Medical University of Plovdiv, Plovdiv, Bulgaria.
Folia Med (Plovdiv). 2023 Feb 28;65(1):99-110. doi: 10.3897/folmed.65.e71406.
The emergence of severe acute respiratory syndrome coronavirus disease (COVID-19) in China at the end of 2019 caused a massive global outbreak that has become a major public health issue.
Our aim was to investigate the diagnostic potential of chest CT in screening patients suspected of having COVID-19 in high-prevalence settings.
This is a real-life, prospective, observational study involving 260 patients. All patients received chest CT scan at the emergency department (ED) of Kaspela University Hospital, Plovdiv, Bulgaria and RT-PCR testing for suspected COVID-19 from March 27 to December 31, 2020. COVID-19 likelihood was assessed by assigning each CT scan to a particular category of the COVID-19 Reporting and Data System (CO-RADS). IBM SPSS v. 26 was used to process the data.
The male-to-female distribution ratio was 1.4:1 - 150 (57.7%) males vs. 110 (42.3%) females (p=0.014). The median age was 55 yrs (range 46-65 yrs). Discharged patients were 247 (95.0%), the rest died in the COVID-19 intensive care unit. Males were 4.13 times more likely to be diagnosed with CO-RADS≥3 score than females. Increasing age was associated with an increased likelihood of being classified with higher CO-RADS scores. The ROC curves analysis demonstrated that CO-RADS ≥3 was the optimal cutoff for discrimi-nating between a positive and negative PCR (Youden's index J=0.67), with an AUC of 0.825 (95% CI 0.72-0.93), sensitivity of 91.9% (95% CI 87.7%-95.1%), specificity of 75.0% (95% CI 53.3%-90.2%) and accuracy of 76.4% (95% CI 70.7%-81.4%).
The results of this study reveal that a CT examination can provide a quick and accurate diagnosis of patients with sus-pected COVID-19 infection, whereas the PCR test is time-consuming, and the delay in receiving results can be substantial when the incidence curve begins to grow rapidly.
2019 年底，严重急性呼吸综合征冠状病毒病（COVID-19）在中国的出现引发了大规模的全球疫情爆发，成为重大公共卫生问题。
本研究旨在探讨胸部 CT 在高流行地区筛查疑似 COVID-19 患者中的诊断潜力。
这是一项真实的、前瞻性、观察性研究，共纳入 260 例患者。所有患者于 2020 年 3 月 27 日至 12 月 31 日在保加利亚普罗夫迪夫的卡佩拉大学医院急诊科接受胸部 CT 扫描，并接受疑似 COVID-19 的 RT-PCR 检测。通过将每个 CT 扫描分配到 COVID-19 报告和数据系统（CO-RADS）的特定类别来评估 COVID-19 的可能性。采用 IBM SPSS v. 26 处理数据。
男女比例为 1.4:1-150 例（57.7%）男性与 110 例（42.3%）女性（p=0.014）。中位年龄为 55 岁（范围 46-65 岁）。247 例患者出院（95.0%），其余患者死于 COVID-19 重症监护病房。男性被诊断为 CO-RADS≥3 评分的可能性是女性的 4.13 倍。年龄越大，被归类为 CO-RADS 评分较高的可能性越高。ROC 曲线分析表明，CO-RADS≥3 是区分 PCR 阳性和阴性的最佳截断值（Youden 指数 J=0.67），AUC 为 0.825（95%CI 0.72-0.93），敏感性为 91.9%（95%CI 87.7%-95.1%），特异性为 75.0%（95%CI 53.3%-90.2%），准确性为 76.4%（95%CI 70.7%-81.4%）。
本研究结果表明，CT 检查可快速准确地诊断疑似 COVID-19 感染患者，而 PCR 检测耗时较长，当发病率曲线开始快速增长时，等待结果的时间可能会很长。
