Figures
- FIGURE 1
Study population flowchart. ED: emergency department; CT: computed tomography.
Tables
- TABLE 1
Patient characteristics
All patients PCR positive PCR negative p-value Subjects n 187# 86 100 Age years 63.7±15.7 63.4±14.8 64.1±16.5 0.668 Male 108 (57.8) 50 (58.1) 58 (58.0) 0.97 Admission 140 (74.9) 65 (75.6) 75 (75.0) 0.855 Admission ED to IC 9 (4.8) 8 (9.3) 1 (1.0) <0.001 In hospital mortality 9 (4.8) 5 (5.8) 4 (4.0) 0.001 Obesity (based on clinical assessment) 52 (27.8) 27 (31.4) 25 (25) 0.676 Duration of symptoms days 6.5±5.1 7.3±4.1 5.8±5.8 0.007 Comorbidities Asthma 10 (5.3) 3 (3.5) 7 (7.0) 0.033 Chronic cardiovascular disease 44 (23.5) 18 (20.9) 26 (26.0) 0.104 COPD (GOLD stage >2) 30 (5.3) 12 (14.0) 18 (18.0) 0.134 Current malignancy 35 (18.7) 9 (10.5) 26 (26.0) <0.001 Diabetes mellitus 36 (19.3) 21 (24.4) 15 (15.0) 0.001 Laboratory analysis on admission CRP mg·L−1 median (interquartile range) 59 (81.5) 68 (83.8) 49.0 (80.8) 0.73 Procalcitonin ng·mL−1 median (interquartile range) 0.1 (0.25) 0.12 (0.21) 0.1 (0.37) 0.004 Positive blood culture 12 (6.4) 1 (1.2) 11 (11.0) 0.204 Positive influenza A/B 0 0 0 0.593 Observations Modified early warning score (MEWS) 2.6±1.8 2.9±1.6 2.3±1.8 0.605 Temperature °C 37.5±1.2 37.8±1.1 37.2±1.3 0.174 Respiratory rate min-1 21.2±6.9 21.9±7.2 20.7±6.7 0.888 Oxygen saturation % 95.8±3.2 94.9(3.5 96.4±2.8 0.165 Oxygen therapy 58 (0.31) 34 (39.5) 24 (24.0) 0.004 Intubation 9 (4.8) 8 (9.3) 1 (1.0) <0.001 Data are presented as mean±sd or n (%), unless otherwise stated. Statistically significant differences between the PCR positive and PCR negative groups are emphasised in bold text. ED: emergency department; IC: intensive care; GOLD: Global Initiative for Chronic Obstructive Lung Disease; CRP: C-reactive protein. #: One patient had an indeterminate PCR and no repeat PCR, therefore the total amount of patients (187) differs from the sum of the PCR positives (86) and PCR negatives (100).
- TABLE 2
Diagnostic results
PCR positive PCR negative Final diagnosis Lung ultrasound: positive 79 29 91 Lung ultrasound: negative 7 71 10 CT: positive 76 18 CT: negative 10 82 Data are presented as n. CT: computed tomography.
- TABLE 3
Diagnostic accuracy for COVID-19
Lung ultrasound versus PCR CT versus PCR Lung ultrasound versus COVID-19 diagnosis# Sensitivity % (95% CI) 91.9 (84.0–96.7) 88.4 (79.7–94.3) 90.1 (82.5–95.2) Specificity % (95% CI) 71.0 (61.1–79.6) 82.0 (73.1–89.0) 80.0 (69.9–87.9) Positive likelihood ratio 3.2 (2.3–4.3) 4.9 (3.2–7.5) 4.5 (2.9–6.9) Negative likelihood ratio 0.1 (0.06–0.24) 0.14 (0.08–0.26) 0.12 (0.07–0.2) PPV % (95% CI) 73.2 (66.6–78.8) 80.9 (73.4–86.6) 84.2 (77.7–89.2) NPV % (95% CI) 91.0 (83.1–95.4) 89.1 (82.0–93.7) 90.8 (81.7–95.6) Accuracy % (95% CI) 80.7 (74.2–86.1) 85.0 (79.0–89.8) 82.8 (76.6–87.9) CT: computed tomography; COVID-19: coronavirus disease 2019; PPV: positive predictive value; NPV: negative predictive value; CI: confidence interval. #: According to multidisciplinary team, COVID-19 is highly likely.
Supplementary Material
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Supplementary material 00539-2020.SUPPLEMENT
