Diagnostic utility of pharyngeal follicular structures in COVID-19: A large-scale cross-sectional study

IF 4.8 2区医学 Q1 INFECTIOUS DISEASES

International Journal of Infectious Diseases Pub Date : 2024-09-21 DOI:10.1016/j.ijid.2024.107244

Hidenori Takahashi , Miwa Morikawa , Yugo Satake , Hiroki Nagamatsu , Ryutaro Hirose , Yuka Yamada , Naoya Toba , Mio Toyama-Kousaka , Shinichiro Ota , Masahiro Shinoda , Masamichi Mineshita , Masaharu Shinkai

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引用次数: 0

Abstract

Objectives

Pharyngeal follicles similar to those seen in influenza have been observed in patients with coronavirus disease 2019 (COVID-19), suggesting their potential as early-stage diagnostic markers. In this study, we examined the diagnostic potential of pharyngeal follicles for COVID-19, particularly the Omicron variant and its subtypes, to obtain basic data for AI-based diagnostic imaging tools.

Methods

A cross-sectional study was conducted from July 21, 2022, to March 31, 2023, at the Tokyo Shinagawa Hospital's fever clinic. Participants aged ≥15 years who underwent real-time polymerase chain reaction testing for COVID-19 and pharyngeal examinations were included. Demographic details, symptom onset, throat pain, and vaccination status were also recorded. Pharyngeal structures were categorized into four groups: follicles, buds, mixed, or absent.

Results

Of the 1223 participants, 829 (67.8%) tested positive for COVID-19. Among those who tested positive, 73.6% (95% CI: 70.6%-76.6%) had follicular structures, compared to 52.8% (95% CI: 47.9%-57.7%) of those who tested negative (P = 1.0 × 10⁻¹²). Overall, 818 participants exhibited follicular structures (439 with follicles, 281 with buds, and 98 with mixed structures), while 405 lacked any follicular structures. Regression analysis identified throat pain and follicular structures as significant COVID-19 predictors (95% confidence intervals: 2.49-4.85 and 1.43-2.59, respectively). Mixed follicles were identified as a potentially characteristic feature of COVID-19.

Conclusion

Pharyngeal follicular structures demonstrated high sensitivity for early COVID-19 diagnosis.

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COVID-19 中咽滤泡结构的诊断效用：大规模横断面研究

目的：在2019年冠状病毒病（COVID-19）患者中观察到了与流感相似的咽部滤泡，这表明它们有可能成为早期诊断标志物。在本研究中，我们研究了咽部滤泡对COVID-19，尤其是Omicron变异型及其亚型的诊断潜力，为基于人工智能的诊断成像工具获取基础数据：方法：2022 年 7 月 21 日至 2023 年 3 月 31 日，在东京品川医院发热门诊进行了一项横断面研究。研究纳入了年龄≥15 岁、接受了 COVID-19 实时聚合酶链反应（RT-PCR）检测和咽部检查的参与者。此外，还记录了详细的人口统计学资料、发病症状、咽喉疼痛和疫苗接种情况。咽部结构分为四组：滤泡、芽、混合或无：在 1223 名参与者中，829 人（67.8%）的 COVID-19 检测结果呈阳性。在检测结果呈阳性的参与者中，73.6%（95% CI：70.6%-76.6%）有卵泡结构，而在检测结果呈阴性的参与者中，52.8%（95% CI：47.9%-57.7%）有卵泡结构（P = 1.0 × 10-12）。总体而言，818 名参与者表现出卵泡结构（439 人有卵泡，281 人有花蕾，98 人有混合结构），而 405 人没有任何卵泡结构。回归分析发现，咽喉疼痛和卵泡结构是 COVID-19 的重要预测因素（95% 置信区间分别为 2.49-4.85 和 1.43-2.59）。混合滤泡被确定为 COVID-19 的潜在特征：结论：咽部滤泡结构对早期 COVID-19 诊断具有高度敏感性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Infectious Diseases 医学-传染病学

CiteScore

18.90

自引率

2.40%

发文量

1020

审稿时长

30 days

期刊介绍： International Journal of Infectious Diseases (IJID) Publisher: International Society for Infectious Diseases Publication Frequency: Monthly Type: Peer-reviewed, Open Access Scope: Publishes original clinical and laboratory-based research. Reports clinical trials, reviews, and some case reports. Focuses on epidemiology, clinical diagnosis, treatment, and control of infectious diseases. Emphasizes diseases common in under-resourced countries.