scholarly journals 147 A Meta-Analysis Comparing the Diagnostic Accuracy of Initial RT-PCR And CT Scan in Suspected COVID-19 Patients

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Siddiqui ◽  
M Mair ◽  
M Hussain ◽  
S Das
Keyword(s):  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Meta Analysis ◽  
Included Study ◽  
Computed Tomography Scan ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Tomography Scan

Abstract Introduction Reverse transcriptase Polymerase chain reaction(RT-PCR) is considered as the gold standard diagnostic test for COVID-19 infection. It’s accuracy has been doubted and subsequently had effects on planning, performing operations causing. Research has suggested the use of Computed Tomography Scan instead. In this study we performed a meta-analysis comparing the diagnostic accuracy of CT compared to RTPCR. Method Our systematic review and meta-analysis were undertaken as per PRISMA guidelines. The methodological quality of each included study was assessed using the QUADAS-2 tool on RevMan 5.3. We performed data analyses using Stata version 12. Results Sensitivity estimates for CT scan ranged from 0.69 to 1.00 and for RT-PCR varied ranging from 0.47 to 1.00. The pooled estimate of sensitivity for CT was 0.95 (95% CI – 0.88-0.98) and specificity was 0.31 (95% CI – 0.035-0.84). It was found that specificity of initial RT-PCR(100%) was higher than CT(31%). With respect to sensitivity, CT(95%) was superior to RT-PCR(91%) p (0.000) Conclusions Sensitivity of CT is significantly higher than RT-PCR for detecting COVID-19 infection, however as CT findings are not specific. Since CT scans are readily available, protocols can be developed to utilise it to minimalize delay in planning surgery.

scholarly journals A meta-analysis of accuracy and sensitivity of chest CT and RT-PCR in COVID-19 diagnosis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Fatemeh Khatami ◽  
Mohammad Saatchi ◽  
Seyed Saeed Tamehri Zadeh ◽  
Zahra Sadat Aghamir ◽  
Alireza Namazi Shabestari ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Reverse Transcriptase ◽  
Ct Scan ◽  
Predictive Value ◽  
Meta Analysis ◽  
Chest Ct ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Chest Ct Scan

AbstractNowadays there is an ongoing acute respiratory outbreak caused by the novel highly contagious coronavirus (COVID-19). The diagnostic protocol is based on quantitative reverse-transcription polymerase chain reaction (RT-PCR) and chests CT scan, with uncertain accuracy. This meta-analysis study determines the diagnostic value of an initial chest CT scan in patients with COVID-19 infection in comparison with RT-PCR. Three main databases; PubMed (MEDLINE), Scopus, and EMBASE were systematically searched for all published literature from January 1st, 2019, to the 21st May 2020 with the keywords "COVID19 virus", "2019 novel coronavirus", "Wuhan coronavirus", "2019-nCoV", "X-Ray Computed Tomography", "Polymerase Chain Reaction", "Reverse Transcriptase PCR", and "PCR Reverse Transcriptase". All relevant case-series, cross-sectional, and cohort studies were selected. Data extraction and analysis were performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5. Among 1022 articles, 60 studies were eligible for totalizing 5744 patients. The overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan compared to RT-PCR were 87% (95% CI 85–90%), 46% (95% CI 29–63%), 69% (95% CI 56–72%), and 89% (95% CI 82–96%), respectively. It is important to rely on the repeated RT-PCR three times to give 99% accuracy, especially in negative samples. Regarding the overall diagnostic sensitivity of 87% for chest CT, the RT-PCR testing is essential and should be repeated to escape misdiagnosis.

scholarly journals The exact place of PCR and chest CT in screening, staging, and diagnosis of Covid-19: A meta-analysis

2020 ◽  
Author(s):  
Fatemeh Khatami ◽  
Mohammad Saatchi ◽  
Seyed Saeed Tamehri Zadeh ◽  
Zahra Sadat Aghamir ◽  
Alireza Namazi Shabestari ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Reverse Transcriptase ◽  
Ct Scan ◽  
Predictive Value ◽  
Meta Analysis ◽  
Chest Ct ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Chest Ct Scan

