Can chest computed tomography be useful to emergency residents in the diagnosis of COVID-19 pneumonia?

Doğancan Kozak 1, Ahmet Fırat Bektaş 2, Mustafa Korkut 3 * , Caner Işkorur 4
More Detail
1 Department of Emergency Medicine, Atatürk State Hospital, Antalya, Turkey
2 Department of Emergency Medicine, School of Medicine, Akdeniz University, Antalya, Turkey
3 Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
4 Department of Emergency Medicine, Acıbadem Bodrum Hospital, Muğla, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 20, Issue 6, pp. 45-49. https://doi.org/10.23950/jcmk/13875
OPEN ACCESS 571 Views 485 Downloads
Download Full Text (PDF)

ABSTRACT

Aim: During the novel coronavirus disease (COVID-19) pandemic, the workload of emergency department residents (ER) has increased since emergency departments (EDs) are among the first health units to which patients apply. The aim of this study was to investigate the diagnostic value of chest computed tomography (CT) interpretations of emergency department residents in the diagnosis of COVID-19 pneumonia.
Material and methods: Patients who admitted to the tertiary ED between 30.03.2020 and 30.12.2020 with suspected COVID-19 pneumonia and underwent chest CT imaging were retrospectively analyzed. Chest CT images previously reported by the radiologist were reinterpreted by the ER and the diagnostic performance of the ER for COVID-19 pneumonia was calculated.
Results: The study included 2045 patients with suspected COVID-19 pneumonia. Chest CT images of all patients were interpreted and compared by a radiologist and the ER In this study, interpretation by a radiologist was considered as the gold standard. In all patients, the diagnostic performance capacity of ER for COVID-19 pneumonia included a low sensitivity of 66%, a high specificity of 92%, a positive predictive value (PPV) of 83% and a negative predictive value (NPV) of 82%. When patients with positive COVID-19 RT-PCR test results were analyzed, the highest sensitivity, specificity, PPV and NPV of ER were 96%, 82%, 95%, 95% and 86%, respectively.
Conclusion: ER detected COVID-19 pneumonia in COVID-19 (+) patients with high diagnostic value and excluded inconsistent findings. Chest CT interpretation in the ER has a high diagnostic value. It is as important as any other radiologist in outbreak management in the ED.

CITATION

Kozak D, Bektaş AF, Korkut M, Işkorur C. Can chest computed tomography be useful to emergency residents in the diagnosis of COVID-19 pneumonia?. J CLIN MED KAZ. 2023;20(6):45-9. https://doi.org/10.23950/jcmk/13875

REFERENCES

  • Selvi F, Bedel C, Korkut M, et al. Can immature granulocytes predict mortality in coronavirus disease 2019 (COVID‑19) infection in patients with chronic kidney disease? Annals of Clinical and Analytical Medicine. 2021; S513-S517. https://doi.org/10.4328/ACAM.20719
  • Korkut M, Bedel C, Selvi F, et al. Can Peripheral Perfusion Index (PPI) Predict Disease Severity in COVID-19 Patients in the Emergency Department? Ibnosina Journal of Medicine and Biomedical Sciences. 2022; 14: 035-040. https://doi.org/10.1055/s-0042-1748776
  • Guo H, Zhong Q, Chen A, et al. Clinical Course and Virus Shedding of Mild and Moderate COVID-19 in South China: A Retrospective Study. Ann Clin Case Rep; 2264.
  • Zou L, Ruan F, Huang M, et al. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med. 2020; 382: 1177-1179. https://doi.org/10.1056/NEJMc2001737
  • Wu Z and McGoogan JMJj. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323:1239-1242. https://doi.org/10.1001/jama.2020.2648
  • Wölfel R, Corman VM, Guggemos W, et al. Virological assessment of hospitalized patients with COVID-2019. Nature. 2020; 581:465-469. https://doi.org/10.1038/s41586-020-2196-x
  • Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. The New England journal of medicine 2020; 382:1708-1720. https://doi.org/10.1056/NEJMoa2002032
  • Li Y and Xia L. Coronavirus Disease 2019 (COVID-19): Role of Chest CT in Diagnosis and Management. AJR American journal of roentgenology. 2020; 214:1280-1286. https://doi.org/10.2214/AJR.20.22954
  • Prokop M, van Everdingen W, van Rees Vellinga T, et al. CO-RADS: A Categorical CT Assessment Scheme for Patients Suspected of Having COVID-19-Definition and Evaluation. Radiology. 2020; 296: E97-e104. https://doi.org/10.1148/radiol.2020201473
  • Fleiss, J.L. Statistical Methods for Rates and Proportions, 2nd ed.; John Wiley & Sons Inc.: New York, NY,USA, 1981
  • Kim H, Hong H and Yoon SH. Diagnostic Performance of CT and Reverse Transcriptase Polymerase Chain Reaction for Coronavirus Disease 2019: A Meta-Analysis. Radiology. 2020; 296:E145-e155. https://doi.org/10.1148/radiol.2020201343
  • Esposito A, Palmisano A, Scotti GM, et al. Why is chest CT important for early diagnosis of COVID-19? Prevalence matters. MedRxiv 2020. https://doi.org/10.1101/2020.03.30.20047985
  • Hermans JJR, Groen J, Zwets E, et al. Chest CT for triage during COVID-19 on the emergency department: myth or truth? Emergency radiology 2020; 27:641-651. https://doi.org/10.1007/s10140-020-01821-1
  • Cakmak V, Herek D and Cakmak P. Diagnostic Performance of Radiology Residents in Thoracic CT Imaging in Emergency Radiology During The COVID-19 Pandemic. Current medical imaging. 2021; 17:1481-1486. https://doi.org/10.2174/1573405617666210702161433
  • Palmisano A, Scotti GM, Ippolito D, et al. Chest CT in the emergency department for suspected COVID-19 pneumonia. La Radiologia medica 2021; 126: 498-502. https://doi.org/10.1007/s11547-020-01302-y
  • Ducray V, Vlachomitrou AS, Bouscambert-Duchamp M, et al. Chest CT for rapid triage of patients in multiple emergency departments during COVID-19 epidemic: experience report from a large French university hospital. European radiology 2021; 31:795-803. https://doi.org/10.1007/s00330-020-07154-4
  • ACR Recommendations for the use of Chest Radiography and Computed Tomography (CT) for Suspected COVID-19 Infection. https://www.acr.org/Advocacy-and-Economics/ACR-Position Statements/Recommendations-for-Chest-Radiography-and-CT-for-Suspected-COVID19-Infection (March 11, 2020, accessed April 2023)
  • Bai HX, Hsieh B, Xiong Z, et al. Performance of Radiologists in Differentiating COVID-19 from Non-COVID-19 Viral Pneumonia at Chest CT. Radiology. 2020; 296:E46-e54. https://doi.org/10.1148/radiol.2020200823
  • Neri E, Miele V, Coppola F, et al. Use of CT and artificial intelligence in suspected or COVID-19 positive patients: statement of the Italian Society of Medical and Interventional Radiology. 2020; 125: 505-508. https://doi.org/10.1007/s11547-020-01197-9
  • Poortahmasebi V, Zandi M, Soltani S, et al. Clinical performance of RT-PCR and chest CT scan for COVID-19 diagnosis; a systematic review. Frontiers in Emergency Medicine. 2020; 4:e57-e57.