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Real-world evaluation of a computed tomography-first triage strategy for suspected Coronavirus disease 2019 in outpatients in Japan: An observational cohort study.
Miyake, Shigeta; Higurashi, Takuma; Jono, Takashi; Akimoto, Taisuke; Ogawa, Fumihiro; Oi, Yasufumi; Tanaka, Katsushi; Hara, Yu; Kobayashi, Nobuaki; Kato, Hideaki; Yamashiro, Tsuneo; Utsunomiya, Daisuke; Nakajima, Atsushi; Yamamoto, Tetsuya; Maeda, Shin; Kaneko, Takeshi; Takeuchi, Ichiro.
  • Miyake S; Team COVID-19, Yokohama City University Hospital.
  • Higurashi T; Department of Neurosurgery.
  • Jono T; Team COVID-19, Yokohama City University Hospital.
  • Akimoto T; Department of Gastroenterology and Hepatology.
  • Ogawa F; Team COVID-19, Yokohama City University Hospital.
  • Oi Y; Department of Neurology and Stroke Medicine.
  • Tanaka K; Team COVID-19, Yokohama City University Hospital.
  • Hara Y; Department of Neurosurgery.
  • Kobayashi N; Team COVID-19, Yokohama City University Hospital.
  • Kato H; Department of Emergency Medicine.
  • Yamashiro T; Team COVID-19, Yokohama City University Hospital.
  • Utsunomiya D; Department of Emergency Medicine.
  • Nakajima A; Team COVID-19, Yokohama City University Hospital.
  • Yamamoto T; Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama.
  • Maeda S; Team COVID-19, Yokohama City University Hospital.
  • Kaneko T; Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama.
  • Takeuchi I; Team COVID-19, Yokohama City University Hospital.
Medicine (Baltimore) ; 100(22): e26161, 2021 Jun 04.
Article in English | MEDLINE | ID: covidwho-1258818
Semantic information from SemMedBD (by NLM)
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ABSTRACT
ABSTRACT The Coronavirus disease 2019 pandemic continues to spread worldwide. Because of the absence of reliable rapid diagnostic systems, patients with symptoms of Coronavirus disease 2019 are treated as suspected of the disease. Use of computed tomography findings in Coronavirus disease 2019 are expected to be a reasonable method for triaging patients, and computed tomography-first triage strategies have been proposed. However, clinical evaluation of a computed tomography-first triage protocol is lacking.The aim of this study is to investigate the real-world efficacy and limitations of a computed tomography-first triage strategy in patients with suspected Coronavirus disease 2019.This was a single-center cohort study evaluating outpatients with fever who received medical examination at Yokohama City University Hospital, prospectively registered between 9 February and 5 May 2020. We treated according to the computed tomography-first triage protocol. The primary outcome was efficacy of the computed tomography-first triage protocol for patients with fever in an outpatient clinic. Efficacy of the computed tomography-first triage protocol for outpatients with fever was evaluated using sensitivity, specificity, positive predictive value, and negative predictive value. We conducted additional analyses of the isolation time of feverish outpatients and final diagnoses.In total, 108 consecutive outpatients with fever were examined at our hospital. Using the computed tomography-first triage protocol, 48 (44.9%) patients were classified as suspected Coronavirus disease 2019. Nine patients (18.8%) in this group were positive for severe acute respiratory syndrome coronavirus 2 using polymerase chain reaction; no patients in the group considered less likely to have Coronavirus disease 2019 tested positive for the virus. The protocol significantly shortened the duration of isolation for the not-suspected versus the suspected group (70.5 vs 1037.0 minutes, P < .001).Our computed tomography-first triage protocol was acceptable for screening patients with suspected Coronavirus disease 2019. This protocol will be helpful for appropriate triage, especially in areas where polymerase chain reaction is inadequate.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Tomography, X-Ray Computed / Triage / COVID-19 Type of study: Diagnostic study / Etiology study / Clinical Practice Guide / Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Asia Language: English Journal: Medicine (Baltimore) Year: 2021 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: Tomography, X-Ray Computed / Triage / COVID-19 Type of study: Diagnostic study / Etiology study / Clinical Practice Guide / Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Asia Language: English Journal: Medicine (Baltimore) Year: 2021 Document Type: Article