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[Construction and evaluation of a novel diagnosis process for 2019-Corona Virus Disease].

Identifieur interne : 000C95 ( Ncbi/Merge ); précédent : 000C94; suivant : 000C96

[Construction and evaluation of a novel diagnosis process for 2019-Corona Virus Disease].

Auteurs : Z. Xiong [République populaire de Chine] ; L. Fu [République populaire de Chine] ; H. Zhou [République populaire de Chine] ; J K Liu [République populaire de Chine] ; A M Wang [République populaire de Chine] ; Y. Huang [République populaire de Chine] ; X. Huang [République populaire de Chine] ; B. Yi [République populaire de Chine] ; J. Wu [République populaire de Chine] ; C H Li [République populaire de Chine] ; J. Quan [République populaire de Chine] ; M. Li [République populaire de Chine] ; Y S Leng [République populaire de Chine] ; W J Luo [République populaire de Chine] ; C P Hu [République populaire de Chine] ; W H Liao [République populaire de Chine]

Source :

RBID : pubmed:32157849

Abstract

Objective: To construct and evaluate a diagnosis process for 2019-Corona Virus Disease (COVID-19). Methods: A continuous cohort of adults and adolescent (≥12 years) who screened COVID-19 was included in Xiangya Hospital of Central South University from January 23 to February 3, 2020 in which cases were divided the test library and the verification library. Their gender, age, onset time were recorded. Take epidemiological history, fever, and the blood lymphocytes decline as clinical indicators, used CT to evaluate the possibility of COVID-19 and range of lung involvement. According to the current national standards, throat swabs of suspected cases were collected and the nucleic acid of COVID-19 was detected by reverse transcription-polymerase chain reaction (RT-PCR). The Xiangya process was constructed according to multi-index, compared with clinical indicators, CT results and national standards, the efficiency of detecting confirmed cases were verified in the test and verification library. Results: A continuous cohort of 382 adults who screened COVID-19 was included in which 261 cases were in the test library and 121 cases were in the verification library. In the 382 cases, 192 were males (50.3%) and 190 were females (49.7%), with a median age of 35 years (range: 15-92 years). There were 183 cases (47.9%) with epidemiological history, 275 cases (72.0%) with fever, 212 cases (55.5%) with decreased hemolytic lymphocytes, CT positive 114 cases (29.8%), 43 cases (11.3%) with positive CT-COVID-19, and 30 cases (7.9%) with positive throat swab nucleic acid. Compared with clinical indicators, the sensitivity and specificity of CT were 0.950 and 0.704, respectively. The accuracy of CT to make a definite diagnosis was higher than that of epidemiological history, fever, and blood lymph count decline (0.809 vs 0.660, 0.532, 0.596, P=0.001, 0.002, 0.003, respectively). The sensitivity of this process and the program recommended by the Health Commission all were high (all were 1.000) , and the specificity and accuracy of the process were higher than the program recommended by the Health Commission (0.872 vs 0.765, 0.778 vs 0.592, both P<0.001). The CT-COVID-19 would have reduced the missed diagnosis rate caused by false negative of nucleic acid test (31 vs 64, difference rate 51.6%), the positive rate of nucleic acid test was 64.5% (20/31). In validation library, the specificity and accuracy of the Xiangya process was 0.967, the positive rate of nucleic acid test was 76.9% (10/13). Conclusions: The Xiangya process can predict the nucleic acid test results of COVID-19 well, and can be applied as a reliable basis for confirmed cases detection in adults and adolescent (≥12 years) in areas other than Hubei during the epidemic period of COVID-19. The cohort size needs to be increased for further validation.

