Chest computed tomography and alveolar-arterial oxygen gradient as rapid tools to diagnose and triage mildly symptomatic COVID-19 pneumonia patients
| Autor: | Jan Peringa, Marlise P. de Roos, Paul Bresser, Pieter-Paul W. Hekking, Herre J. Reesink, Iris D. Kilsdonk, Nynke Dijkstra, Peter W.A. Kunst |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Receiver operating characteristic business.industry lcsh:R lcsh:Medicine 030204 cardiovascular system & hematology Early warning score medicine.disease Logistic regression Triage 030218 nuclear medicine & medical imaging Oxygen tension 03 medical and health sciences Pneumonia 0302 clinical medicine Internal medicine Cardiology medicine Breathing Original Article business Perfusion |
| Zdroj: | ERJ Open Research, Vol 7, Iss 1 (2021) ERJ Open Research article-version (AM) Accepted Manuscript |
| ISSN: | 2312-0541 |
| Popis: | BackgroundIn the coronavirus disease 2019 (COVID-19) pandemic, rapid clinical triage is crucial to determine which patients need hospitalisation. We hypothesised that chest computed tomography (CT) and alveolar-arterial oxygen tension ratio (A-a) gradient may be useful to triage these patients, since they reflect the severity of the pneumonia-associated ventilation/perfusion abnormalities.MethodsA retrospective analysis was performed in 235 consecutive patients suspected for COVID-19. The diagnostic protocol included low-dose chest CT and arterial blood gas analysis. In patients with CT-based COVID-19 pneumonia, the association between “need for hospitalisation” and A-a gradient was investigated by a multivariable logistic regression model. The A-a gradient was tested as a predictor for need for hospitalisation using receiver operating characteristic curve analysis and a logistic regression model.Results72 out of 235 patients (mean±sd age 55.5±14.6 years, 40% female) screened by chest CT showed evidence for COVID-19 pneumonia. In these patients, A-a gradient was shown to be a predictor of need for hospitalisation, with an optimal decision level (cut-off) of 36.4 mmHg (95% CI 0.70–0.91, pConclusionLow-dose chest CT and the A-a gradient may serve as rapid and accurate tools to diagnose COVID-19 pneumonia and to select mildly symptomatic patients in need for hospitalisation. |
| Databáze: | OpenAIRE |
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