scholarly journals The Limited Sensitivity of Chest Computed Tomography Relative to Reverse Transcription Polymerase Chain Reaction for Severe Acute Respiratory Syndrome Coronavirus-2 Infection

2020 ◽  
Vol 55 (12) ◽  
pp. 754-761 ◽  
Author(s):  
Joseph V. Waller ◽  
Isabel E. Allen ◽  
Keldon K. Lin ◽  
Michael J. Diaz ◽  
Travis S. Henry ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Polymerase Chain Reaction ◽  
Severe Acute Respiratory Syndrome ◽  
Reverse Transcription ◽  
Chain Reaction ◽  
Chest Computed Tomography ◽  
Polymerase Chain ◽  
Limited Sensitivity

scholarly journals Accuracy of chest computed tomography and reverse transcription polymerase chain reaction in diagnosis of 2019 novel coronavirus disease; a systematic review and meta-analysis

2021 ◽  
Vol 7 (2) ◽  
pp. e36-e36
Author(s):  
Kamyar Shokraee ◽  
Hossein Mahdavi ◽  
Parsa Panahi ◽  
Farnoosh Seirafianpour ◽  
Amir Mohammad Jahromizadeh ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Polymerase Chain Reaction ◽  
Reverse Transcription ◽  
Meta Analysis ◽  
Chest Ct ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Chest Computed Tomography ◽  
Polymerase Chain

Introduction: This study aims to measure the diagnostic accuracy of chest computed tomography (CT) and reverse transcription polymerase chain reaction assay (RT-PCR) in COVID-19 in a systematic review and meta-analysis. Methods: PubMed, Scopus, Embase, and Google Scholar, WHO, SSRN, and MedRxiv have been searched on March 26, 2020 for all the alternative names of the disease and virus. Risk of bias assessment was based on QUADAS-2. Data from English-language studies after January 12, 2019 were pooled to calculate necessary diagnostic values and underwent diagnostic test accuracy, random-effects, proportions, and subgroup meta-analysis. Results: Pooled from 27 included studies, the sensitivity of chest CT was calculated 96.6%, specificity 22.5%, diagnostic odds ratio (DOR) 8.2, positive likelihood ratio (PLR) 1.2 (95% CI: 1.1-1.4), and negative likelihood ratio (NLR) 0.15 (95% CI: 0.1-0.3). The sensitivity for initial RT-PCR was 79.7%, the specificity 100%, and NLR 0.18. Conclusion: Considering the results, in order to diagnose COVID-19 (coronavirus disease 2019), it is recommended to initially performing chest CT to rule out the uninfected people. In suspicious cases, we suggest RT-PCR to confirm the disease. Performing serial RT-PCR instead of the one-time test is highly recommended, to let the viral loads reach the diagnostic levels, especially in cases of high clinical suspicion.

scholarly journals Diagnosis of the coronavirus disease 2019 with chest computed tomography: A retrospective inter-observer agreement study between radiologists and clinicians

2020 ◽  
pp. 102490792096864
Author(s):  
Ferhat Cengel ◽  
Okan Gurkan ◽  
Mustafa Calik ◽  
Mustafa Asim Demirkol ◽  
Elif Sargin Altunok ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Polymerase Chain Reaction ◽  
Reverse Transcription ◽  
Gold Standard ◽  
Diagnostic Performance ◽  
Observer Agreement ◽  
Chain Reaction ◽  
Chest Computed Tomography ◽  
Radiological Society ◽  
Polymerase Chain

Background: Effective triage and early detection are very important for the control and treatment of coronavirus disease 2019. For this purpose, reverse transcription polymerase chain reaction and chest computed tomography are used in emergency departments. Objective: The aim of the study was to examine the diagnostic performance of computed tomography and to compare the inter-observer agreement among radiologists and between clinicians, in a coronavirus disease 2019 pneumonia high-prevalence area. Methods: After exclusions, 534 patients were retrospectively included in this study. Reverse transcription polymerase chain reaction was considered as gold standard for diagnosis. All computed tomography images were independently reviewed by two radiologists who were blinded to reverse transcription polymerase chain reaction results and other clinical information. Each computed tomography scan was scored in four categories as typical, intermediate, atypical, and negative, regarding coronavirus disease 2019 pneumonia according to Radiological Society of North America guideline. As for the evaluation of the diagnostic performance, typical and intermediate appearances were accepted as positive for coronavirus disease 2019. In addition, the computed tomography scans were scored by two clinicians as coronavirus disease 2019 positive and negative. Results: The study group included 534 patients after the exclusion criteria. As a result of the repeated reverse transcription polymerase chain reaction tests, 396 (74%) patients were diagnosed with coronavirus disease 2019, 138 (26%) patients had a negative result and were evaluated as a control group. When the reverse transcription polymerase chain reaction results were referenced as the gold standard; the accuracy rates of radiologists and clinicians (R1, R2, C1, and C2) in the diagnosis of coronavirus disease 2019 were 78%, 79%, 73%, and 71%, their sensitivity rates were 83%, 83%, 74%, and 75%, and the negative predictive values were 57%, 58%, 49%, and 46%, respectively. Inter-observer agreements among the reviewers ranged from good to excellent. Conclusions: Radiological Society of North America guideline related to coronavirus disease 2019 has excellent inter-observer agreement among chest radiologists. In this study, radiologists and clinicians have presented similar and good diagnostic performances in the evaluation of coronavirus disease 2019–suspected patients with chest computed tomography in high-epidemic area.