DOI: 10.3760/cma.j.cn112137-20200228-00499
PubMed: 32157849

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<name sortKey="Liu, J K" sort="Liu, J K" uniqKey="Liu J" first="J K" last="Liu">J K Liu</name>
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<name sortKey="Huang, Y" sort="Huang, Y" uniqKey="Huang Y" first="Y" last="Huang">Y. Huang</name>
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<name sortKey="Huang, X" sort="Huang, X" uniqKey="Huang X" first="X" last="Huang">X. Huang</name>
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<name sortKey="Yi, B" sort="Yi, B" uniqKey="Yi B" first="B" last="Yi">B. Yi</name>
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<nlm:affiliation>Department of Clinical Laboratory, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
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<name sortKey="Wu, J" sort="Wu, J" uniqKey="Wu J" first="J" last="Wu">J. Wu</name>
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<name sortKey="Li, M" sort="Li, M" uniqKey="Li M" first="M" last="Li">M. Li</name>
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<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Respiratory and Critical Care Medicine, Xiangya Hospital of Central South University, Changsha 410008</wicri:regionArea>
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<name sortKey="Hu, C P" sort="Hu, C P" uniqKey="Hu C" first="C P" last="Hu">C P Hu</name>
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<name sortKey="Liao, W H" sort="Liao, W H" uniqKey="Liao W" first="W H" last="Liao">W H Liao</name>
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<title xml:lang="en">[Construction and evaluation of a novel diagnosis process for 2019-Corona Virus Disease].</title>
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<nlm:affiliation>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
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<name sortKey="Fu, L" sort="Fu, L" uniqKey="Fu L" first="L" last="Fu">L. Fu</name>
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<wicri:regionArea>Department of Infectious Diseases, Xiangya Hospital of Central South University, Changsha 410008</wicri:regionArea>
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<name sortKey="Zhou, H" sort="Zhou, H" uniqKey="Zhou H" first="H" last="Zhou">H. Zhou</name>
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<nlm:affiliation>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
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<name sortKey="Liu, J K" sort="Liu, J K" uniqKey="Liu J" first="J K" last="Liu">J K Liu</name>
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<nlm:affiliation>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008</wicri:regionArea>
<wicri:noRegion>Changsha 410008</wicri:noRegion>
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<name sortKey="Wang, A M" sort="Wang, A M" uniqKey="Wang A" first="A M" last="Wang">A M Wang</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Emergency, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Emergency, Xiangya Hospital of Central South University, Changsha 410008</wicri:regionArea>
<wicri:noRegion>Changsha 410008</wicri:noRegion>
</affiliation>
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<name sortKey="Huang, Y" sort="Huang, Y" uniqKey="Huang Y" first="Y" last="Huang">Y. Huang</name>
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<nlm:affiliation>Department of Infectious Diseases, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Diseases, Xiangya Hospital of Central South University, Changsha 410008</wicri:regionArea>
<wicri:noRegion>Changsha 410008</wicri:noRegion>
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<name sortKey="Huang, X" sort="Huang, X" uniqKey="Huang X" first="X" last="Huang">X. Huang</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Infection Control Center, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infection Control Center, Xiangya Hospital of Central South University, Changsha 410008</wicri:regionArea>
<wicri:noRegion>Changsha 410008</wicri:noRegion>
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<name sortKey="Yi, B" sort="Yi, B" uniqKey="Yi B" first="B" last="Yi">B. Yi</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Clinical Laboratory, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Clinical Laboratory, Xiangya Hospital of Central South University, Changsha 410008</wicri:regionArea>
<wicri:noRegion>Changsha 410008</wicri:noRegion>
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<name sortKey="Wu, J" sort="Wu, J" uniqKey="Wu J" first="J" last="Wu">J. Wu</name>
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<nlm:affiliation>Department of Medical Section, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Medical Section, Xiangya Hospital of Central South University, Changsha 410008</wicri:regionArea>
<wicri:noRegion>Changsha 410008</wicri:noRegion>
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<name sortKey="Li, C H" sort="Li, C H" uniqKey="Li C" first="C H" last="Li">C H Li</name>
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<nlm:affiliation>Department of Infection Control Center, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infection Control Center, Xiangya Hospital of Central South University, Changsha 410008</wicri:regionArea>
