Have a personal or library account? Click to login
To Retest or Not to Retest the Experience of a Cardiology Emergency Clinic During the COVID-19 Pandemic Cover

To Retest or Not to Retest the Experience of a Cardiology Emergency Clinic During the COVID-19 Pandemic

Open Access
|Sep 2022

Figures & Tables

Figure 1

Flowchart of the negative retested and the positive retested patients hospitalized in the Cardiology Unit between 1st May 2020 and 31st December 2020.
Flowchart of the negative retested and the positive retested patients hospitalized in the Cardiology Unit between 1st May 2020 and 31st December 2020.

Figure 2

Most important reasons for deciding RT-PCR retesting of patients, expressed in percent.
Most important reasons for deciding RT-PCR retesting of patients, expressed in percent.

Figure 3

Secondary most important for deciding RT-PCR retesting of patients, expressed in percent.
Secondary most important for deciding RT-PCR retesting of patients, expressed in percent.

Figure 4

Comparison between admission diagnostic in negative-retested and positive patients, expressed in percent from the entire lots.
Comparison between admission diagnostic in negative-retested and positive patients, expressed in percent from the entire lots.

Figure 5

Patients exhibiting both symptoms and imagistic changes on Chest X-ray or thoracic CT-scan, expressed in percent (comparison between negative-retested and positive patients).
Patients exhibiting both symptoms and imagistic changes on Chest X-ray or thoracic CT-scan, expressed in percent (comparison between negative-retested and positive patients).

Figure 6

ROC curves for different parameters and the result of the first and second RT-PCR test. Panel A- ROC curve for the concomitant presence of both Covid-19 suggestive symptoms and imagistic changes and the result of the first RT-PCR test (AUC=0.626, CI 0.542–0.710), Panel B- ROC curve for the concomitant presence of both Covid-19 suggestive symptoms and imagistic changes and the result of the second RT-PCR test (AUC=0.683, CI 0.548–0.817), Panel C- ROC curve for the presence of lymphopenia at admission and the result of the first RTPCR test (AUC=0.527, CI 0.438–0.616), Panel D- ROC curve for the presence of lymphopenia at admission and the result of the second RT-PCR test (AUC=0.563, CI 0.412–0.713), Panel E- ROC curve for the value of ferritin at admission and the result of the first RT-PCR test (for a value >172ug/L, a sensitivity of 71% and a specificity of 55.5%, AUC=0.648, CI 0.551–0.746), Panel F- ROC curve for the value of ferritin at admission and the result of the second RT-PCR test (for a value >162.5ug/L, a sensitivity of 77.8% and a specificity of 56.1%, AUC=0.618, CI 0.464–0.771), Panel G- ROC curve for the maximum temperature during hospitalization and the result of the first RT-PCR test (for a value >37.3 Celsius grades, a sensitivity of 75% and a specificity of 66.2%, AUC=0.680, CI 0.533–0.827), Panel H- ROC curve for the maximum temperature during hospitalization and the result of the second RT-PCR test (for a value >37.5 Celsius grades, a sensitivity of 100% and a specificity of 76.8%, AUC=0.862, CI 0.795–0.929), Se-sensitivity, Sp-specificity.
ROC curves for different parameters and the result of the first and second RT-PCR test. Panel A- ROC curve for the concomitant presence of both Covid-19 suggestive symptoms and imagistic changes and the result of the first RT-PCR test (AUC=0.626, CI 0.542–0.710), Panel B- ROC curve for the concomitant presence of both Covid-19 suggestive symptoms and imagistic changes and the result of the second RT-PCR test (AUC=0.683, CI 0.548–0.817), Panel C- ROC curve for the presence of lymphopenia at admission and the result of the first RTPCR test (AUC=0.527, CI 0.438–0.616), Panel D- ROC curve for the presence of lymphopenia at admission and the result of the second RT-PCR test (AUC=0.563, CI 0.412–0.713), Panel E- ROC curve for the value of ferritin at admission and the result of the first RT-PCR test (for a value >172ug/L, a sensitivity of 71% and a specificity of 55.5%, AUC=0.648, CI 0.551–0.746), Panel F- ROC curve for the value of ferritin at admission and the result of the second RT-PCR test (for a value >162.5ug/L, a sensitivity of 77.8% and a specificity of 56.1%, AUC=0.618, CI 0.464–0.771), Panel G- ROC curve for the maximum temperature during hospitalization and the result of the first RT-PCR test (for a value >37.3 Celsius grades, a sensitivity of 75% and a specificity of 66.2%, AUC=0.680, CI 0.533–0.827), Panel H- ROC curve for the maximum temperature during hospitalization and the result of the second RT-PCR test (for a value >37.5 Celsius grades, a sensitivity of 100% and a specificity of 76.8%, AUC=0.862, CI 0.795–0.929), Se-sensitivity, Sp-specificity.

