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Thomas C, Naudin M, Tasu JP, Leclerc C, Depaire L, Subervillle M, Vionnet M, Guillevin R, Herpe G. Efficacy of chest CT scan for COVID-19 diagnosis in a low prevalence and incidence region. Eur Radiol 2021; 31:8141-8146. [PMID: 33871709 PMCID: PMC8054502 DOI: 10.1007/s00330-021-07863-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/11/2021] [Accepted: 03/10/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Value of chest CT was mainly studied in area of high COVID-19 incidence. The aim of this study was therefore to evaluate chest CT performances to diagnose COVID-19 pneumonia with regard to RT-PCR as reference standard in a low incidence area. METHODS A survey was sent to radiology department in 4 hospitals in an administrative French region of weak disease prevalence (3.4%). Study design was approved by the local institutional review board and recorded on the clinicaltrial.gov website (NCT04339686). Written informed consent was waived due to retrospective anonymized data collection. Patients who underwent a RT-PCR and a chest CT scan within 48 h for COVID-19 pneumonia suspicion were consecutively included. Diagnostic accuracy including the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of chest CT regarding RT-PCR as reference standard were calculated. RESULTS One hundred twenty-nine patients had abnormal chest CT findings compatible with a COVID-19 pneumonia (26%, 129/487). Among the 358 negative chest CT findings, 3% (10/358) were RT-PCR positive. Chest CT sensitivity, specificity, positive, and negative predictive value were respectively 87% (IC95: 85, 89; 69/79), 85% (IC95: 83, 87; 348/408), 53% (IC95: 50, 56; 69/129), and 97% (IC95: 95, 99; 348/358). CONCLUSIONS In a low prevalence area, chest CT scan is a good diagnostic tool to rule out COVID-19 infection among symptomatic suspected patients. KEY POINTS • In a low prevalence area (3.4% in the administrative area and 5.8% at mean in the study) chest CT sensitivity and specificity for diagnosing COVID-19 pneumonia were 87% and 85% respectively. • In patients with negative chest CT for COVID-19 pneumonia, the negative predictive value of COVID-19 infection was 97% (348/358 subjects). • Performance of CT was equivalent between the 4 centers participating to this study.
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Affiliation(s)
- Clément Thomas
- Radiology Department, University Hospital Centre Poitiers, Poitiers, Vienne, France
- Dactim Mis, LMA, UMR CNRS 7348, Poitiers, Vienne, France
| | - Mathieu Naudin
- Dactim Mis, LMA, UMR CNRS 7348, Poitiers, Vienne, France
| | - Jean-Pierre Tasu
- Radiology Department, University Hospital Centre Poitiers, Poitiers, Vienne, France
- LaTIM, UMR 1101, INSERM, Bretagne University, Finistère, Brest, France
| | | | - Lucas Depaire
- Radiology Department, University Hospital Centre Poitiers, Poitiers, Vienne, France
- Hospital Centre of Angoulême, Charente, Angoulême, France
| | - Marie Subervillle
- Radiology Department, University Hospital Centre Poitiers, Poitiers, Vienne, France
- Hospital Centre of Chatêllerault, Chatêllerault, Vienne, France
| | - Mathilde Vionnet
- Radiology Department, University Hospital Centre Poitiers, Poitiers, Vienne, France
- Hospital Centre of Angoulême, Charente, Angoulême, France
| | - Rémy Guillevin
- Radiology Department, University Hospital Centre Poitiers, Poitiers, Vienne, France
- Dactim Mis, LMA, UMR CNRS 7348, Poitiers, Vienne, France
| | - Guillaume Herpe
- Radiology Department, University Hospital Centre Poitiers, Poitiers, Vienne, France.
- Dactim Mis, LMA, UMR CNRS 7348, Poitiers, Vienne, France.