<wicri:noRegion>Changsha 410008</wicri:noRegion>
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<name sortKey="Quan, J" sort="Quan, J" uniqKey="Quan J" first="J" last="Quan">J. Quan</name>
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<nlm:affiliation>Department of Infectious Diseases, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Diseases, Xiangya Hospital of Central South University, Changsha 410008</wicri:regionArea>
<wicri:noRegion>Changsha 410008</wicri:noRegion>
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<author>
<name sortKey="Li, M" sort="Li, M" uniqKey="Li M" first="M" last="Li">M. Li</name>
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<nlm:affiliation>Department of Respiratory and Critical Care Medicine, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Respiratory and Critical Care Medicine, Xiangya Hospital of Central South University, Changsha 410008</wicri:regionArea>
<wicri:noRegion>Changsha 410008</wicri:noRegion>
</affiliation>
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<name sortKey="Leng, Y S" sort="Leng, Y S" uniqKey="Leng Y" first="Y S" last="Leng">Y S Leng</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008</wicri:regionArea>
<wicri:noRegion>Changsha 410008</wicri:noRegion>
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<name sortKey="Luo, W J" sort="Luo, W J" uniqKey="Luo W" first="W J" last="Luo">W J Luo</name>
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<nlm:affiliation>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008</wicri:regionArea>
<wicri:noRegion>Changsha 410008</wicri:noRegion>
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<name sortKey="Hu, C P" sort="Hu, C P" uniqKey="Hu C" first="C P" last="Hu">C P Hu</name>
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<nlm:affiliation>Department of Respiratory and Critical Care Medicine, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Respiratory and Critical Care Medicine, Xiangya Hospital of Central South University, Changsha 410008</wicri:regionArea>
<wicri:noRegion>Changsha 410008</wicri:noRegion>
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<name sortKey="Liao, W H" sort="Liao, W H" uniqKey="Liao W" first="W H" last="Liao">W H Liao</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008</wicri:regionArea>
<wicri:noRegion>Changsha 410008</wicri:noRegion>
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<series>
<title level="j">Zhonghua yi xue za zhi</title>
<idno type="ISSN">0376-2491</idno>
<imprint>
<date when="2020" type="published">2020</date>
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<div type="abstract" xml:lang="en">
<b>Objective:</b>
To construct and evaluate a diagnosis process for 2019-Corona Virus Disease (COVID-19).
<b>Methods:</b>
A continuous cohort of adults and adolescent (≥12 years) who screened COVID-19 was included in Xiangya Hospital of Central South University from January 23 to February 3, 2020 in which cases were divided the test library and the verification library. Their gender, age, onset time were recorded. Take epidemiological history, fever, and the blood lymphocytes decline as clinical indicators, used CT to evaluate the possibility of COVID-19 and range of lung involvement. According to the current national standards, throat swabs of suspected cases were collected and the nucleic acid of COVID-19 was detected by reverse transcription-polymerase chain reaction (RT-PCR). The Xiangya process was constructed according to multi-index, compared with clinical indicators, CT results and national standards, the efficiency of detecting confirmed cases were verified in the test and verification library.
<b>Results:</b>
A continuous cohort of 382 adults who screened COVID-19 was included in which 261 cases were in the test library and 121 cases were in the verification library. In the 382 cases, 192 were males (50.3%) and 190 were females (49.7%), with a median age of 35 years (range: 15-92 years). There were 183 cases (47.9%) with epidemiological history, 275 cases (72.0%) with fever, 212 cases (55.5%) with decreased hemolytic lymphocytes, CT positive 114 cases (29.8%), 43 cases (11.3%) with positive CT-COVID-19, and 30 cases (7.9%) with positive throat swab nucleic acid. Compared with clinical indicators, the sensitivity and specificity of CT were 0.950 and 0.704, respectively. The accuracy of CT to make a definite diagnosis was higher than that of epidemiological history, fever, and blood lymph count decline (0.809 vs 0.660, 0.532, 0.596,
<i>P</i>
=0.001, 0.002, 0.003, respectively). The sensitivity of this process and the program recommended by the Health Commission all were high (all were 1.000) , and the specificity and accuracy of the process were higher than the program recommended by the Health Commission (0.872 vs 0.765, 0.778 vs 0.592, both
<i>P</i>
<0.001). The CT-COVID-19 would have reduced the missed diagnosis rate caused by false negative of nucleic acid test (31 vs 64, difference rate 51.6%), the positive rate of nucleic acid test was 64.5% (20/31). In validation library, the specificity and accuracy of the Xiangya process was 0.967, the positive rate of nucleic acid test was 76.9% (10/13).