scholarly journals Role of Chest Computed Tomography versus Real Time Reverse Transcription Polymerase Chain Reaction for Diagnosis of COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Dina M. Ali ◽  
Lamiaa G. Zake ◽  
Nevine K. El Kady
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Polymerase Chain Reaction ◽  
Reverse Transcription ◽  
Meta Analysis ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Chest Computed Tomography ◽  
Polymerase Chain

Background. The current global pandemic of COVID-19 is considered a public health emergency. The diagnosis of COVID-19 depends on detection of the viral nucleic acid by real time reverse transcription polymerase chain reaction (RT-PCR). However, false-negative RT-PCR tests are reported and could hinder the control of the pandemic. Chest computed tomography could achieve a more reliable diagnosis and represent a complementary diagnostic tool. Aim. To perform a meta-analysis and systematic review to find out the role of chest computed tomography versus RT-PCR for precise diagnosis of COVID-19 infection. Methods. We searched three electronic databases (PubMed, ScienceDirect, and Scopus) from April 1 to April 20, 2020, to find out articles including the accuracy of chest computed tomography scan versus RT-PCR for diagnosis of SARS-CoV-2 infection. Observational studies, case series, and case reports were included. Results. A total of 238 articles were retrieved from the search strategy. Following screening, 39 articles were chosen for full text assessment and finally 35 articles were included for qualitative and quantitative analysis. Chest computed tomography showed a wide range of sensitivity varied from 12%–100%. Conclusion. Chest computed tomography is playing a key role for diagnosis and detection of COVID-19 infection. Computed tomography image findings may precede the initially positive RT-PCR assay.

scholarly journals Multiplex Real-Time Reverse-Transcription Polymerase Chain Reaction Assays for Diagnostic Testing of Severe Acute Respiratory Syndrome Coronavirus 2 and Seasonal Influenza Viruses: A Challenge of the Phase 3 Pandemic Setting

2020 ◽  
Author(s):  
Fabiola Mancini ◽  
Fabrizio Barbanti ◽  
Maria Scaturro ◽  
Stefano Fontana ◽  
Angela Di Martino ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Severe Acute Respiratory Syndrome ◽  
Real Time ◽  
Reverse Transcription ◽  
Seasonal Influenza ◽  
Influenza Viruses ◽  
Activity Period ◽  
Clinical Samples ◽  
Chain Reaction ◽  
Polymerase Chain

Abstract Background Pandemic coronavirus disease 2019 (COVID-19) disease represents a challenge for healthcare structures. The molecular confirmation of samples from infected individuals is crucial and therefore guides public health decision making. Clusters and possibly increased diffuse transmission could occur in the context of the next influenza season. For this reason, a diagnostic test able to discriminate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from influenza viruses is urgently needed. Methods A multiplex real-time reverse-transcription polymerase chain reaction (PCR) assay was assessed using 1 laboratory protocol with different real-time PCR instruments. Overall, 1000 clinical samples (600 from samples SARS-CoV-2–infected patients, 200 samples from influenza-infected patients, and 200 negative samples) were analyzed. Results The assay developed was able to detect and discriminate each virus target and to intercept coinfections. The limit of quantification of each assay ranged between 5 and 10 genomic copy numbers, with a cutoff value of 37.7 and 37.8 for influenza and SARS-CoV-2 viruses, respectively. Only 2 influenza coinfections were detected in COVID-19 samples. Conclusions This study suggests that multiplex assay is a rapid, valid, and accurate method for the detection of SARS-CoV-2 and influenza viruses in clinical samples. The test may be an important diagnostic tool for both diagnostic and surveillance purposes during the seasonal influenza activity period.

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