Fiche publication
Date publication
juin 2021
Journal
Radiology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr OHANA Mickaël
Tous les auteurs :
Revel MP, Boussouar S, de Margerie-Mellon C, Saab I, Lapotre T, Mompoint D, Chassagnon G, Milon A, Lederlin M, Bennani S, Molière S, Debray MP, Bompard F, Dangeard S, Hani C, Ohana M, Bommart S, Jalaber C, El Hajjam M, Petit I, Fournier L, Khalil A, Brillet PY, Bellin MF, Redheuil A, Rocher L, Bousson V, Rousset P, Grégory J, Deux JF, Dion E, Valeyre D, Porcher R, Jilet L, Abdoul H
Lien Pubmed
Résumé
Background There are conflicting data regarding the diagnostic performance of Chest computed tomography (CT) for COVID-19 pneumonia. Disease extent on CT has been reported to influence prognosis. Purpose To create a large publicly available dataset and assess the diagnostic and prognostic value of CT in COVID-19 pneumonia. Materials and Methods This multicenter observational retrospective cohort study (ClinicalTrials.gov: NCT04355507) involved 20 French university hospitals. Eligible subjects presented at the emergency departments of the hospitals involved between March 1st and April 30th, 2020 and underwent both thoracic CT and RT-PCR for suspected COVID-19 pneumonia. CT images were read blinded to initial reports, RT-PCR, demographic characteristics, clinical symptoms, and outcome. Readers classified CT scans as positive or negative for COVID-19, based on criteria published by the French Society of Radiology. Multivariable logistic regression was used to develop a model predicting severe outcome (intubation or death) at 1-month follow-up in subjects positive for both RT-PCR and CT, using clinical and radiological features. Results Of 10,930 subjects screened for eligibility, 10,735 (median age 65 years, interquartile range, 51-77 years; 6,147 men) were included and 6,448 (60.0%) had a positive RT-PCR result. With RT-PCR as reference, the sensitivity and specificity and CT were 80.2% (95%CI: 79.3, 81.2) and 79.7% (95%CI: 78.5, 80.9), respectively with strong agreement between junior and senior radiologists (Gwet's AC1 coefficient: 0.79) Of all the variables analysed, the extent of pneumonia on CT (OR 3.25, 95%CI: 2.71, 3.89) was the best predictor of severe outcome at one month. A score based solely on clinical variables predicted a severe outcome with an AUC of 0.64 (95%CI: 0.62, 0.66), improving to 0.69 (95%CI: 0.6, 0.71) when it also included the extent of pneumonia and coronary calcium score on CT. Conclusion Using pre-defined criteria, CT reading is not influenced by reader's experience and helps predict the outcome at one month. Published under a CC BY 4.0 license. See also the editorial by Rubin.
Référence
Radiology. 2021 Jun 29;:210384
