Abstract 13883: The Presence of Coronary Calcifications on the Chest CT Scan Performed to Diagnose Covid-19 is Associated With a Worse Prognosis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jean Guillaume DILLINGER ◽  
Fatima Azzahra Benmessaoud ◽  
Theo Pezel ◽  
Sebastian Voicu ◽  
Georgios Sideris ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Metabolic Diseases ◽  
Invasive Mechanical Ventilation ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Cross Sectional ◽  
Risk Patients ◽  
Cv Disease ◽  
Worse Prognosis ◽  
Chest Ct Scan

Introduction: With the coronavirus disease (COVID-19) outbreak, early identification of the most severely impacted patients is essential. Previous cardiovascular (CV) and metabolic diseases affect the COVID-19 prognosis. In high CV risk patients, coronary artery calcification (CAC) is associated with a higher incidence of CV outcomes. Hypothesis: To assess the association between the presence of CAC on the chest CT performed to diagnose COVID-19 and the occurrence of severe COVID-19 outcomes. Methods: Cross-sectional study on consecutive patients from 40 to 80 years of age, hospitalized for COVID-19 infection, with a chest CT without contrast injection performed on the day of admission. Patients with CV disease history were excluded. CAC was defined as any area ≥1mm2 with a density >130 Hounsfield units on the known coronary track. The primary outcome was the rate of patients with severe progression, defined as a score of 5 to 7 on the WHO Blueprint expert group scale (noninvasive or invasive mechanical ventilation, extracorporeal membrane oxygenation, death) within 8 days following hospital admission. Results: 134 consecutive patients (60±8 years) were included. CAC was detected in 61 patients (46%). The primary outcome occurred in 29 (48%) of those 61 patients with CAC compared to 15 (21%) without CAC (HR 2.9; 95% CI [1.6 - 5.3]; p=0.0008). In patients ≤60 years (n=69), CAC was detected in 28% and the primary outcome occurred in 58% of patients with CAC compared to 16% without CAC (p=0.0006). In patients >60 years (n=65), CAC was detected in 63% of patients. In this population, the primary outcome occurred in 43% of patients with CAC compared to 30% without CAC without significant interaction. Multivariate analysis showed that CAC was independently associated with poor prognosis (HR 3.4; 95% CI [1.5 - 7.8]; p= 0.004). Conclusions: The evidence of CAC on initial chest CT performed in patients with COVID-19 is associated with a worse prognosis.

scholarly journals Evaluation of Chest CT Scan as a Screening and Diagnostic Tool in Trauma Patients with Coronavirus Disease 2019 (COVID-19): A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Hossein Abdolrahimzadeh Fard ◽  
Salahaddin Mahmudi-Azer ◽  
Sepideh Sefidbakht ◽  
Pooya Iranpour ◽  
Shahram Bolandparvaz ◽  
...  
Keyword(s):  
Ct Scan ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Trauma Patients ◽  
Ct Scanner ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chest Ct Scan

Background. The lack of enough medical evidence about COVID-19 regarding optimal prevention, diagnosis, and treatment contributes negatively to the rapid increase in the number of cases globally. A chest computerized tomography (CT) scan has been introduced as the most sensitive diagnostic method. Therefore, this research aimed to examine and evaluate the chest CT  scan as a screening measure of COVID-19 in trauma patients. Methods. This cross-sectional study was conducted in Rajaee Hospital in Shiraz from February to May 2020. All patients underwent unenhanced CT with a 16-slice CT scanner. The CT scans were evaluated in a blinded manner, and the main CT scan features were described and classified into four groups according to RSNA recommendation. Subsequently, the first two Radiological Society of North America (RSNA) categories with the highest probability of COVID-19 pneumonia (i.e., typical and indeterminate) were merged into the “positive CT scan group” and those with radiologic features with the least probability of COVID-19 pneumonia into “negative CT scan group.” Results. Chest CT scan had a sensitivity of 68%, specificity of 56%, positive predictive value of 34.8%, negative predictive value of 83.7%, and accuracy of 59.3% in detecting COVID-19 among trauma patients. Moreover, for the diagnosis of COVID-19 by CT scan in asymptomatic individuals, a sensitivity of 100%, specificity of 66.7%, and negative predictive value of 100% were obtained ( p value: 0.05). Conclusion. Findings of the study indicated that the CT scan’s sensitivity and specificity is less effective in diagnosing trauma patients with COVID-19 compared with nontraumatic people.

scholarly journals Triggers of defensive medical behaviours: a cross-sectional study among physicians in the Netherlands

