 59 +/- 15.8 years): 423/454 (93%) patients with highly suggestive CT, 97/127 (76%) with suggestive CT, and 31/115 (27%) with non-suggestive CT had positive RT-PCR. CT sensitivity ranged from 73 to 77% and from 90 to 94% for high and low positivity threshold, respectively. Specificity ranged from 79 to 84% for high positivity threshold and was about 58% for low positivity threshold. PPV remained >/= 90% in all cases. Ground-glass was more frequent in patients with positive RT-PCR in all CT classes. Blood tests were significantly associated with RT-PCR and CT classes. Leukocytes, lymphocytes, neutrophils, and platelets decreased, CRP and LDH increased from non-suggestive to suggestive CT classes. CONCLUSIONS: During the outbreak peak (in a high-prevalence setting), CT presented high PPV and may be considered a good reference to recognize COVID-19 patients while waiting for RT-PCR confirmation. KEY POINTS: * During the epidemic peak, CT showed high positive predictive value and sensitivity for COVID-19 pneumonia when compared with RT-PCR. * Blood tests were significantly associated with RT-PCR and CT classes.
  • |*Betacoronavirus[MESH]
  • |*Pandemics[MESH]
  • |COVID-19[MESH]
  • |Coronavirus Infections/*diagnosis/epidemiology[MESH]
  • |Cross-Sectional Studies[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Italy/epidemiology[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Pneumonia, Viral/*diagnosis/epidemiology[MESH]
  • |Prospective Studies[MESH]
  • |Reproducibility of Results[MESH]
  • |SARS-CoV-2[MESH]


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