Rate of True-Positive Findings of COVID-19 Typical Appearance at Chest CT per RSNA Consensus Guidelines in an Increasingly Vaccinated Population.
Rate of True-Positive Findings of COVID-19 Typical Appearance at Chest CT per RSNA Consensus Guidelines in an Increasingly Vaccinated Population.
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COVID-19的真实阳性发现的速率在越来越多的疫苗接种人群中，每RSNA共识指南的典型外观。
作者：
RSNA关于COVID-19相关胸部CT的共识指南被广泛使用，但据作者所知，尚未评估接种疫苗患者中COVID-19肺炎的真阳性发现率。使用RSNA指南，在聚合酶链反应（PCR）证实的COVID-19感染的完全接种疫苗患者与未接种疫苗患者中，评估胸部CT中COVID-19典型外观的真阳性发现率。包括在2021年1月至2022年1月期间在四级学术医疗中心接受胸部CT检查后7天内，在胸部CT图像上有典型表现的COVID-19患者，以及一次COVID-19 PCR检测结果呈阳性或两次检测结果呈阴性的患者。真阳性结果定义为胸部CT图像解释为COVID-19典型表现和7天内PCR证实的COVID-19感染。构建逻辑回归模型，以量化PCR结果与疫苗接种状态、疫苗接种状态与COVID-19变异体以及疫苗接种状态与月数之间的关联。纳入了652例CT扫描归类为典型外观的患者（中位年龄59岁; IQR 48-72岁; 371例男性[57%]）。在这些患者中，483人（74%）未接种疫苗，169人（26%）完全接种疫苗。接种疫苗的患者与未接种疫苗的患者相比，CT图像上被评定为典型外观的真阳性结果的总体发生率较低（70/169 [41%; 95%CI：34，49] vs 352/483 [73%; 95%CI：69，77];比值比[OR]，3.8 [95%CI：2.6，5.5]; P <0.001）。在COVID-19变异体α高峰期，与完全接种疫苗的患者相比，未接种疫苗的患者更有可能在CT图像上出现真阳性结果（OR，16; 95% CI：6，42; P < .001）和Delta（OR，8; 95% CI：4，16; P <0.001），但在Omicron变体的峰值期间没有发现统计学差异（OR，1.7; 95% CI：0.3，11; P = 0.56）。确诊为COVID-19突破性感染的完全接种疫苗的患者在胸部CT中COVID-19典型表现的真阳性发现率较低。© RSNA，2022 本文提供补充材料
RSNA consensus guidelines for COVID-19–related chest CT are widely used but, to the knowledge of the authors, their rate of true-positive findings for COVID-19 pneumonia in vaccinated patients has not been assessed. To assess the rate of true-positive findings of typical appearance for COVID-19 at chest CT by using RSNA guidelines in fully vaccinated patients with polymerase chain reaction (PCR)-confirmed COVID-19 infection compared with unvaccinated patients. Included were patients with COVID-19 who had typical appearance on chest CT images and one PCR test for COVID-19 with a positive result or two tests with negative results within 7 days of undergoing chest CT between January 2021 and January 2022 at a quaternary academic medical center. True-positive findings were defined as chest CT images interpreted as COVID-19 typical appearance and PCR-confirmed COVID-19 infection within 7 days. Logistic regression models were constructed to quantify the association between PCR results and vaccination status, vaccination status and COVID-19 variants, and vaccination status and number of months. Included were 652 patients (median age, 59 years; IQR, 48–72 years; 371 men [57%]) with CT scans classified as typical appearance. Of those patients, 483 (74%) were unvaccinated and 169 (26%) were fully vaccinated. The overall rate of true-positive findings on CT images rated as typical appearance was lower in vaccinated versus unvaccinated patients (70 of 169 [41%; 95% CI: 34, 49] vs 352 of 483 [73%; 95% CI: 69, 77]; odds ratio [OR], 3.8 [95% CI: 2.6, 5.5]; P < .001). Unvaccinated patients were more likely to have true-positive findings on CT images compared with fully vaccinated patients during the peaks of COVID-19 variants Alpha (OR, 16; 95% CI: 6, 42; P < .001) and Delta (OR, 8; 95% CI: 4, 16; P < .001), but no statistical differences were found during the peak of the Omicron variant (OR, 1.7; 95% CI: 0.3, 11; P = .56). Fully vaccinated patients with confirmed COVID-19 breakthrough infections had lower rates of true-positive findings of COVID-19 typical appearance at chest CT. © RSNA, 2022 Supplemental material is available for this article
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DOI：
10.1056/nejmoa2119451
发表时间：
2022-04-21
期刊：
The New England journal of medicine
影响因子：
--
作者：
Andrews N;Stowe J;Kirsebom F;Toffa S;Rickeard T;Gallagher E;Gower C;Kall M;Groves N;O'Connell AM;Simons D;Blomquist PB;Zaidi A;Nash S;Iwani Binti Abdul Aziz N;Thelwall S;Dabrera G;Myers R;Amirthalingam G;Gharbia S;Barrett JC;Elson R;Ladhani SN;Ferguson N;Zambon M;Campbell CNJ;Brown K;Hopkins S;Chand M;Ramsay M;Lopez Bernal J
通讯作者：
Lopez Bernal J
DOI：
10.1056/nejmoa2035389
发表时间：
2021-02-04
期刊：
The New England journal of medicine
影响因子：
--
作者：
Baden LR;El Sahly HM;Essink B;Kotloff K;Frey S;Novak R;Diemert D;Spector SA;Rouphael N;Creech CB;McGettigan J;Khetan S;Segall N;Solis J;Brosz A;Fierro C;Schwartz H;Neuzil K;Corey L;Gilbert P;Janes H;Follmann D;Marovich M;Mascola J;Polakowski L;Ledgerwood J;Graham BS;Bennett H;Pajon R;Knightly C;Leav B;Deng W;Zhou H;Han S;Ivarsson M;Miller J;Zaks T;COVE Study Group
通讯作者：
COVE Study Group
DOI：
10.1148/ryct.2020200276
发表时间：
2020-10-01
期刊：
RADIOLOGY-CARDIOTHORACIC IMAGING
影响因子：
--
作者：
Som, Avik;Lang, Min;Little, Brent P.
通讯作者：
Little, Brent P.
影响因子：
120.7
作者：
Accorsi, Emma K.;Britton, Amadea;Verani, Jennifer R.
通讯作者：
Verani, Jennifer R.
影响因子：
12.7
作者：
Wang, Lulan;Cheng, Genhong
通讯作者：
Cheng, Genhong