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Determinants of Chest X-Ray Sensitivity for COVID- 19: A Multi-Institutional Study in the United States.
Stephanie, Stephanie; Shum, Thomas; Cleveland, Heather; Challa, Suryanarayana R; Herring, Allison; Jacobson, Francine L; Hatabu, Hiroto; Byrne, Suzanne C; Shashi, Kumar; Araki, Tetsuro; Hernandez, Jose A; White, Charles S; Hossain, Rydhwana; Hunsaker, Andetta R; Hammer, Mark M.
Afiliación
  • Stephanie S; Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); De
  • Shum T; Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); De
  • Cleveland H; Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); De
  • Challa SR; Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); De
  • Herring A; Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); De
  • Jacobson FL; Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); De
  • Hatabu H; Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); De
  • Byrne SC; Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); De
  • Shashi K; Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); De
  • Araki T; Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); De
  • Hernandez JA; Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); De
  • White CS; Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); De
  • Hossain R; Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); De
  • Hunsaker AR; Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); De
  • Hammer MM; Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); De
Radiol Cardiothorac Imaging ; 2(5): e200337, 2020 Oct.
Article en En | MEDLINE | ID: mdl-33778628
ABSTRACT

PURPOSE:

To evaluate the sensitivity, specificity, and severity of chest x-rays (CXR) and chest CTs over time in confirmed COVID-19+ and COVID-19- patients and to evaluate determinants of false negatives.

METHODS:

In a retrospective multi-institutional study, 254 RT-PCR verified COVID-19+ patients with at least one CXR or chest CT were compared with 254 age- and gender-matched COVID-19- controls. CXR severity, sensitivity, and specificity were determined with respect to time after onset of symptoms; sensitivity and specificity for chest CTs without time stratification. Performance of serial CXRs against CTs was determined by comparing area under the receiver operating characteristic curves (AUC). A multivariable logistic regression analysis was performed to assess factors related to false negative CXR.

RESULTS:

COVID-19+ CXR severity and sensitivity increased with time (from sensitivity of 55% at ≤2 days to 79% at >11 days; p<0.001 for trends of both severity and sensitivity) whereas CXR specificity decreased over time (from 83% to 70%, p=0.02). Serial CXR demonstrated increase in AUC (first CXR AUC=0.79, second CXR=0.87, p=0.02), and second CXR approached the accuracy of CT (AUC=0.92, p=0.11). COVID-19 sensitivity of first CXR, second CXR, and CT was 73%, 83%, and 88%, whereas specificity was 80%, 73%, and 77%, respectively. Normal and mild severity CXR findings were the largest factor behind false-negative CXRs (40% normal and 87% combined normal/mild). Young age and African-American ethnicity increased false negative rates.

CONCLUSION:

CXR sensitivity in COVID-19 detection increases with time, and serial CXRs of COVID-19+ patients has accuracy approaching that of chest CT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies Idioma: En Revista: Radiol Cardiothorac Imaging Año: 2020 Tipo del documento: Article
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies Idioma: En Revista: Radiol Cardiothorac Imaging Año: 2020 Tipo del documento: Article