Download This Paper
Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.
The Impact of Chest Computed Tomography in a COVID-19 Reference Hospital - First Wave - Distrito Federal - Brazil
23 Pages Posted: 10 Jan 2022
More...Abstract
Objectives: To evaluate the diagnostic accuracy of chest CT for the diagnosis of COVID-19 associated with the clinical presentation and in relation to the PCR-RT. Sensitivity, specificity, positive predictive value and negative predictive value, gender, age group and degree of lung involvement will be evaluated.
Methods: We evaluated 1545 patients suspected of COVID-19 with chest CT, delineating the age range and degree of lung involvement, and 306 patients suspected of COVID-19 with chest CT and PCR-RT, delineating sensitivity, specificity, accuracy, prevalence, positive predictive value, and negative predictive value.
Results: Of the 1545 examinations, 53% were men and 47% were women, there was greater involvement in the 50-59 age group. In the pulmonary study, 32.45% were normal, 12.50% were other diseases and 55.05% were COVID-19. In the degree of lung involvement 37.70% were mild (up to 25% of the lung area), 35.76% were moderate (25 to 50% of the lung area), and 26.54% were severe (between 50 and 100%). In the distribution by age group of patients affected by covid-19, there was a greater involvement between 50-59 years with 56% of patients classified between moderate (27.6%) and severe (28.0%). Between tomography and PCR-RT, the sensitivity was 68.8%, specificity 59.5%, accuracy 91.3%, with prevalence 31.9%, positive predictive value 44.3% and negative predictive value 80.3%, in females, sensitivity 55.3%, positive predictive value 37.1%, negative predictive value 75.3%, in males, sensitivity 81.6%, positive predictive value 50, 6 and negative predictive value 86.6%.The sensitivities are different between the genders with p of 0.005 and specificity of 0.938, and with age effect, starting at 45 years we have a p of 0.057 that decreases to 0.006 at 80 years for sensitivity and specificity.
Conclusions: The sensitivity and accuracy of CT scan in relation to PCR-RT was significant, highlighting that PCR-RT is difficult to perform and that may have affected the results obtained, reducing the sensitivity by false negative PCR-RT. Sensitivity increases with prevalence and is more significant in the older age group and in men, who are more affected in this pathology.
Funding Information: None.
Declaration of Interests: None.
Ethics Approval Statement: The present study was approved by the Research Ethics Committee of the Fundação de Ensino e Pesquisa FEPECS/Escola Superior de Ciências da Saúde ESCS. All participants were exempted from signing the informed consent form.
Keywords: Computed tomography, Sensitivity, Specificity, COVID-19, Reverse Transcriptase Polymerase Chain Reaction, PCR-RT, Prevalence, Age Group.
Suggested Citation: Suggested Citation