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.
Keywords: COVID-19; Sensitivity and specificity; Thorax; Tomography, X-ray computed.
【저자키워드】 COVID-19, Sensitivity and specificity, Tomography, X-Ray Computed, Thorax, 【초록키워드】 Pneumonia, hospital, diagnostic, Local, RT-PCR, Prevalence, X-ray, sensitivity, specificity, Diagnostic accuracy, Positive predictive value, Disease prevalence, Chest CT, COVID-19 infection, symptomatic, Patient, incidence, performance, reference standard, diagnose, retrospective, chest CT scan, Negative predictive value, COVID-19 incidence, website, written Informed Consent, French, diagnosing, positive, anonymized data, suspected patients, value, evaluate, approved, calculated, subjects, recorded, NPV, PPV, 【제목키워드】 Prevalence, COVID-19 diagnosis, incidence, chest CT scan,