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 MODERATED e-POSTER SESSION 06:
Infectious Diseases and COVID-19
PP39
Background and Aim: The sensitivity of the nasal swabs is low and false-negative results may worsen both the spread of the outbreak, due to inappropriate allocation of patients, and the prognosis of patients, due to inappropriate and/or delayed treatment. To the best of our knowledge, to date no study has investigated the diagnostic accuracy of a multidisciplinary team (MDT, i.e. pulmonary physician and thoracic radiologist) diagnosis of COVID-19 in suspected cases with negative nasal swabs that underwent subsequent BAL. The aim of this study was to evaluate the accuracy of the MDT diagnosis of COVID-19 in suspected cases not confirmed by nasal swabs, compared to BAL (that for the purpose of this study was considered the diagnostic gold standard).
Methods: Here we present the interim analysis of a study developed as a part of a wider international research project: the Dragon project (IMI2 - Call 21; Grant agreement number 101005122). This pilot study is a multi-center, retrospective, observational study, but interim analysis here presented is limited to a single center (Florence University Hospital).All consecutive patients admitted for suspected COVID-19 that resulted negative to two consecutive nasal swabs underwent BAL. MDTs with different expertise levels were asked to provide a provisional diagnosis (up to three choices allowed), confidence levels and management decision (patient allocation and treatment) after reviewing clinical, HRCT and BAL data in a stepwise fashion.
Results: We enrolled 86 patients, median age 63 years (range 19-90), 52 males (60.5%), 50 (60%) current or former smokers. 83 (95%) patients had one or more comorbidities (median 3, rage 1-10; Charlson CI 4.6, 0-11). BMI 24.3 (14.3-24.5), P/F 295 (76-547). Only 7 cases were found positive on BAL (8.4%).For the MDT 1 sensitivity,specificity,positive and negative predictive value were respectively: 28% (2/7), 60% (48/79), 6% (2/33), 90% (48/53). For the MDT2 (younger) sensitivity, specificity, positive and negative predictive value were respectively: 57% (4/7), 81% (64/79), 21% (4/19), 95% (64/67). The concordance between the two MDTs was poor: 60% of cases, with a kappa of 0.09 (SE 0.1).
Conclusions: The negative predictive value of a MDT diagnosis of COVID-19 is high irrespective of expertise level of the MDTs. However the sensitivity and the positive predictive value are miserable and the inter-observer variability is strikingly high.Therefore,BAL has a relevant role in confirming COVID-19 infections even if the proportion of positive cases is very small.
        ACCURACY OF THE MULTIDISCIPLINARY DIAGNOSIS OF COVID-19 IN PATIENTS
WITH NEGATIVE NASOPHARYNGEAL SWABS RT-PCR, EVALUATED USING BAL AS DIAGNOSTIC GOLD STANDARD
Sara Tomassetti1, Valentina Luzzi1, Giulia Biadene1, Guja Bernacchi1, Sonia Bambina1, Marco De Martino1, Leonardo Gori1, Edoardo Cavigli2, Diletta Cozzi2, Vittorio Miele2, Gian Maria Rossolini1, Simona Pollini1, Cosimo Nardi3, Stefano Colagrande3, Anna Peired3, Alessandro Morettini4,Carlo Nozzoli4,Anna Poggesi1,4,Lorenzo Menicacci4,Valentina Scotti4,Giorgia Falchetti4, Elias Romano4, Ombretta Para4, Lorenzo Caruso4, Federico Lavorini1
1 Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
2 Radiology Department, Careggi University Hospital, Florence, Italy
3 Department of Biomedical, Experimental and Clinical Sciences, Radiodiagnostic Unit n. 2, University of Florence - Careggi University Hospital, Florence, Italy
4 Department of Internal and Emergency Medicine, Careggi Hospital, Florence, Italy
         ECBIP 2021 69
6th European Congress
for Bronchology and Interventional Pulmonology
OCTOBER ECBIP 15 - 17
ATHENS - GREECE 2021
Book of Abstracts
    














































































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