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e025108 ◽  
Author(s):  
Erik Renkema ◽  
Kees Ahaus ◽  
Manda Broekhuis ◽  
Maria Tims
Keyword(s):  
Primary Outcome ◽  
Response Rate ◽  
Cross Sectional Study ◽  
Avoidance Behaviour ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Self Blame ◽  
Prescribe Medicine ◽  
Risk Patients ◽  
Defensive Behaviours

ObjectivesThis study investigated whether the attitudes of physicians towards justified and unjustified litigation, and their perception of patient pressure in demanding care, influence their use of defensive medical behaviours.DesignCross-sectional survey using exploratory factor analysis was conducted to determine litigation attitude and perceived patient pressure factors. Regression analyses were used to regress these factors on to the ordering of extra tests or procedures (defensive assurance behaviour) or the avoidance of high-risk patients or procedures (defensive avoidance behaviour).SettingData were collected from eight Dutch hospitals.ParticipantsRespondents were 160 physicians and 54 residents (response rate 25%) of the hospital departments of (1) anaesthesiology, (2) colon, stomach and liver diseases, (3) gynaecology, (4) internal medicine, (5) neurology and (6) surgery.Primary outcome measuresRespondents’ application of defensive assurance and avoidance behaviours.Results‘Disapproval of justified litigation’ and ‘Concerns about unjustified litigation’ were positively related to both assurance (β=0.21, p<0.01, and β=0.28, p<0.001, respectively) and avoidance (β=0.16, p<0.05, and β=0.18, p<0.05, respectively) behaviours. ‘Self-blame for justified litigation’ was not significantly related to both defensive behaviours. Perceived patient pressures to refer (β=0.18, p<0.05) and to prescribe medicine (β=0.23, p<0.01) had direct positive relationships with assurance behaviour, whereas perceived patient pressure to prescribe medicine was also positively related to avoidance behaviour (β=0.14, p<0.05). No difference was found between physicians and residents in their defensive medical behaviour.ConclusionsPhysicians adopted more defensive medical behaviours if they had stronger thoughts and emotions towards (un)justified litigation. Further, physicians should be aware that perceived patient pressure for care can lead to them adopting defensive behaviours that negatively affects the quality and safety of patient care.

CLINICAL CORRELATION AND AGREEMENT BETWEEN THE CHEST CT SCAN AND CHEST X-RAY FINDINGS IN TUBERCULIN-POSITIVE CHILDREN: A PROSPECTIVE CROSS SECTIONAL STUDY

CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 40S
Author(s):  
Beverly D. Delacruz ◽  
Nerissa A. Deleon ◽  
Milagros S. Bautista ◽  
Fernando Ayuyao ◽  
Teresita Deguia
Keyword(s):  
Ct Scan ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Clinical Correlation ◽  
Sectional Study ◽  
Cross Sectional ◽  
X Ray ◽  
Chest X Ray ◽  
Chest Ct Scan

scholarly journals Spectrum of Ground Glass Opacities in Chest CT of COVID-19 Patients in Karbala, Iraq

2020 ◽  
Vol 6 (3) ◽  
Author(s):  
Dhia Mahdey Alghazali ◽  
Maytham A Maamera ◽  
Haider Fadel Alkazraji ◽  
Ali A Abutiheen
Keyword(s):  
Ct Scan ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Ground Glass ◽  
P Value ◽  
Late Time ◽  
Chi Square ◽  
Cross Sectional ◽  
Male Predominance ◽  
Chest Ct Scan

Objective: To describe the ground-glass opacities (GGO) seen in chest CT scans of COVID-19 patients and to estimate the association between these opacities and the time of clinical presentation. Patients and methods: A cross-sectional study involving 81 COVID-19 confirmed patients in Imam Al-Hussein Medical city in Karbala-Iraq during the period from March 1st to April 20, 2020. Chest CT scan findings were evaluated by 2 radiologists and categorized accordingly. Chi-square test was used for statistical analysis and a P value of less than 0.05 was considered statistically significant. Results: The mean age ± standard deviation of patients was 53.5 ± 17.1 years, with male predominance as 63 (77.8%) of cases were males. Nearly half of the patients were presented within the second week of starting the sign and symptoms. GGO was present in 79 scans (97.5%), followed by consolidation opacity in 29 patients (35.8%). Four types of GGO were described. Bilateral multiple subpleural GGO was the most prevalent type. There was a significant association between late time of patient presentation and more extensive GGO type. Conclusion: Chest CT scan is valuable in the diagnosis and management of COVID-19 cases. The presence of GGO in CT scan of a patient that previously had no chest illness is highly suggestive of COVID-19 disease, different types of GGO were seen. Bilateral confluent type of GGO is associated with more serious and delayed status and warns the need for intensive care unit admission.