<b>Conclusions:</b>
The Xiangya process can predict the nucleic acid test results of COVID-19 well, and can be applied as a reliable basis for confirmed cases detection in adults and adolescent (≥12 years) in areas other than Hubei during the epidemic period of COVID-19. The cohort size needs to be increased for further validation.</div>
</front>
</TEI>
<pubmed>
<MedlineCitation Status="Publisher" Owner="NLM">
<PMID Version="1">32157849</PMID>
<DateRevised>
<Year>2020</Year>
<Month>03</Month>
<Day>11</Day>
</DateRevised>
<Article PubModel="Print-Electronic">
<Journal>
<ISSN IssnType="Print">0376-2491</ISSN>
<JournalIssue CitedMedium="Print">
<Volume>100</Volume>
<Issue>0</Issue>
<PubDate>
<Year>2020</Year>
<Month>Mar</Month>
<Day>11</Day>
</PubDate>
</JournalIssue>
<Title>Zhonghua yi xue za zhi</Title>
<ISOAbbreviation>Zhonghua Yi Xue Za Zhi</ISOAbbreviation>
</Journal>
<ArticleTitle>[Construction and evaluation of a novel diagnosis process for 2019-Corona Virus Disease].</ArticleTitle>
<Pagination>
<MedlinePgn>E019</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.3760/cma.j.cn112137-20200228-00499</ELocationID>
<Abstract>
<AbstractText>
<b>Objective:</b>
To construct and evaluate a diagnosis process for 2019-Corona Virus Disease (COVID-19).
<b>Methods:</b>
A continuous cohort of adults and adolescent (≥12 years) who screened COVID-19 was included in Xiangya Hospital of Central South University from January 23 to February 3, 2020 in which cases were divided the test library and the verification library. Their gender, age, onset time were recorded. Take epidemiological history, fever, and the blood lymphocytes decline as clinical indicators, used CT to evaluate the possibility of COVID-19 and range of lung involvement. According to the current national standards, throat swabs of suspected cases were collected and the nucleic acid of COVID-19 was detected by reverse transcription-polymerase chain reaction (RT-PCR). The Xiangya process was constructed according to multi-index, compared with clinical indicators, CT results and national standards, the efficiency of detecting confirmed cases were verified in the test and verification library.
<b>Results:</b>
A continuous cohort of 382 adults who screened COVID-19 was included in which 261 cases were in the test library and 121 cases were in the verification library. In the 382 cases, 192 were males (50.3%) and 190 were females (49.7%), with a median age of 35 years (range: 15-92 years). There were 183 cases (47.9%) with epidemiological history, 275 cases (72.0%) with fever, 212 cases (55.5%) with decreased hemolytic lymphocytes, CT positive 114 cases (29.8%), 43 cases (11.3%) with positive CT-COVID-19, and 30 cases (7.9%) with positive throat swab nucleic acid. Compared with clinical indicators, the sensitivity and specificity of CT were 0.950 and 0.704, respectively. The accuracy of CT to make a definite diagnosis was higher than that of epidemiological history, fever, and blood lymph count decline (0.809 vs 0.660, 0.532, 0.596,
<i>P</i>
=0.001, 0.002, 0.003, respectively). The sensitivity of this process and the program recommended by the Health Commission all were high (all were 1.000) , and the specificity and accuracy of the process were higher than the program recommended by the Health Commission (0.872 vs 0.765, 0.778 vs 0.592, both
<i>P</i>
<0.001). The CT-COVID-19 would have reduced the missed diagnosis rate caused by false negative of nucleic acid test (31 vs 64, difference rate 51.6%), the positive rate of nucleic acid test was 64.5% (20/31). In validation library, the specificity and accuracy of the Xiangya process was 0.967, the positive rate of nucleic acid test was 76.9% (10/13).
