Validation of Diagnostic Accuracy and Disease Severity Correlation of Chest Computed Tomography Severity Scores in Patients with COVID-19 Pneumonia
The aim of our study was to establish and compare the diagnostic accuracy and clinical applicability of published chest CT severity scoring systems used for COVID-19 pneumonia assessment and to propose the most efficient CT scoring system with the highest diagnostic performance and the most accurate...
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MDPI AG
2024-01-01
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Online Access: | https://www.mdpi.com/2075-4418/14/2/148 |
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author | Ivan Brumini Doris Dodig Iva Žuža Klaudija Višković Armin Mehmedović Nina Bartolović Helena Šušak Đurđica Cekinović Grbeša Damir Miletić |
author_facet | Ivan Brumini Doris Dodig Iva Žuža Klaudija Višković Armin Mehmedović Nina Bartolović Helena Šušak Đurđica Cekinović Grbeša Damir Miletić |
author_sort | Ivan Brumini |
collection | DOAJ |
description | The aim of our study was to establish and compare the diagnostic accuracy and clinical applicability of published chest CT severity scoring systems used for COVID-19 pneumonia assessment and to propose the most efficient CT scoring system with the highest diagnostic performance and the most accurate prediction of disease severity. This retrospective study included 218 patients with PCR-confirmed SARS-CoV-2 infection and chest CT. Two radiologists blindly evaluated CT scans and calculated nine different CT severity scores (CT SSs). The diagnostic validity of CT SSs was tested by ROC analysis. Interobserver agreement was excellent (intraclass correlation coefficient: 0.982–0.995). The predominance of either consolidations or a combination of consolidations and ground-glass opacities (GGOs) was a predictor of more severe disease (both <i>p</i> < 0.005), while GGO prevalence alone was not. Correlation between all CT SSs was high, ranging from 0.848 to 0.971. CT SS 30 had the highest diagnostic accuracy (AUC = 0.805) in discriminating mild from severe COVID-19 disease compared to all the other proposed scoring systems (AUC range 0.755–0.788). In conclusion, CT SS 30 achieved the highest diagnostic accuracy in predicting the severity of COVID-19 disease while maintaining simplicity, reproducibility, and applicability in complex clinical settings. |
first_indexed | 2024-03-08T11:00:41Z |
format | Article |
id | doaj.art-f439152443a64dc0b46eb145817fec5f |
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issn | 2075-4418 |
language | English |
last_indexed | 2024-03-08T11:00:41Z |
publishDate | 2024-01-01 |
publisher | MDPI AG |
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series | Diagnostics |
spelling | doaj.art-f439152443a64dc0b46eb145817fec5f2024-01-26T16:01:00ZengMDPI AGDiagnostics2075-44182024-01-0114214810.3390/diagnostics14020148Validation of Diagnostic Accuracy and Disease Severity Correlation of Chest Computed Tomography Severity Scores in Patients with COVID-19 PneumoniaIvan Brumini0Doris Dodig1Iva Žuža2Klaudija Višković3Armin Mehmedović4Nina Bartolović5Helena Šušak6Đurđica Cekinović Grbeša7Damir Miletić8Department of Diagnostic and Interventional Radiology, University Hospital Rijeka, Kresimirova 42, 51000 Rijeka, CroatiaEuropean Telemedicine Clinic S.L., C/Marina 16-18, 08005 Barcelona, SpainDepartment of Diagnostic and Interventional Radiology, University Hospital Rijeka, Kresimirova 42, 51000 Rijeka, CroatiaUniversity Hospital for Infectious Diseases “Dr. Fran Mihaljevic”, Mirogojska 8, 10000 Zagreb, CroatiaEuropean Telemedicine Clinic S.L., C/Marina 16-18, 08005 Barcelona, SpainDepartment of Diagnostic and Interventional Radiology, University Hospital Rijeka, Kresimirova 42, 51000 Rijeka, CroatiaUniversity Hospital for Infectious Diseases “Dr. Fran Mihaljevic”, Mirogojska 8, 10000 Zagreb, CroatiaDepartment for Infectious Diseases, University Hospital Rijeka, Kresimirova 42, 51000 Rijeka, CroatiaDepartment of Diagnostic and Interventional Radiology, University Hospital Rijeka, Kresimirova 42, 51000 Rijeka, CroatiaThe aim of our study was to establish and compare the diagnostic accuracy and clinical applicability of published chest CT severity scoring systems used for COVID-19 pneumonia assessment and to propose the most efficient CT scoring system with the highest diagnostic performance and the most accurate prediction of disease severity. This retrospective study included 218 patients with PCR-confirmed SARS-CoV-2 infection and chest CT. Two radiologists blindly evaluated CT scans and calculated nine different CT severity scores (CT SSs). The diagnostic validity of CT SSs was tested by ROC analysis. Interobserver agreement was excellent (intraclass correlation coefficient: 0.982–0.995). The predominance of either consolidations or a combination of consolidations and ground-glass opacities (GGOs) was a predictor of more severe disease (both <i>p</i> < 0.005), while GGO prevalence alone was not. Correlation between all CT SSs was high, ranging from 0.848 to 0.971. CT SS 30 had the highest diagnostic accuracy (AUC = 0.805) in discriminating mild from severe COVID-19 disease compared to all the other proposed scoring systems (AUC range 0.755–0.788). In conclusion, CT SS 30 achieved the highest diagnostic accuracy in predicting the severity of COVID-19 disease while maintaining simplicity, reproducibility, and applicability in complex clinical settings.https://www.mdpi.com/2075-4418/14/2/148COVID-19pneumoniaSARS-CoV-2thorax |
spellingShingle | Ivan Brumini Doris Dodig Iva Žuža Klaudija Višković Armin Mehmedović Nina Bartolović Helena Šušak Đurđica Cekinović Grbeša Damir Miletić Validation of Diagnostic Accuracy and Disease Severity Correlation of Chest Computed Tomography Severity Scores in Patients with COVID-19 Pneumonia Diagnostics COVID-19 pneumonia SARS-CoV-2 thorax |
title | Validation of Diagnostic Accuracy and Disease Severity Correlation of Chest Computed Tomography Severity Scores in Patients with COVID-19 Pneumonia |
title_full | Validation of Diagnostic Accuracy and Disease Severity Correlation of Chest Computed Tomography Severity Scores in Patients with COVID-19 Pneumonia |
title_fullStr | Validation of Diagnostic Accuracy and Disease Severity Correlation of Chest Computed Tomography Severity Scores in Patients with COVID-19 Pneumonia |
title_full_unstemmed | Validation of Diagnostic Accuracy and Disease Severity Correlation of Chest Computed Tomography Severity Scores in Patients with COVID-19 Pneumonia |
title_short | Validation of Diagnostic Accuracy and Disease Severity Correlation of Chest Computed Tomography Severity Scores in Patients with COVID-19 Pneumonia |
title_sort | validation of diagnostic accuracy and disease severity correlation of chest computed tomography severity scores in patients with covid 19 pneumonia |
topic | COVID-19 pneumonia SARS-CoV-2 thorax |
url | https://www.mdpi.com/2075-4418/14/2/148 |
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