Comparison between biological parameters in negative retested patients and positive patients_

ParameterNegative patients (mean ± standard deviation)Positive patients (mean ± standard deviation)P value
Admission hemoglobin level(g/dl)13.62 ± 9.1612.66 ± 2.350.4
Leukocytes at admission (×103/μl)11.10 ± 4.5310.54 ± 7.050.43
Neutrophils at admission (percent) (%)73.73 ± 12.0873.34 ± 11.160.81
Neutrophils at admission (absolute value) (×103/μl)8.71 ± 5.947.25 ± 2.970.055
Lymphocyte at admission (percent) (%)15.81 ± 8.6216.36 ± 8.780.57
Lymphocyte at admission (absolute value) (×103/μl)1.58 ± 0.881.5 ± 0.820.54
Monocyte at admission (percent) (%)9.07 ± 8.128.7 ± 3.620.711
Monocyte at admission (absolute value) (×103/μl)0.93 ± 0.650.91 ± 0.770.77
Leukocytes at 48h (×103/μl)9.59 ± 3.429.65 ± 3.430.92
Neutrophils at 48h (percent) (%)69.64 ± 10.1771.48 ± 11.890.29
Neutrophils at 48h (absolute value) (×103/μl)7.12 ± 5.177.13 ± 3.030.99
Lymphocyte at 48h (percent) (%)18.22 ± 8.0719.08 ± 12.970.57
Lymphocyte at 48h (absolute value) (×103/μl)2.11 ± 3.591.59 ± 1.030.34
Monocyte at 48h (percent) (%)9.62 ± 3.028.66 ± 3.260.06
Monocyte at 48h (absolute value) (×103/μl)0.97 ± 0.910.84 ± 0.430.34
Highest Erythrocyte sedimentation rate (ESR) (mm/h)31.07 ± 23.8638.5 ± 23.740.042
Highest C-reactive protein (CRP) (mg/dl)8.12 ± 9.2412.21 ± 14.350.008
Highest Fibrinogen (mg/dl)435.44 ± 160.71448.44 ± 154.270.55
Ferritin (ug/L)309.49 ± 435.33377.22 ± 326.460.371
Highest Troponin I (ng/ml)4647.97 ± 11089.052899.12 ± 5963.790.31
Admission NTproBNP (pg/ml)4105.78 ± 7968.382623.6 ± 3993.310.27
Admission aspartate aminotransferase (AST) (mg/dl)109.5 ± 335.3655.24 ± 69.030.18
Admission alanine aminotransferase (ALT) (mg/dl)68.2 ± 144.4762.3 ± 134.070.76
Admission urea (BUN) (mg/dl)57.66 ± 40.7558.77 ± 40.280.84
Admission creatinine (mg/dl)1.33 ± 1.231.59 ± 1.80.17
Admission eGFR (estimated glomerular filtration rate) (ml/min)69.27 ± 30.7866.11 ± 32.060.45
Glycated hemoglobin (HbA1c) (%)6.59 ± 3.986.61 ± 1.180.97
Admission activated partial thromboplastin time (aPTT) (s)36.65 ± 25.4335.75 ± 15.780.78
Admission creatine kinase (CK) (U/L)567.37 ± 1094.96307.16 ± 530.520.06
Admission creatine kinase myocardial band (CK-MB) (U/L)69.56 ± 132.4126.85 ± 36.740.011
Admission lactate dehydrogenase (LDH) (U/L)428.87 ± 420.59320.05 ± 133.260.129