<b>Conclusions:</b>
The Xiangya process can predict the nucleic acid test results of COVID-19 well, and can be applied as a reliable basis for confirmed cases detection in adults and adolescent (≥12 years) in areas other than Hubei during the epidemic period of COVID-19. The cohort size needs to be increased for further validation.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y">
<Author ValidYN="Y">
<LastName>Xiong</LastName>
<ForeName>Z</ForeName>
<Initials>Z</Initials>
<AffiliationInfo>
<Affiliation>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Fu</LastName>
<ForeName>L</ForeName>
<Initials>L</Initials>
<AffiliationInfo>
<Affiliation>Department of Infectious Diseases, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Zhou</LastName>
<ForeName>H</ForeName>
<Initials>H</Initials>
<AffiliationInfo>
<Affiliation>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Liu</LastName>
<ForeName>J K</ForeName>
<Initials>JK</Initials>
<AffiliationInfo>
<Affiliation>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Wang</LastName>
<ForeName>A M</ForeName>
<Initials>AM</Initials>
<AffiliationInfo>
<Affiliation>Department of Emergency, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Huang</LastName>
<ForeName>Y</ForeName>
<Initials>Y</Initials>
<AffiliationInfo>
<Affiliation>Department of Infectious Diseases, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Huang</LastName>
<ForeName>X</ForeName>
<Initials>X</Initials>
<AffiliationInfo>
<Affiliation>Department of Infection Control Center, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Yi</LastName>
<ForeName>B</ForeName>
<Initials>B</Initials>
<AffiliationInfo>
<Affiliation>Department of Clinical Laboratory, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Wu</LastName>
<ForeName>J</ForeName>
<Initials>J</Initials>
<AffiliationInfo>
<Affiliation>Department of Medical Section, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Li</LastName>
<ForeName>C H</ForeName>
<Initials>CH</Initials>
<AffiliationInfo>
<Affiliation>Department of Infection Control Center, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Quan</LastName>
<ForeName>J</ForeName>
<Initials>J</Initials>
<AffiliationInfo>
<Affiliation>Department of Infectious Diseases, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Li</LastName>
<ForeName>M</ForeName>
<Initials>M</Initials>
<AffiliationInfo>
<Affiliation>Department of Respiratory and Critical Care Medicine, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Leng</LastName>
<ForeName>Y S</ForeName>
<Initials>YS</Initials>
<AffiliationInfo>
<Affiliation>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Luo</LastName>
<ForeName>W J</ForeName>
<Initials>WJ</Initials>
<AffiliationInfo>
<Affiliation>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Hu</LastName>
<ForeName>C P</ForeName>
<Initials>CP</Initials>
<AffiliationInfo>
<Affiliation>Department of Respiratory and Critical Care Medicine, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Liao</LastName>
<ForeName>W H</ForeName>
<Initials>WH</Initials>
<AffiliationInfo>
<Affiliation>Department of Radiology, Xiangya Hospital of Central South University, Changsha 410008, China.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>chi</Language>
<GrantList CompleteYN="Y">
<Grant>
<GrantID>81500001, 81671676</GrantID>
<Agency>National Natural Science Foundation of China</Agency>
<Country></Country>
</Grant>
</GrantList>
<PublicationTypeList>