scholarly journals Evaluation of Chest CT scan as a screening and diagnostic tool in trauma patients with coronavirus disease 2019 (COVID-19): a cross-sectional study in southern Iran

2020 ◽  
Author(s):  
Hossein Abdolrahimzadeh Fard ◽  
Salahaddin Mahmudi-Azer ◽  
Sepideh Sefidbakht ◽  
Pooya Iranpour ◽  
Shahram Bolandparvaz ◽  
...  
Keyword(s):  
Ct Scan ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Trauma Patients ◽  
Ct Scanner ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chest Ct Scan

Abstract Purpose: The lack of enough medical evidence about COVID-19 regarding optimal prevention, diagnosis, and treatment contributes negatively to the rapid increase in the number of cases globally. A chest computerized tomography (CT) scan has been introduced as the most sensitive diagnostic method. Therefore, this research aimed to examine and evaluate the chest CT scan as a screening measure of COVID-19 in trauma patients.Methods: This cross-sectional study was conducted in Rajaee Hospital in Shiraz from February to May 2020. All patients underwent unenhanced CT with a 16-slice CT scanner. The CT-scans were evaluated in a blinded manner and main CT scan features were described and classified into four groups according to RSNA recommendation. Subsequently, the first two RSNA categories with the highest probability of COVID pneumonia (i.e. typical and indeterminate) were merged into the “positive CT scan group” and those with radiologic features with the least probability of COVID pneumonia into “negative CT scan group”.Results: Chest CT scan had a sensitivity (68%), specificity (56%), positive predictive value (34.8%), negative predictive value (83.7%), and accuracy (59.3%) in detecting COVID-19 among trauma patients. Also, for the diagnosis of COVID-19 by CT scan in asymptomatic individuals a sensitivity of 100% and a specificity of 66.7% and a negative predictive value of 100% was obtained.Conclusion: Findings of the study indicated that the CT scan's sensitivity and specificity is less effective in diagnosing trauma patients with COVID-19 in comparison to non-traumatic people.

scholarly journals Clinical predictors of abnormal chest CT scan findings following blunt chest trauma: A cross-sectional study

2020 ◽  
Vol 23 (1) ◽  
pp. 51-55
Author(s):  
Saeed Safari ◽  
Melina Farbod ◽  
Hamidreza Hatamabadi ◽  
Mahmoud Yousefifard ◽  
Navid Mokhtari
Keyword(s):  
Ct Scan ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Sectional Study ◽  
Clinical Predictors ◽  
Cross Sectional ◽  
Abnormal Chest ◽  
Chest Ct Scan

scholarly journals A Multicenter Survey on the Trend of Chest CT Scan Utilization: Tracing the First Footsteps of COVID-19 in Iran

2020 ◽  
Vol 23 (11) ◽  
pp. 787-793
Author(s):  
Amir Reza Radmard ◽  
Ali Gholamrezanezhad ◽  
Seyed Ali Montazeri ◽  
Amir Kasaeian ◽  
Nemat Nematollahy ◽  
...  
Keyword(s):  
Ct Scan ◽  
Viral Disease ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Ct Scans ◽  
Cross Sectional ◽  
Large Cities ◽  
Multicenter Survey ◽  
Negative Balance ◽  
Chest Ct Scan

Background: Chest computed tomography (CT) scan has been used widely to diagnose COVID-19 in Iran. Objectives: To trace the footsteps of COVID-19 in Iran by exploring the trend in using chest CT scans and its economic impact on radiology departments. Methods: In this cross-sectional study, the number of imaging examinations from 33 tertiary radiology departments in 9 large cities of Iran was collected from September 23, 2019 to March 20, 2020 (Months 1 to 6) and the corresponding months in 2018–2019. Results: A 50.2% increase was noted in the chest CT scan utilization in 2019–2020 compared to 2018–2019. This increase was +15%, +15%, +27%, +2%, +1% in Months 1–5 of 2019–2020, respectively. In Month 6 of 2019–2020, a 251% increase in the acquisition of chest CT scans was observed compared to the Month 6 of 2018–2019. Following negative balance of revenue from Month 1 to 5 with respect to the inflation rate, the total income in Month 6 was further 1.5% less than the same Month in 2018–19. Conclusion: The observed peak in chest CT utilization in Month 3 prior to the surge in Month 6 could be explained by the seasonal influenza. However, unawareness about an emerging viral disease, i.e. COVID-19, might have underutilized chest CT in Months 4 and 5 before the official announcement in Month 6. The unbalanced increase in the workload of radiology departments in the shortage of cardiothoracic radiologists with the simultaneous decrease in income initiated a vicious cycle that worsened the economic repercussions of the pandemic.

