{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:07:52Z","timestamp":1740146872447,"version":"3.37.3"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T00:00:00Z","timestamp":1677196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009105","name":"Ministry of Internal Affairs and Communications","doi-asserted-by":"publisher","award":["0300490076"],"award-info":[{"award-number":["0300490076"]}],"id":[{"id":"10.13039\/501100009105","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Chest CT has been proposed as a screening test to rule out SARS-CoV-2 lung infection in acute stroke. Our objectives are to analyze the predictive value of neck CT angiography (CTA) source images compared with conventional chest CT, the interobserver concordance and the reliability of the diagnosis using a mobile app.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A retrospective observational study that included acute stroke patients admitted to a stroke center. Two raters blinded to the clinical data evaluated and classified the pulmonary findings in chest CT and neck CTA source images according to the COVID-19 Reporting and Data System (CO-RADS). CTA findings were evaluated using a conventional workstation and the JOIN mobile app. Scores of 3\u20135 were grouped as appearing typical or indeterminate for COVID-19 lung involvement and 0\u20132 as appearing atypical or negative for pneumonia. SARS-CoV-2 infection was confirmed by polymerase chain reaction (PCR).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 242 patients were included (42 with PCR-confirmed COVID-19). In the cohort of 43 patients with both neck CTA and chest CT, the predictive value for COVID-19 was equivalent (sensitivity, 53.8%; specificity, 92.9%). The interobserver agreement in the classification into CO-RADS 3\u20135 or 1\u20132 in CTA was good (K = 0.694; standard error, 0.107). In the cohort of 242 patients with neck CTA, the intraobserver agreement between the workstation and the JOIN app was perfect (K = 1.000; standard error 0.000).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Neck CTA enables the accurate identification of COVID-19-associated lung abnormalities in acute stroke. CO-RADS evaluations through mobile applications have a predictive value similar to the usual platforms.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0281955","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T18:32:44Z","timestamp":1677263564000},"page":"e0281955","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neck CT angiography in acute stroke: An open window for fast detection of COVID-19 lung involvement? Applicability in telemedicine"],"prefix":"10.1371","volume":"18","author":[{"given":"Jorge","family":"Ucl\u00e9s","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilio","family":"Cuesta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo","family":"Rigual","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Rodr\u00edguez-Pardo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerardo","family":"Ruiz-Ares","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Nav\u00eda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9s","family":"Fern\u00e1ndez-Prieto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"\u00c1lvarez-Muelas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4302-6580","authenticated-orcid":true,"given":"Mar\u00eda Alonso","family":"de Leci\u00f1ana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0363-862X","authenticated-orcid":true,"given":"Blanca","family":"Fuentes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,2,24]]},"reference":[{"key":"pone.0281955.ref001","first-page":"2022","article-title":"Rapid, point-of-care antigen tests for diagnosis of SARS-CoV-2 infection.","author":"J Dinnes","year":"2022","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"pone.0281955.ref002","article-title":"Optimisation of COVID-19 diagnostic pathways in acute hospital admissions to prevent nosocomial transmission","volume":"1","author":"R Livingstone","year":"2022","journal-title":"Clinical Respiratory Journal Published Online First"},{"key":"pone.0281955.ref003","first-page":"258","article-title":"Acute stroke care during the COVID-19 pandemic. Ictus Madrid Program recommendations","volume":"35","author":"J Rodr\u00edguez-Pardo","year":"2020","journal-title":"Neurolog\u00eda"},{"key":"pone.0281955.ref004","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1177\/1747493020923234","article-title":"Management of acute ischemic stroke in patients with COVID-19 infection: Report of an international panel","volume":"15","author":"AI Qureshi","year":"2020","journal-title":"International Journal of Stroke"},{"key":"pone.0281955.ref005","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1136\/svn-2020-000429","article-title":"Approaches to global stroke care during the COVID-19 pandemic","volume":"5","author":"L Liu","year":"2020","journal-title":"Stroke Vasc Neurol"},{"key":"pone.0281955.ref006","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1161\/STROKEAHA.120.031769","article-title":"Stroke Acute Management and Outcomes During the COVID-19 Outbreak: A Cohort Study From the Madrid Stroke Network","volume":"52","author":"B Fuentes","year":"2021","journal-title":"Stroke"},{"key":"pone.0281955.ref007","doi-asserted-by":"crossref","first-page":"3098","DOI":"10.1161\/STROKEAHA.112.669325","article-title":"Smartphone teleradiology application is successfully incorporated into a telestroke network environment","volume":"43","author":"BM Demaerschalk","year":"2012","journal-title":"Stroke"},{"key":"pone.0281955.ref008","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1177\/1747493017694386","article-title":"Feasibility and utility of an integrated medical imaging and informatics smartphone system for management of acute stroke","volume":"12","author":"K Shkirkova","year":"2017","journal-title":"Int J Stroke"},{"key":"pone.0281955.ref009","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1177\/1357633X19881863","article-title":"Reliability and accuracy of individual Alberta Stroke Program Early CT Score regions using a medical and a smartphone reading system in a telestroke network","volume":"27","author":"AJ Salazar","year":"2021","journal-title":"J Telemed Telecare"},{"key":"pone.0281955.ref010","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.clineuro.2018.06.012","article-title":"Accuracy of smartphone-based evaluation of Emergent Large Vessel Occlusion on CTA.","volume":"171","author":"DT Hidlay","year":"2018","journal-title":"Clin Neurol Neurosurg"},{"key":"pone.0281955.ref011","doi-asserted-by":"crossref","first-page":"E97","DOI":"10.1148\/radiol.2020201473","article-title":"CO-RADS: A Categorical CT Assessment Scheme for Patients Suspected of Having COVID-19-Definition and Evaluation.","volume":"296","author":"M Prokop","year":"2020","journal-title":"Radiology"},{"key":"pone.0281955.ref012","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/RTI.0000000000000524","article-title":"Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. 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A Global Multicenter Observational Study","volume":"42","author":"A Mahammedi","year":"2021","journal-title":"AJNR Am J Neuroradiol"},{"key":"pone.0281955.ref022","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.3174\/ajnr.A6607","article-title":"CT scanning in suspected stroke or head trauma: Is it worth going the extra mile and including the chest to screen for COVID-19 infection?","volume":"41","author":"RM Kwee","year":"2020","journal-title":"American Journal of Neuroradiology"},{"key":"pone.0281955.ref023","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1007\/s10140-020-01822-0","article-title":"Lung apical findings in coronavirus disease (COVID-19) infection on neck and cervical spine CT","volume":"27","author":"BP Applewhite","year":"2020","journal-title":"Emerg Radiol"},{"key":"pone.0281955.ref024","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.3174\/ajnr.A6608","article-title":"Surprise diagnosis of COVID-19 following neuroimaging evaluation for unrelated reasons during the pandemic in hot spots","volume":"41","author":"R Jain","year":"2020","journal-title":"American Journal of Neuroradiology"},{"key":"pone.0281955.ref025","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1136\/neurintsurg-2020-016188","article-title":"Incidental COVID-19 related lung apical findings on stroke CTA during the COVID-19 pandemic.","volume":"12","author":"S Kihira","year":"2020","journal-title":"J Neurointerv Surg"},{"key":"pone.0281955.ref026","doi-asserted-by":"crossref","first-page":"E72","DOI":"10.1148\/radiol.2020201160","article-title":"Frequency and Distribution of Chest Radiographic Findings in Patients Positive for COVID-19","volume":"296","author":"HYF Wong","year":"2020","journal-title":"Radiology"},{"key":"pone.0281955.ref027","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1161\/STROKEAHA.114.004872","article-title":"Smartphone-assisted prehospital medical information system for analyzing data on prehospital stroke care","volume":"45","author":"T Nakae","year":"2014","journal-title":"Stroke"},{"key":"pone.0281955.ref028","doi-asserted-by":"crossref","first-page":"69","DOI":"10.5469\/neuroint.2017.12.2.69","article-title":"Mobile Real-time Tracking of Acute Stroke Patients and Instant, Secure Inter-team Communication\u2014the Join App","volume":"12","author":"SA Munich","year":"2017","journal-title":"Neurointervention"},{"key":"pone.0281955.ref029","article-title":"Extending stroke CT angiography to the full chest allows for detection of additional pulmonary opacifications in acute stroke patients","volume":"29","author":"D Hasan","year":"2022","journal-title":"Curr Med Imaging Published Online First"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0281955","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T18:33:01Z","timestamp":1677263581000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0281955"}},"subtitle":[],"editor":[{"given":"Victor Daniel","family":"Miron","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,2,24]]},"references-count":29,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0281955","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2023,2,24]]}}}