Coronavirus Disease 2019 (COVID-19) diagnostic technologies: A country-based retrospective analysis of screening and containment procedures during the first wave of the pandemic
Coronavirus Disease 2019 (COVID-19) diagnostic technologies: A country-based retrospective analysis of screening and containment procedures during the first wave of the pandemic
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DOI：
10.1016/j.clinimag.2020.08.014
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发表时间：
2020-11-01
期刊：
影响因子：
2.1
通讯作者：
Gholamrezanezhad, Ali
中科院分区：
文献类型：
--
作者：
Fields, Brandon K. K.;Demirjian, Natalie L.;Gholamrezanezhad, Ali
自 2019 年 12 月首次报告新型冠状病毒以来，2019 年冠状病毒病 (COVID-19) 大流行已使世界各地的医疗系统陷入瘫痪。虽然许多初步筛查方案以病毒的实验室检测为中心，但与胸部计算机断层扫描相比，早期检测被认为敏感性较差，尤其是在无症状疾病中。再加上世界许多地区缺乏逆转录聚合酶链反应（RT-PCR）检测试剂盒，这些地区转而使用先进的成像技术作为一线筛查方式。然而，与之前的严重急性呼吸系统综合症和中东呼吸系统综合症冠状病毒流行相比，胸部 X 光检查并未表现出最佳的敏感性，因此在一线筛查方案中没有多大用处。尽管当前的国家和国际指南建议使用 RT-PCR 作为 COVID-19 疑似病例的主要筛查工具，但机构和区域协议在发布通用建议时必须考虑当地资源的可用性。迄今为止，世界范围内成功的遏制和社会缓解战略都取决于政府的统一反应，尽管这些做法的基本意识形态可能并不广泛适用于许多西方国家。随着放射科工作人员的压力持续加大，早期结果表明，在未来几个月内，使用机器学习算法作为风险分层模式将发挥巨大的作用。
Since first report of a novel coronavirus in December of 2019, the Coronavirus Disease 2019 (COVID-19) pandemic has crippled healthcare systems around the world. While many initial screening protocols centered around laboratory detection of the virus, early testing assays were thought to be poorly sensitive in comparison to chest computed tomography, especially in asymptomatic disease. Coupled with shortages of reverse transcription polymerase chain reaction (RT-PCR) testing kits in many parts of the world, these regions instead turned to the use of advanced imaging as a first-line screening modality. However, in contrast to previous Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome coronavirus epidemics, chest X-ray has not demonstrated optimal sensitivity to be of much utility in first-line screening protocols. Though current national and international guidelines recommend for the use of RT-PCR as the primary screening tool for suspected cases of COVID-19, institutional and regional protocols must consider local availability of resources when issuing universal recommendations. Successful containment and social mitigation strategies worldwide have been thus far predicated on unified governmental responses, though the underlying ideologies of these practices may not be widely applicable in many Western nations. As the strain on the radiology workforce continues to mount, early results indicate a promising role for the use of machine-learning algorithms as risk stratification schema in the months to come.