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Radiology . Efficacy of Chest CT for COVID-19 Pneumonia in France

tetano

Editor, Senior Moderator
Radiology


. 2020 Sep 1;202568.
doi: 10.1148/radiol.2020202568. Online ahead of print.
Efficacy of Chest CT for COVID-19 Pneumonia in France


Guillaume Herpe[SUP] 1 [/SUP], Mathieu Lederlin[SUP] 1 [/SUP], Mathieu Naudin[SUP] 1 [/SUP], Micka?l Ohana[SUP] 1 [/SUP], Kathia Chaumoitre[SUP] 1 [/SUP], Jules Gregory[SUP] 1 [/SUP], Val?rie Vilgrain[SUP] 1 [/SUP], Cornelia Anna Freitag[SUP] 1 [/SUP], Constance De Margerie-Mellon[SUP] 1 [/SUP], Violaine Flory[SUP] 1 [/SUP], Marie Ludwig[SUP] 1 [/SUP], Lydiane Mondot[SUP] 1 [/SUP], Isabelle Fitton[SUP] 1 [/SUP], Alexis Jacquier[SUP] 1 [/SUP], Robert Raymond[SUP] 1 [/SUP], Paul Ardilouze[SUP] 1 [/SUP], Isabelle Petit[SUP] 1 [/SUP], Alban Gervaise[SUP] 1 [/SUP], Olivier Bayle[SUP] 1 [/SUP], Arielle Crombe[SUP] 1 [/SUP], Magloire Mekuko Sokeng[SUP] 1 [/SUP], Cl?ment Thomas[SUP] 1 [/SUP], Geraldine Henry[SUP] 1 [/SUP], Virginie Bliah[SUP] 1 [/SUP], Thomas Le Tat[SUP] 1 [/SUP], Marc-Samir Guillot[SUP] 1 [/SUP], Paul Gendrin[SUP] 1 [/SUP], Marc Garetier[SUP] 1 [/SUP], Estelle Bertolle[SUP] 1 [/SUP], Catherine Montagne[SUP] 1 [/SUP], Benjamin Langlet[SUP] 1 [/SUP], Abdulrazak Kalaaji[SUP] 1 [/SUP], Hampar Kayayan[SUP] 1 [/SUP], Florian Desmots[SUP] 1 [/SUP], Benjamin Dhaene[SUP] 1 [/SUP], Pierre-Jean Saulnier[SUP] 1 [/SUP], Remy Guillevin[SUP] 1 [/SUP], Jean-Michel Bartoli[SUP] 1 [/SUP], Jean-Paul Beregi[SUP] 1 [/SUP], Jean Pierre Tasu[SUP] 1 [/SUP]



Affiliations

Abstract

Background The role and performance of chest CT in the diagnosis of the coronavirus disease 2019 (COVID-19) pandemic remains under active investigation. Purpose To evaluate the French national experience using Chest CT for COVID-19, results of chest CT and RT-PCR were compared together and with the final discharge diagnosis used as reference standard. Materials and Methods A structured CT scan survey (NCT04339686) was sent to 26 hospital radiology departments in France between March 2 and April 24 2020. These dates correspond to the peak of the national COVID-19 epidemic. Radiology departments were selected to reflect the estimated geographical prevalence heterogeneities of the epidemic. All symptomatic patients suspected of having a COVID-19 pneumonia who underwent within 48 hours both initial chest CT and at least one RT-PCR testing were included. The final discharge diagnosis, based on multiparametric items, was recorded. Data for each center were prospectively collected and gathered each week. Test efficacy was determined by using Mann-Whitney Test, Student's t-test, Chi-square test and Pearson's correlation. A p value <.05 determined statistical significance. Results Twenty-six of 26 hospital radiology departments responded to the survey with 7500 patients entered; 2652 did not have RT-PCR results or had unknown or excess delay between RT-PCR and CT. After exclusions, 4824 patients (mean age 64, ? 19 yrs, 2669 males) were included. Using final diagnosis as the reference, 2564 of the 4824 patients were positive for COVID-19 (53%). Sensitivity, specificity, NPV and PPV of chest CT for diagnosing COVID-19 were 2319/2564 (90%, 95% confidence interval [CI]: 89, 91), 2056/2260 (91%, 95%CI: 91, 92%), 2056/2300 (89%, 95%CI; 87, 90%) and 2319/2524 (92%, 95%CI 91, 93%) respectively. There was no significant difference for chest CT efficacy among the 26 geographically separate sites, each with varying amounts of disease prevalence. Conclusion Use of chest CT for the initial diagnosis and triage of suspected COVID-19 patients was successful.
 
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