scholarly journals Descriptive Analysis of Chest Computed Tomography Scan in Coronavirus Disease 2019 Pneumonia: Correlation with Reverse Transcription-polymerase Chain Reaction and Clinical Features

2021 ◽  
Vol 9 (B) ◽  
pp. 865-871
Author(s):  
Rusli Muljadi ◽  
Mira Yuniarti ◽  
Ricardo Tan ◽  
Teodorus Alfons Pratama ◽  
Ignatius Bima Prasetya ◽  
...  
Keyword(s):  
Social Sciences ◽  
Ct Scan ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Cross Sectional ◽  
The Social ◽  
Polymerase Chain ◽  
Chest Ct Scan

BACKGROUND: Reverse transcriptase-polymerase chain reaction (RT-PCR) is the primary diagnostic tool to confirm coronavirus disease 2019 (COVID-2019) due to its high specificity. However, it has relatively low sensitivity and time consuming. In contrast, chest computed tomography (CT) has high sensitivity and achieves quick results. It may, therefore, play a critical role in screening and diagnosing COVID-19. A cross-sectional study was done in 212 patients with confirmed cases and patients under surveillance for COVID-19 tested for RT-PCR and chest CT scan. Statistical analysis was performed using SPSS Version 23 (Statistical Package for the Social Sciences, IBM Corp., Armonk, NY, USA). AIM: We aim to investigate the diagnostic value of chest CT in correlation to RT-PCR in Indonesia. METHODS: A cross-sectional study was done in 212 patients with confirmed cases and patients under surveillance for COVID-19 tested for RT-PCR and chest CT scan. Statistical analysis was performed using SPSS Version 23 (Statistical Package for the Social Sciences, IBM Corp., Armonk, NY, USA). RESULTS: From a total of 212 patients, 92% of them were diagnosed as confirmed cases of COVID-19. It was found that the sensitivity of CT scan for COVID-19 patients was 72.3% (65.5% and 78.5%) with positive predictive value (PPV) of 93.9% (90.9% and 96.0%) and the sensitivity and PPV improve in symptomatic patients. Typical chest CT scan lesions were 8.0 times which were more likely (3.9–16.4; p <0.001) to be detected in symptomatic patients while patients with severe CT scan findings were 4.4 times more likely (3.0–6.5; p <0.001) to be admitted to the intensive care unit. CONCLUSION: A high PPV suggests that a chest CT scan can detect COVID-19 lesions, but the absence of the lesions would not exclude the disease’s presence.

scholarly journals Evaluation of Chest CT scan as a screening and diagnostic tool in trauma patients with coronavirus disease 2019 (COVID-19): a cross-sectional study in southern Iran

2020 ◽  
Author(s):  
Hossein Abdolrahimzadeh Fard ◽  
Salahaddin Mahmudi-Azer ◽  
Sepideh Sefidbakht ◽  
Pooya Iranpour ◽  
Shahram Bolandparvaz ◽  
...  
Keyword(s):  
Ct Scan ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Trauma Patients ◽  
Ct Scanner ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chest Ct Scan

Abstract Background: The lack of enough medical evidence about COVID-19 regarding optimal prevention, diagnosis, and treatment contributes negatively to the rapid increase in the number of cases globally. A chest computerized tomography (CT) scan has been introduced as the most sensitive diagnostic method. Therefore, this research aimed to examine and evaluate the chest CT scan as a screening measure of COVID-19 in trauma patients. Method: This cross-sectional study was conducted in Rajaee Hospital in Shiraz from February to May 2020. All patients underwent unenhanced CT with a 16-slice CT scanner. The CT-scans were evaluated in a blinded manner and main CT scan features were described and classified into four groups according to RSNA recommendation. Subsequently, the first two RSNA categories with the highest probability of COVID pneumonia (i.e. typical and indeterminate) were merged into the “positive CT scan group” and those with radiologic features with the least probability of COVID pneumonia into “negative CT scan group”.Results: Chest CT scan had a sensitivity (68%), specificity (56%), positive predictive value (34.8%), negative predictive value (83.7%), and accuracy (59.3%) in detecting COVID-19 among trauma patients. Also, for the diagnosis of COVID-19 by CT scan in asymptomatic individuals a sensitivity of 100% and a specificity of 66.7% and a negative predictive value of 100% was obtained.Conclusion: Findings of the study indicated that the CT scan's sensitivity and specificity is less effective in diagnosing trauma patients with COVID-19 in comparison to non-traumatic people.

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