Emergency department CT examinations demonstrate no evidence of early viral circulation at the start of the COVID-19 pandemic—a multicentre epidemiological study
Abstract Background Biological studies suggested that the COVID-19 outbreak in France occurred before the first official diagnosis on January 24, 2020. We investigated this controversial topic using a large collection of chest CTs performed throughout French emergency departments within 6 months bef...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2024-01-01
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| Series: | Insights into Imaging |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13244-023-01590-8 |
| _version_ | 1797349867567185920 |
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| author | Amandine Crombé Claire Dupont François Casalonga Mylène Seux Nicolas Favard Agnès Coulon Thomas Jurkovic Hubert Nivet Guillaume Gorincour |
| author_facet | Amandine Crombé Claire Dupont François Casalonga Mylène Seux Nicolas Favard Agnès Coulon Thomas Jurkovic Hubert Nivet Guillaume Gorincour |
| author_sort | Amandine Crombé |
| collection | DOAJ |
| description | Abstract Background Biological studies suggested that the COVID-19 outbreak in France occurred before the first official diagnosis on January 24, 2020. We investigated this controversial topic using a large collection of chest CTs performed throughout French emergency departments within 6 months before the 1st lockdown. Results Overall, 49,311 consecutive patients (median age: 60 years, 23,636/49,311 [47.9%] women) with available chest CT images and reports from 61 emergency departments between September 1, 2020, and March 16, 2020 (day before the 1st French lockdown), were retrospectively included in this multicentre study. In the macroscopic analysis of reports automatically (labelled for presence of ground glass opacities [GGOs], reticulations, and bilateral and subpleural abnormalities), we found a significant breakpoint on February 17, 2020, for the weekly time series with 1, 2 and ≥ 3 of these 4 radiological features, with 146/49,311 (0.3%) patients showing bilateral abnormalities and ground glass opacities (GGOs) from that day. According to radiologists, 22/146 (15.1%) CT images showed typical characteristics of COVID-19, including 4/146 (2.7%) before February 2020. According to hospital records, one patient remained without microbial diagnosis, two patients had proven influenza A and one patient had concomitant influenza A and mycoplasma infection. Conclusion These results suggest that SARS-CoV-2 was not circulating in the areas covered by the 61 emergency departments involved in our study before the official beginning of the COVID-19 outbreak in France. In emergency patients, the strong resemblance among mycoplasma, influenza A and SARS-CoV-2 lung infections on chest CT and the nonspecificity of CT patterns in low prevalence periods is stressed. Critical relevance statement We proposed here an innovative approach to revisit a controversial ‘real’ start of the COVID-19 pandemic in France based on (1) a population-level approach combining text mining, time series analysis and an epidemiological dataset and (2) a patient-level approach with careful retrospective reading of chest CT scans complemented by analysis of samples performed contemporarily to the chest CT. We showed no evidence that SARS-CoV-2 was actively circulating in France before February 2020. Graphical Abstract |
| first_indexed | 2024-03-08T12:37:34Z |
| format | Article |
| id | doaj.art-847a2bb67daa4c17a246aa958fe0b83c |
| institution | Directory Open Access Journal |
| issn | 1869-4101 |
| language | English |
| last_indexed | 2024-03-08T12:37:34Z |
| publishDate | 2024-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Insights into Imaging |
| spelling | doaj.art-847a2bb67daa4c17a246aa958fe0b83c2024-01-21T12:24:06ZengSpringerOpenInsights into Imaging1869-41012024-01-0115111610.1186/s13244-023-01590-8Emergency department CT examinations demonstrate no evidence of early viral circulation at the start of the COVID-19 pandemic—a multicentre epidemiological studyAmandine Crombé0Claire Dupont1François Casalonga2Mylène Seux3Nicolas Favard4Agnès Coulon5Thomas Jurkovic6Hubert Nivet7Guillaume Gorincour8IMADISIMADISIMADISIMADISIMADISIMADISIMADISIMADISIMADISAbstract Background Biological studies suggested that the COVID-19 outbreak in France occurred before the first official diagnosis on January 24, 2020. We investigated this controversial topic using a large collection of chest CTs performed throughout French emergency departments within 6 months before the 1st lockdown. Results Overall, 49,311 consecutive patients (median age: 60 years, 23,636/49,311 [47.9%] women) with available chest CT images and reports from 61 emergency departments between September 1, 2020, and March 16, 2020 (day before the 1st French lockdown), were retrospectively included in this multicentre study. In the macroscopic analysis of reports automatically (labelled for presence of ground glass opacities [GGOs], reticulations, and bilateral and subpleural abnormalities), we found a significant breakpoint on February 17, 2020, for the weekly time series with 1, 2 and ≥ 3 of these 4 radiological features, with 146/49,311 (0.3%) patients showing bilateral abnormalities and ground glass opacities (GGOs) from that day. According to radiologists, 22/146 (15.1%) CT images showed typical characteristics of COVID-19, including 4/146 (2.7%) before February 2020. According to hospital records, one patient remained without microbial diagnosis, two patients had proven influenza A and one patient had concomitant influenza A and mycoplasma infection. Conclusion These results suggest that SARS-CoV-2 was not circulating in the areas covered by the 61 emergency departments involved in our study before the official beginning of the COVID-19 outbreak in France. In emergency patients, the strong resemblance among mycoplasma, influenza A and SARS-CoV-2 lung infections on chest CT and the nonspecificity of CT patterns in low prevalence periods is stressed. Critical relevance statement We proposed here an innovative approach to revisit a controversial ‘real’ start of the COVID-19 pandemic in France based on (1) a population-level approach combining text mining, time series analysis and an epidemiological dataset and (2) a patient-level approach with careful retrospective reading of chest CT scans complemented by analysis of samples performed contemporarily to the chest CT. We showed no evidence that SARS-CoV-2 was actively circulating in France before February 2020. Graphical Abstracthttps://doi.org/10.1186/s13244-023-01590-8Computed tomographyTime series analysisCoronavirus disease 2019SARS-CoV-2Report text mining |
| spellingShingle | Amandine Crombé Claire Dupont François Casalonga Mylène Seux Nicolas Favard Agnès Coulon Thomas Jurkovic Hubert Nivet Guillaume Gorincour Emergency department CT examinations demonstrate no evidence of early viral circulation at the start of the COVID-19 pandemic—a multicentre epidemiological study Insights into Imaging Computed tomography Time series analysis Coronavirus disease 2019 SARS-CoV-2 Report text mining |
| title | Emergency department CT examinations demonstrate no evidence of early viral circulation at the start of the COVID-19 pandemic—a multicentre epidemiological study |
| title_full | Emergency department CT examinations demonstrate no evidence of early viral circulation at the start of the COVID-19 pandemic—a multicentre epidemiological study |
| title_fullStr | Emergency department CT examinations demonstrate no evidence of early viral circulation at the start of the COVID-19 pandemic—a multicentre epidemiological study |
| title_full_unstemmed | Emergency department CT examinations demonstrate no evidence of early viral circulation at the start of the COVID-19 pandemic—a multicentre epidemiological study |
| title_short | Emergency department CT examinations demonstrate no evidence of early viral circulation at the start of the COVID-19 pandemic—a multicentre epidemiological study |
| title_sort | emergency department ct examinations demonstrate no evidence of early viral circulation at the start of the covid 19 pandemic a multicentre epidemiological study |
| topic | Computed tomography Time series analysis Coronavirus disease 2019 SARS-CoV-2 Report text mining |
| url | https://doi.org/10.1186/s13244-023-01590-8 |
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