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arXiv · 2007.15476

Diagnostic Accuracy of Computed Tomography for Identifying Hospitalization in Patients with Suspected COVID-19

Sergey P. Morozov·Roman V. Reshetnikov·Victor A. Gombolevskiy·Natalia V. Ledikhova·Ivan A. Blokhin·Vladislav G. Kljashtorny·Olesya A. Mokienko·Anton V. Vladzymyrskyy
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Abstract

The controversy of computed tomography (CT) use in COVID-19 screening is associated with ambiguous characteristics of chest CT as a diagnostic test. The reported values of CT sensitivity and specificity calculated using RT-PCR as a reference standard vary widely. The objective of this study was to reevaluate the diagnostic and prognostic value of CT using an alternative approach. This study included 973 symptomatic COVID-19 patients aged 42 $\pm$ 17 years, 56% females. We reviewed the disease dynamics between the initial and follow-up CT studies using a "CT0-4" grading system. Sensitivity and specificity were calculated as conditional probabilities that a patient's condition would improve or deteriorate relative to the initial CT study results. For the calculation of negative (NPV) and positive (PPV) predictive values, we estimated the COVID-19 prevalence in Moscow. We used several ARIMA and EST models with different parameters to fit the data on total cases of COVID-19 from March 6, 2020, to July 20, 2020, and forecast the incidence. The "CT0-4" grading scale demonstrated low sensitivity (28%) but high specificity (95%). The best statistical model for describing the pandemic in Moscow was ETS with multiplicative trend, error, and season type. According to our calculations, with the predicted prevalence of 2.1%, the values of NPV and PPV would be 98% and 10%, correspondingly. We associate the low sensitivity and PPV values with the small sample size of the patients with severe symptoms and non-optimal methodological setup for measuring these specific characteristics. The "CT0-4" grading scale was highly specific and predictive for identifying admissions to hospitals of COVID-19 patients. Despite the ambiguous accuracy, chest CT proved to be an effective practical tool for patient management during the pandemic, provided that the necessary infrastructure and human resources are available.

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Sergey P. Morozov, Roman V. Reshetnikov, Victor A. Gombolevskiy, Natalia V. Ledikhova, Ivan A. Blokhin, Vladislav G. Kljashtorny, Olesya A. Mokienko, Anton V. Vladzymyrskyy. 2020-07-29. Diagnostic Accuracy of Computed Tomography for Identifying Hospitalization in Patients with Suspected COVID-19. https://arxiv.org/abs/2007.15476

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