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Valletta RC, Camargo LAD, Rodrigues SO, Silva SVD, Gonçalves MC, Queiroz NR, Galvão Filho AR, Avelino MAG. Olfactory dysfunction in the scenario of COVID-19 pandemic in patients screened by the telemonitoring. EINSTEIN-SAO PAULO 2021; 19:eAO6204. [PMID: 34644743 PMCID: PMC8483635 DOI: 10.31744/einstein_journal/2021ao6204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/01/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess the clinical and epidemiological profile of patients with olfactory dysfunction in the scenario of COVID-19 pandemic. METHODS The study selected patients with loss of smell, previously screened by telemonitoring system of the Municipal Health Department of Goiânia (GO), Brazil, who agreed to answer a questionnaire about COVID-19 symptoms and findings of exams. The interviews were conducted by six otolaryngologists, who applied the specific questionnaire, over the phone. RESULTS A total of 13,910 patients underwent telemonitoring, and 627 (4.51%) had olfactory loss complaints. Out of them, 330 were included in the survey. We observed a higher prevalence of altered smell in women (67%), and in patients aged under 50 years (86%). In most cases the manifestations had a sudden onset (70%), and in the first 5 days of illness (80%). The most prevalent associated symptom was a change in taste (89%), and only 2.7% of interviewed patients required hospitalization. CONCLUSION Anosmia in COVID-19 is more prevalent in females and individuals aged under 50 years. It is a relevant initial symptom predictive of the disease, together with dysgeusia.
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Kato S, Ishiwata Y, Aoki R, Iwasawa T, Hagiwara E, Ogura T, Utsunomiya D. Imaging of COVID-19: An update of current evidences. Diagn Interv Imaging 2021; 102:493-500. [PMID: 34088635 PMCID: PMC8148573 DOI: 10.1016/j.diii.2021.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 12/15/2022]
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been reported as a global emergency. As respiratory dysfunction is a major clinical presentation of COVID-19, chest computed tomography (CT) plays a central role in the diagnosis and management of patients with COVID-19. Recent advances in imaging approaches using artificial intelligence have been essential as a quantification and diagnostic tool to differentiate COVID-19 from other respiratory infectious diseases. Furthermore, cardiovascular involvement in patients with COVID-19 is not negligible and may result in rapid worsening of the disease and sudden death. Cardiac magnetic resonance imaging can accurately depict myocardial involvement in SARS-CoV-2 infection. This review summarizes the role of the radiology department in the management and the diagnosis of COVID-19, with a special emphasis on ultra-high-resolution CT findings, cardiovascular complications and the potential of artificial intelligence.
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Affiliation(s)
- Shingo Kato
- Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, 236-0004 Yokohama, Kanagawa, Japan.
| | - Yoshinobu Ishiwata
- Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, 236-0004 Yokohama, Kanagawa, Japan
| | - Ryo Aoki
- Department of Diagnostic Radiology, Yokohama City University Medical Center, 232-0024 Yokohama, Kanagawa, Japan
| | - Tae Iwasawa
- Department of Diagnostic Radiology, Kanagawa Cardiovascular and Respiratory Center, 236-0051 Yokohama, Kanagawa, Japan
| | - Eri Hagiwara
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 236-0051 Yokohama, Kanagawa, Japan
| | - Takashi Ogura
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 236-0051 Yokohama, Kanagawa, Japan
| | - Daisuke Utsunomiya
- Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, 236-0004 Yokohama, Kanagawa, Japan
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Farfour E, Asso-Bonnet M, Vasse M. The ID NOW COVID-19, a high-speed high-performance assay. Eur J Clin Microbiol Infect Dis 2021; 40:2041-2045. [PMID: 33855651 PMCID: PMC8046641 DOI: 10.1007/s10096-021-04243-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/31/2021] [Indexed: 10/26/2022]
Abstract
The ID NOW COVID-19 assay is a promising tool for the rapid identification of COVID-19 patients. However, its performances were questioned. We evaluate the ID NOW COVID-19 in comparison to a reference RT-PCR using a collection of 48 fresh nasopharyngeal swabs sampled on universal transport media (UTM). Only 2 false negatives of the ID NOW COVID-19 were identified. They display PCR cycle threshold values of 37.5 and 39.2. The positive percent agreement and the negative percent agreement were 94.9% and 100%, respectively. The Kappa value was 0.88. The ID NOW COVID-19 combines high-speed and accurate processing. Using UTM, the ID NOW COVID-19 could be repeated in the case of invalid result. Further analyses, such as screening of genetic variants or genome sequencing, could also be performed with the same sample. As for all tests, the results should be interpreted according to clinical and epidemiological context.
