Effect of age on computed tomography findings: Specificity and sensitivity in coronavirus disease 2019 infection

Erdal Karavas; Edhem Unver; Sonay Aydın; Gonul Seven Yalcin; Erdem Fatihoglu; Ufuk Kuyrukluyildiz; Yusuf Kemal Arslan; Mustafa Yazici

doi:10.5501/wjv.v11.i5.331

Effect of age on computed tomography findings: Specificity and sensitivity in coronavirus disease 2019 infection

World J Virol. 2022 Sep 25;11(5):331-340. doi: 10.5501/wjv.v11.i5.331.

Authors

Erdal Karavas¹, Edhem Unver², Sonay Aydın³, Gonul Seven Yalcin², Erdem Fatihoglu¹, Ufuk Kuyrukluyildiz⁴, Yusuf Kemal Arslan⁵, Mustafa Yazici⁶

Affiliations

¹ Department of Radiology, Erzincan Binali Yildirim University, Erzincan 24100, Turkey.
² Department of Pulmonology, Erzincan Binali Yildirim University, Erzincan 24100, Turkey.
³ Department of Radiology, Erzincan Binali Yildirim University, Erzincan 24100, Turkey. sonay.aydin@erzincan.edu.tr.
⁴ Department of Anesthesiology and Reanimation, Erzincan Binali Yıldırım University, Erzincan 24100, Turkey.
⁵ Department of Biostatistics, Erzincan Binali Yildirim University, Erzincan 24100, Turkey.
⁶ Department of Dermatology, Erzincan Binali Yildirim University, Erzincan 24100, Turkey.

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a pandemic caused by the severe acute respiratory syndrome coronavirus in 2019. Although the real-time reverse tr-anscription PCR test for viral nucleic acids is the gold standard for COVID-19 diagnosis, computed tomography (CT) has grown in importance.

Aim: To evaluate the sensitivity and specificity of thoracic CT findings of COVID-19 pneumonia according to age groups.

Methods: PCR and CT results from 411 patients were reviewed. The diagnosis of COVID-19 pneumonia was made by three radiologists. Lymphadenopathy, pericardial effusion, pleurisy, pleural thickening, pleural effusion, location features of the lesions, ground glass, consolidation, air bronchogram, vascular enlargement, bronchial dilatation, halo finding, inverted halo sign, nodularity, air bubble, subpleural band (curvilinear density), reticular density, crazy paving pattern, and fibrosis findings were recorded. The patients were divided into nine groups by decades while calculating the sensitivity, specificity, and diagnostic efficacy for CT positivity.

Results: The mean age of the cases was 48.1 ± 22.7 years. The CT finding with the highest diagnostic power was ground glass. Vascular enlargement and bronchial dilatation followed ground glass. Peri-cardial effusion was the finding with the lowest diagnostic accuracy. The incidence of lymphadenopathy, pleurisy, pleural thickening, peripheral localization, bilateral, ground glass, vascular enlargement, bronchial dilatation, subpleural band, reticular density, crazy paving appearance, and fibrosis all increased increase significantly with age in patients with positive real-time reverse transcription PCR test.

Conclusion: There are few publications comparing sensitivity and specificity of thoracic CT findings according to age. In cases of COVID-19 pneumonia, there is an increase in the variety and frequency of CT findings with age, and parallel to this the sensitivity and specificity of the findings increase. COVID-19 cases in the pediatric age group have fewer lung findings than adults, and this situation decreases the diagnostic value of CT in pediatric patients.

Keywords: COVID-19; Diagnosis; Pediatric age; SARS-CoV-2; Thoracic computerized tomography.