Multiple regression analysis for the result of the second RT-PCR test (positive/negative)_

Pearson Coefficient of Correlation (R)Coefficient of determination (R2)P valueOdds Ratio (OR)
Predictive model*0.8280.6860.0141.035

Comparison between demographic, electrocardiographic, echocardiographic, clinical and imagistic parameters in negative retested and positive patient_

Parameter Negative patientsPositive patientsP value
Age mean (years)65.07 ± 14.2466.57 ± 13.120.42
Age maximum (years)9295NA
Age minimum (years)2831NA
Demographic dataGender34.1% female, 65.9% male40% female, 60% male0.35
Most frequent county of provenience60.6% Bucharest (capital)58.5% Bucharest (capital)NA
9.8% Giurgiu8.6% Ilfov
7.6% Ilfov7.1% Giurgiu
Atrial arrhythmias (%)25%35.7%0.08
ECG parametersVentricular arrhythmias (%)8.8%7.1%0.6
Atrioventricular block6.9%10%0.38
Mitral regurgitation36.04%30%0.008
Mitral stenosis0.7%00.65
Aortic regurgitation7.06%4.28%0.15
Echocardiographic parametersAortic stenosis8.83%14.2%0.56
LVEF mean (%)39.47 ± 12.46%41.72 ± 15.37%0.2
LVEF reduced (<40%)46.1%37.5%0.35
LVEF mid-range (≥40%, <50%)24.3%27.5%0.41
LVEF preserved (≥50%)29.6%35%0.18
Bronchial rales (%)11.9%11.4%0.6
Crackles (%)31.8%25.7%0.29
Low-grade fever (%)25.7%22.1%0.54
High-grade fever (%)7.3%18.6%0.004
Highest temperature during hospitalization (Celsius grades)36.67 ± 2.7937.47 ± 0.780.15
SaO2 (arterial oxygen saturation) (%)93.95 ± 13.4895.16 ± 3.470.56
Clinical parametersCough (%)34.8%54.3%0.003
Myalgia (%)1.5%8.6%0.002
Dysphagia (%)1.5%1.4%0.6
Ageusia/Anosmia (%)0.4%1.4%0.72
Dyspnea (%)54.5%59.4%0.47
Digestive symptoms (nausea, vomiting, diarrhea) (%)1.1%2.9%0.29
Accentuation of the interstitial pattern on chest X-ray (%)75.8%81.4%0.2
Pulmonary condensation or alveolitis on the chest X-Ray (%)48.1%44.3%0.49
Pulmonary imagingGround-glass image on thoracic CT scan (%)6.4%11.4%0.06
Subpleural condensation on thoracic CT scan (%)3.8%10%0.022
DOI: https://doi.org/10.2478/rjc-2022-0018 | Journal eISSN: 2734-6382 | Journal ISSN: 1220-658X
Language: English
Page range: 93 - 102
Published on: Sep 1, 2022
Published by: Romanian Society of Cardiology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2022 Miruna F. Ştefan, Stefania L. Magda, Dan V. Bratu, Graţiela Cosmulescu, Maria C.B. Şuran, Elena Bădulescu, Andreea E. Velcea, Sorina Mihăilă, Loredana Iacobescu, Roxana C. Rimbaş, Dragoş Vinereanu, published by Romanian Society of Cardiology
This work is licensed under the Creative Commons Attribution 4.0 License.