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Affiliation(s)
- Eric Farfour
- Service de biologie clinique, Hôpital Foch, Suresnes, France.
| | - M Asso-Bonnet
- Service de biologie clinique, Hôpital Foch, Suresnes, France
| | - M Vasse
- Service de biologie clinique, Hôpital Foch, Suresnes, France
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Karahasan Yagci A, Sarinoglu RC, Bilgin H, Yanılmaz Ö, Sayın E, Deniz G, Guncu MM, Doyuk Z, Barıs C, Kuzan BN, Aslan B, Korten V, Cimsit C. Relationship of the cycle threshold values of SARS-CoV-2 polymerase chain reaction and total severity score of computerized tomography in patients with COVID 19. Int J Infect Dis 2020; 101:160-166. [PMID: 32992013 PMCID: PMC7521909 DOI: 10.1016/j.ijid.2020.09.1449] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 01/08/2023] Open
Abstract
AIM Studies analyzing viral load in COVID-19 patients and any data that compare viral load with chest computerized tomography (CT) severity are limited. This study aimed to evaluate the severity of chest CT in reverse transcriptase polymerase chain reaction (RT-PCR)-positive patients and factors associated with it. METHODOLOGY SARS-CoV-2 RNA was extracted from nasopharyngeal swab samples by using Bio-speedy viral nucleic acid buffer. The RT-PCR tests were performed with primers and probes targeting the RdRp gene (Bioexen LTD, Turkey) and results were quantified as cycle threshold (Ct) values. Chest CT of SARS-CoV-2 RNA-positive patients (n = 730) in a period from 22 March to 20 May 2020 were evaluated. The total severity score (TSS) of chest CT ranged 0-20 and was calculated by summing up the degree of acute lung inflammation lesion involvement of each of the five lung lobes. RESULTS Of the 284 patients who were hospitalized, 27 (9.5%) of them died. Of 236 (32.3%) patients, there were no findings on CT and 216 (91.5%) of them were outpatients (median age 35 years). TSS was significantly higher in hospitalized patients; 5.3% had severe changes. Ct values were lower among outpatients, indicating higher viral load. An inverse relation between viral load and TSS was detected in both groups. CT severity was related to age, and older patients had higher TSS (p < 0.01). CONCLUSION Viral load was not a critical factor for hospitalization and mortality. Outpatients had considerable amounts of virus in their nasopharynx, which made them contagious to their contacts. Viral load is important in detecting early stages of COVID-19, to minimize potential spread, whereas chest CT can help identify cases requiring extensive medical care.
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Affiliation(s)
- Ayşegul Karahasan Yagci
- Medical Microbiology Marmara University, School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey
| | - Rabia Can Sarinoglu
- Medical Microbiology Marmara University, School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey
| | - Huseyin Bilgin
- Infectious Diseases and Clinical Microbiology, Marmara University, School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey
| | - Özgür Yanılmaz
- Medical Microbiology Marmara University, School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey
| | - Elvan Sayın
- Medical Microbiology Marmara University, School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey
| | - Guneser Deniz
- Medical Microbiology Marmara University, School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey
| | - Mehmet Mucahit Guncu
- Medical Microbiology Marmara University, School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey; Institute of Health Sciences, Marmara University, Maltepe Istanbul 34854 Turkey
| | - Zahide Doyuk
- Medical Microbiology Marmara University, School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey
| | - Can Barıs
- Medical Microbiology Marmara University, School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey
| | - Beyza Nur Kuzan
- Radiology, Marmara University, School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey
| | - Bülent Aslan
- Radiology, Marmara University, School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey
| | - Volkan Korten
- Infectious Diseases and Clinical Microbiology, Marmara University, School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey
| | - Cagatay Cimsit
- Radiology, Marmara University, School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey
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Duan X, Guo X, Qiang J. Reply to "A SARS-CoV-2 RT-PCR and Chest CT, two complementary approaches for COVID-19 diagnosis". Jpn J Radiol 2020; 38:1211-1212. [PMID: 32968962 PMCID: PMC7510764 DOI: 10.1007/s11604-020-01046-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/10/2020] [Indexed: 01/19/2023]
Affiliation(s)
- Xiaopei Duan
- Department of Radiology, The First Affiliated Hospital, College of Clinical Medicine, Medical College of Henan University of Science and Technology, Luoyang, 471003, China
| | - Xinyu Guo
- State Key Laboratory of Respiratory Disease, Sino-French Hoffmann Institute, School of Basic Medical Science, Guangzhou Medical University, Guangzhou, 511436, China
| | - Jun Qiang
- Department of Radiology, The First Affiliated Hospital, College of Clinical Medicine, Medical College of Henan University of Science and Technology, Luoyang, 471003, China.
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