Abstract Introduction: Nowadays there is an ongoing acute respiratory outbreak causing by the novel highly contagious coronavirus (nCoV). There are two diagnostic protocol based on chest CT scan and quantitative reverse-transcription polymerase chain reaction (RT-PCR) which their diagnostic accuracy is under the debate. We designed this meta-analysis study to determine the diagnostic value of initial chest CT scan in patients with nCoV infection in comparison with RT- PCR.Search strategy and statistical analysis: Three main databases the PubMed (MEDLINE), Scopus, and EMBASE was systematically searched for all published literatures from January 1st, 2019, to the 27th march 2020 with key grouping of “COVID19 virus”, “2019 novel coronavirus”, “Wuhan coronavirus”, “2019-nCoV”, “X-Ray Computed Tomography”, “Polymerase Chain Reaction”, “Reverse Transcriptase PCR”, and “PCR Reverse Transcriptase”. All relevant case- series, cross-sectional, and cohort studies were selected. Data extraction was done in Excel 2007 (Microsoft Corporation, Redmond, CA) and their analysis was performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5.Result: From first recruited 668 articles we end up to the final 47 studies, which comprised a total sample size of 4238 patients. In compare to RT-PCR, the overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan were 86% (95% CI: 83% -90%), 43 % (95% CI: 26% -60%), 67% (95% CI: 57% -78%), and 84% (95% CI: 74% -95%) respectively. However the RT-PCR should be repeated for three times in order to give the 99% accuracy especially in negative samples.Conclusion: According to the acceptable sensitivity of chest CT scan, it can be employed complement to RT-PCR to diagnosis patients who are clinically suspicious for nCoV.

scholarly journals A systematic review and meta-analysis comparing the diagnostic accuracy of initial RT-PCR and CT scan in suspected COVID-19 patients

2020 ◽  
pp. 20201039
Author(s):  
Manish Devendra Devendra Mair ◽  
Mohammed Hussain ◽  
Saad Siddiqui ◽  
Sudip Das ◽  
Andrew Baker ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Meta Analysis ◽  
Final Analysis ◽  
Inclusion Criteria ◽  
Rt Pcr ◽  
History Of ◽  
Accurate Comparison ◽  
Polymerase Chain

Objective: To perform a systematic review and meta-analysis to compare the diagnostic accuracy of Computed tomography (CT) and initial Reverse transcriptase polymerase chain reaction (RT-PCR) for detecting COVID-19 infection. Methods: We searched three databases, PubMed, EMBASE and EMCARE to identify studies reporting diagnostic accuracy of both CT and RT-PCR in detecting COVID-19 infection between December 2019 and May 2020. For accurate comparison, only those studies which had patients undergoing both, CT and RT-PCR were included. Pooled diagnostic accuracy of both the tests was calculated by using a bivariate random effects model. Results: Based on inclusion criteria, only 11 studies consisting of 1834 patients were included in the final analysis that reported diagnostic accuracy of both CT and RT-PCR, in the same set of patients. Sensitivity estimates for CT scan ranged from 0.69 to 1.00 and for RT-PCR varied ranging from 0.47 to 1.00. The pooled estimates of sensitivity for CT and RT-PCR was 0.91 [95% CI (0.84–0.97)] and 0.84 [95% CI (0.71–0.94)] respectively. On subgroup analysis, pooled sensitivity of CT and RT-PCR was 0.95 [95% CI (0.88–0.98)] and 0.91 [95% CI (0.80–0.96), p = o.ooo1]. The pooled specificity of CT and RT-PCR was 0.31 [95% CI (0.035–0.84)] and 1.00 [95% CI (0.96–1.00)]. Conclusion: CT is more sensitive than RT-PCR in detecting COVID-19 infection, but has a very low specificity. Advances in knowledge: Since the results of a CT scan are available quickly, it can be used as an adjunctive initial diagnostic test for patients with a history of positive contact or epidemiological history.

scholarly journals Systematic Review and Meta-analysis of Real-time Polymerase Chain Reaction assay for the detection of COVID-19 from clinical samples in low-and middle-income countries: Protocol

2021 ◽  
Author(s):  
Emmanuel Oladipo Babafemi
Keyword(s):  
Systematic Review ◽  
Polymerase Chain Reaction ◽  
Real Time ◽  
Meta Analysis ◽  
Clinical Samples ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Pcr Assay ◽  
Middle Income ◽  
Polymerase Chain

Abstract Background: COVID-19 has spread globally since its discovery in Hubei province, China in December 2019 and became pandemic in 2020. COVID-19 is a new betacoronavirus and a variant of severe acute respiratory syndrome coronavirus 2 (SARA- CoV-2). Rapid, accurate and reliable diagnosis of COVID-19 will prevent the spread and allow for appropriate management. The main objective of this systematic review is to identify, appraise and summarise the published evidence on the diagnostic performance and effectiveness of SARS-CoV-2 virus in the diagnosis of current or previous COVID-19 using real-time polymerase chain reaction (RT-PCR) assay in low-and middle-income countries (LMICs). Methods: We will search MEDLINE/PubMed, EMBASE, BIOSIS, LILACS, Cochrane Infectious Diseases Group Specialised Register (CIDG SR), Global Health, and CINAHL for published studies for the diagnosis of COVID-19 using real-time polymerase chain reaction assay in LMICs There will be no restriction regarding the language, date of publication, and publication status. We will include retrospective, cross-sectional and cohort observational studies will be included in the review. Selection of studies, data extraction and management, assessment of risk of bias, and quality of evidence will be performed by two independent reviewers (EB and BC). A third researcher (GM) will be consulted in case of discrepancies. Depending on the availability and quality of the data, a meta-analysis will be performed. Otherwise, findings will be qualitatively reported. Discussion: To our knowledge, this is the first systematic review and meta-analysis to assess the uptake of RT-PCR assay for SARS-CoV-2 detection from clinical samples in human in LMICs. This review will make available evidence on the uptake, accuracy, approach, and interpretation of results of this assay in the context of COVID-19 diagnosis which will meet an urgent need, considering the diagnostic challenges of RT-PCR assay for COVID-19 diagnosis in humans. Systematic review registration: PROSPERO CRD42021271894

