Contribution of chest CT in patients suspected of having COVID-19 and medico-economic impact of the COVID-19 pandemic in the radiology department of Fann (Dakar-Senegal)
DOI:
https://doi.org/10.55715/jaim.v13i1.145Keywords:
COVID-19, Chest CT, Radiology, Economic impact, AfricaAbstract
Objectives:To evaluate the contribution of thoracic CT in the diagnosis of patients suspected of having COVID-19 in comparison with the current reference technique (RT-PCR) and to determine the medico-economic impact of COVID-19 in the radiology and medical imaging department of the National Hospital University Center of Fann.
Materials and methods:It was a retrospective, descriptive study over a period of 4 months between April 1 and July 31, 2020, in the radiology department of the CHNU of Fann.
Patients were included if they were clinically suspected of having COVID-19 and had undergone a thoracic CT scan and a nasopharyngeal swab for RT-PCR analysis.
The parameters studied were epidemiological data, clinical data, images suggestive of COVID-19 (ground glass opacities, condensation, reticulations, lesion topography, extent of lesions), the existence or not of pulmonary embolism, abnormalities in favor of superinfection, associated lesions, impact on the rate of attendance of the different modalities, and impact on revenue. The diagnostic performance of CT was calculated with RT-PCR as a reference tool.
Results:In our series the median age was 62 years and the sex ratio 1.61.
Fever was reported in 7 patients (2.23%); cough in 17 patients (5.41%); dyspnea in 30 patients (9.55%) and ARDS in 63 patients (20.07%). The clinic was not specified in 163 patients (51.91%). Chest CT came back normal in 20 patients (6.37%), suggestive of COVID-19 in 274 patients (87.26%) and not suggestive of COVID-19 in 20 patients (6.37%). RT-PCR was positive in 125 patients (39.80%). The sensitivity and specificity of CT were 91.2% and 15.34% respectively, and the PPV, NPV and accuracy rate were 42%, 72.5% and 45.5% respectively. The decrease in attendance was estimated at 59% for standard radiography, 55% for ultrasound, 24% for CT and 87% for mammography. In our study, there was a 40% decrease in revenue in the second quarter of 2020 compared to the first quarter.
Conclusion: Chest CT has a high sensitivity for the diagnosis of COVID-19. As such, it can be considered a primary tool for detecting lung lesions suggestive of COVID-19 pneumonia.
The medico-economic impact of COVID-19 has been significant.
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