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The Impact of Chest Computed Tomography in a COVID-19 Reference Hospital - First Wave - Distrito Federal - Brazil

23 Pages Posted: 10 Jan 2022

See all articles by Gleim Dias de Souza

Gleim Dias de Souza

Asa Norte Regional Hospital - Radiology and Imaging Center

Luciana Rodrigues Queiroz de Souza

Asa Norte Regional Hospital - Radiology and Imaging Center

Gabriela Gomes de Souza

Universidade de Brasília - Radiology and Imaging Department

Thales Queiroz Souza

Universidade de Brasília

Ulysses Rodrigues Castro

Asa Norte Regional Hospital

Adriano Guimaraes Ibiapina

Asa Norte Regional Hospital

Paulo Henrique Ramos Feitosa

Asa Norte Regional Hospital - Pulmonology Service

Sergio Aron Ajzen

Federal University of São Paulo (UNIFESP)

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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

Souza, Gleim Dias de and Queiroz de Souza, Luciana Rodrigues and Gomes de Souza, Gabriela and Souza, Thales Queiroz and Castro, Ulysses Rodrigues and Ibiapina, Adriano Guimaraes and Feitosa, Paulo Henrique Ramos and Ajzen, Sergio Aron, The Impact of Chest Computed Tomography in a COVID-19 Reference Hospital - First Wave - Distrito Federal - Brazil. Available at SSRN: https://ssrn.com/abstract=4005199 or http://dx.doi.org/10.2139/ssrn.4005199

Gleim Dias de Souza (Contact Author)

Asa Norte Regional Hospital - Radiology and Imaging Center ( email )

Brasília - DF
Brazil

Luciana Rodrigues Queiroz de Souza

Asa Norte Regional Hospital - Radiology and Imaging Center

Brasília - DF
Brazil

Gabriela Gomes de Souza

Universidade de Brasília - Radiology and Imaging Department

Distrito Federal-Brasília
Brazil

Thales Queiroz Souza

Universidade de Brasília

Campus Universitário Darcy Ribeiro
Brasília, Distrito Federal 70910-900
Brazil

Ulysses Rodrigues Castro

Asa Norte Regional Hospital

Brasília - DF
Brazil

Adriano Guimaraes Ibiapina

Asa Norte Regional Hospital

Brasília - DF
Brazil

Paulo Henrique Ramos Feitosa

Asa Norte Regional Hospital - Pulmonology Service

Distrito Federal-Brasília
Brazil

Sergio Aron Ajzen

Federal University of São Paulo (UNIFESP)

Rua Sena Madureira, 1500 - 5º andar
Vila Clementino
São Paulo, Sao Paulo 04021001
Brazil

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