scholarly journals High Resolution CHEST CT(HRCT) Evaluation in Patients Hospitalized with COVID-19 Infection

2020 ◽  
Author(s):  
Maulin Patel ◽  
Junad Chowdhury ◽  
Matthew Zheng ◽  
Osheen Abramian ◽  
Steven Verga ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
High Resolution ◽  
Diagnostic Accuracy ◽  
Reverse Transcriptase ◽  
Retrospective Analysis ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Bottom Line ◽  
Polymerase Chain

AbstractIntroductionCurrently the main diagnostic modality for COVID-19 (Coronavirus disease-2019) is reverse transcriptase polymerase chain reaction (RT-PCR) via nasopharyngeal swab which has high false negative rates. We evaluated the performance of high-resolution computed tomography (HRCT) imaging in the diagnosis of suspected COVID-19 infection compared to RT-PCR nasopharyngeal swab alone in patients hospitalized for suspected COVID-19 infection.MethodsThis was a retrospective analysis of 324 consecutive patients admitted to Temple University Hospital. All hospitalized patients who had RT-PCR testing and HRCT were included in the study. HRCTs were classified as Category 1, 2 or 3. Patients were then divided into four groups based on HRCT category and RT-PCR swab results for analysis.ResultsThe average age of patients was 59.4 (±15.2) years and 123 (38.9%) were female. Predominant ethnicity was African American 148 (46.11%). 161 patients tested positive by RT-PCR, while 41 tested positive by HRCT. 167 (52.02%) had category 1 scan, 63 (19.63%) had category 2 scan and 91 (28.35%) had category 3 HRCT scans. There was substantial agreement between our radiologists for HRCT classification (κ = 0.64). Sensitivity and specificity of HRCT classification system was 77.6 and 73.7 respectively. Ferritin, LDH, AST and ALT were higher in Group 1 and D-dimers levels was higher in Group 3; differences however were not statistically significant.ConclusionDue to its high infectivity and asymptomatic transmission, until a highly sensitive and specific COVID-19 test is developed, HRCT should be incorporated into the assessment of patients who are hospitalized with suspected COVID-19.Key PointsKey QuestionCan High Resolution CT chest (HRCT) improve diagnostic accuracy of current Nasopharyngeal swab in suspected COVID-19 patients?Bottom LineIn this retrospective analysis, our novel HRCT classification identified 20% of all COVID-19 patients who had negative nasopharyngeal reverse transcriptase polymerase chain reaction (RT-PCR) tests but had HRCT findings consistent with COVID-19 pneumonia. These patients were ruled out for other infections and laboratory markers were similar to other RT-PCR positive patientsWhy Read onOur new HRCT classification when combined with RT-PCR can improve diagnostic accuracy while promptly improving triaging in COVID-19 patients.

scholarly journals Neurological Manifestations of Novel Coronavirus Disease in a 2-Month-Old Infant: A Case Report

2020 ◽  
Author(s):  
Mojtaba Kamali Aghdam ◽  
Hassan Bakhtiari ◽  
Diana Noemi Diaz ◽  
Kambiz Eftekhari
Keyword(s):  
Respiratory Symptoms ◽  
Clinical Evidence ◽  
Neurological Manifestations ◽  
Computed Tomography Scan ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Novel Coronavirus ◽  
A Minor ◽  
The Brain ◽  
Tomography Scan

AbstractThe main manifestations of novel coronavirus usually include fever and cough. Neurological manifestations have not been properly identified in children. A 65-day-old infant was hospitalized due to poor feeding, weakness, lethargy, and occasional cough. She suffered several seizures during her hospitalization. The brain computed tomography scan depicted a minor hemorrhage. Due to the exacerbation of her condition during hospital stay and the presence of respiratory symptoms in her parents, coronavirus disease was suspected. Reverse transcription–polymerase chain reaction (PCR) of coronavirus was positive for both: child and parents. In children with neurological manifestations such as lethargy, recurrent seizures, cerebral hemorrhage, and clinical evidence of respiratory symptoms in his/her relatives, PCR testing for coronavirus is recommended.

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