<PublicationType UI="D004740">English Abstract</PublicationType>
<PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic">
<Year>2020</Year>
<Month>03</Month>
<Day>11</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo>
<Country>China</Country>
<MedlineTA>Zhonghua Yi Xue Za Zhi</MedlineTA>
<NlmUniqueID>7511141</NlmUniqueID>
<ISSNLinking>0376-2491</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>IM</CitationSubset>
<OtherAbstract Type="Publisher" Language="chi">
<AbstractText>
<b>目的:</b>
构建新型冠状病毒肺炎(COVID-19)的诊断流程(简称湘雅流程),评估其准确度。
<b>方法:</b>
纳入2020年1月23日至2月3日在中南大学湘雅医院排查COVID-19的≥12岁人群连续队列,按时间顺序分为试验库和验证库;记录该队列患者的性别、年龄、病程、流行病学史及发热,检测血常规及流感抗体。所有患者均行胸部CT,评价罹患COVID-19的可能性(第1类和第2类被认为CT-COVID-19阳性,可能为COVID-19),评估肺受累范围。按国家卫健委推荐诊疗方案(简称卫健委方案),采集疑似病例咽拭子标本,实时荧光定量聚合酶链式反应(RT-PCR)法检测新型冠状病毒核酸,在试验库中计算流行病学史、发热、血淋巴细胞降低及CT检出核酸阳性的效能,多指标构建COVID-19诊断的湘雅流程,检验湘雅流程及卫健委方案检出核酸阳性的效能,最后在验证库内验证湘雅流程的效能。
<b>结果:</b>
共纳入382例排查者,其中试验库261例、验证库121例;男192例(50.3%)、女190例(49.7%),中位年龄35岁(范围:15~92岁),有流行病学史183例(47.9%)、发热275例(72.0%)、血淋巴细胞降低212例(55.5%),胸部CT异常114例(29.8%),CT-COVID-19阳性43例(11.3%),咽拭子核酸阳性30例(7.9%)。胸部CT检出核酸阳性的灵敏度及特异度分别为0.950与0.704,准确度(0.809)均高于流行病学史(0.660)、发热(0.532)及血淋巴细胞降低(0.596)(
<i>P</i>
=0.001、0.002、0.003)。湘雅流程与卫健委方案均具有较高的灵敏度(均为1.000),但特异度、准确度均高于后者(0.872比0.765、0.778比0.592,均
<i>P</i>
<0.001)。湘雅流程需检测核酸的人数少于卫健委方案(31比64例),相差率为51.6%,核酸检测阳性率为64.5%(20/31)。在验证库中,湘雅流程筛选疑似病例的准确度为0.967,核酸检测阳性率为76.9%(10/13)。
<b>结论:</b>
湘雅流程能预判新型冠状病毒核酸的检测结果,在流行期内可作为湖北省外地区≥12岁人群筛选COVID-19疑似病例的参考,但还需扩大样本进一步验证。.</AbstractText>
</OtherAbstract>
<KeywordList Owner="NOTNLM">
<Keyword MajorTopicYN="N">Clinical protocols</Keyword>
<Keyword MajorTopicYN="N">Diagnosis</Keyword>
<Keyword MajorTopicYN="N">Pneumonia, viral</Keyword>
<Keyword MajorTopicYN="N">Program evaluation</Keyword>
<Keyword MajorTopicYN="N">Tomography, X-ray computed</Keyword>
</KeywordList>
</MedlineCitation>
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<Month>3</Month>
<Day>12</Day>
<Hour>6</Hour>
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<PubMedPubDate PubStatus="medline">
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<PublicationStatus>aheadofprint</PublicationStatus>
<ArticleIdList>
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<ArticleId IdType="doi">10.3760/cma.j.cn112137-20200228-00499</ArticleId>
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<list>
<country>
<li>République populaire de Chine</li>
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<name sortKey="Xiong, Z" sort="Xiong, Z" uniqKey="Xiong Z" first="Z" last="Xiong">Z. Xiong</name>
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<name sortKey="Hu, C P" sort="Hu, C P" uniqKey="Hu C" first="C P" last="Hu">C P Hu</name>
<name sortKey="Huang, X" sort="Huang, X" uniqKey="Huang X" first="X" last="Huang">X. Huang</name>
<name sortKey="Huang, Y" sort="Huang, Y" uniqKey="Huang Y" first="Y" last="Huang">Y. Huang</name>
<name sortKey="Leng, Y S" sort="Leng, Y S" uniqKey="Leng Y" first="Y S" last="Leng">Y S Leng</name>
<name sortKey="Li, C H" sort="Li, C H" uniqKey="Li C" first="C H" last="Li">C H Li</name>
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<name sortKey="Liao, W H" sort="Liao, W H" uniqKey="Liao W" first="W H" last="Liao">W H Liao</name>
<name sortKey="Liu, J K" sort="Liu, J K" uniqKey="Liu J" first="J K" last="Liu">J K Liu</name>
<name sortKey="Luo, W J" sort="Luo, W J" uniqKey="Luo W" first="W J" last="Luo">W J Luo</name>
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