scholarly journals Diagnostic value of Chest CT and Initial Real-Time RT-PCR in COVID-19 Infection

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Ugur Kostakoglu ◽  
Aydın Kant ◽  
Serhat Atalar ◽  
Barış Ertunç ◽  
Şükrü Erensoy ◽  
...  
Keyword(s):  
Real Time ◽  
Diagnostic Value ◽  
Chest Ct ◽  
Symptom Duration ◽  
Shortness Of Breath ◽  
Rt Pcr ◽  
Ct Findings ◽  
Group I ◽  
Group Ii ◽  
Pcr Test

Objectives: To evaluate the diagnostic value of the rtRT-PCR test and CT in patients presenting with typical clinical symptoms of COVID-19. Methods: The study with the participation of four center in Turkey was performed retrospectively from 20 March-15 April 2020 in 203 patients confirmed for COVID-19. The initial rtRT-PCR test was positive in 142 (70.0%) of the patients (Group-I) and negative in 61 patients (Group-II). Results: The mean age of the patients in Group-I was 49.7±18.0 years and the time between the onset of symptoms and admission to the hospital was 3.6±2.0 days; whereas the same values for the patients in Group-II were 58.1±19.9 and 5.3±4.2, respectively (p=0.004; p=0.026). Initial rtRT-PCR was found positive with 83.5% sensitivity and 74.1% PPV in patients with symptom duration of less than five days. It was found that rtRT-PCR positivity correlated negatively with the presence of CT findings, age, comorbidity, shortness of breath, and symptom duration, while rtRT-PCR positivity correlated positively with headache. Presence of CT findings was positively correlated with age, comorbidity, shortness of breath, fever, and the symptom duration. Conclusions: It should be noted that a negative result in the rtRT-PCR test does not rule out the possibility of COVID-19 diagnosis in patients whose symptom duration is longer than five days, who are elderly with comorbidities and in particular who present with fever and shortness of breath. In these patients, typical CT findings are diagnostic for COVID-19. A normal chest CT is no reason to loosen up measures of isolation in patients with newly beginning symptoms until the results are obtained from the PCR test. doi: https://doi.org/10.12669/pjms.37.1.2956 How to cite this:Kostakoglu U, Kant A, Atalar S, Ertunc B, Erensoy S, Dalmanoglu E, et al. Diagnostic value of Chest CT and Initial Real-Time RT-PCR in COVID-19 Infection. Pak J Med Sci. 2021;37(1):-234-238. doi: https://doi.org/10.12669/pjms.37.1.2956 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals The role of CT imaging for management of COVID-19 in epidemic area: early experience from a University Hospital

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Vikram rao Bollineni ◽  
Koenraad Hans Nieboer ◽  
Seema Döring ◽  
Nico Buls ◽  
Johan de Mey
Keyword(s):  
Ct Scan ◽  
Predictive Value ◽  
Ct Imaging ◽  
Chest Ct ◽  
University Hospital ◽  
Rt Pcr ◽  
Ct Findings ◽  
Epidemic Area ◽  
Chest Ct Scan ◽  
Pcr Test

Abstract Background To evaluate the clinical value of the chest CT scan compared to the reference standard real-time polymerase chain reaction (RT-PCR) in COVID-19 patients. Methods From March 29th to April 15th of 2020, a total of 240 patients with respiratory distress underwent both a low-dose chest CT scan and RT-PCR tests. The performance of chest CT in diagnosing COVID-19 was assessed with reference to the RT-PCR result. Two board-certified radiologists (mean 24 years of experience chest CT), blinded for the RT-PCR result, reviewed all scans and decided positive or negative chest CT findings by consensus. Results Out of 240 patients, 60% (144/240) had positive RT-PCR results and 89% (213/240) had a positive chest CT scans. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of chest CT in suggesting COVID-19 were 100% (95% CI: 97–100%, 144/240), 28% (95% CI: 19–38%, 27/240), 68% (95% CI: 65–70%) and 100%, respectively. The diagnostic accuracy of the chest CT suggesting COVID-19 was 71% (95% CI: 65–77%). Thirty-three patients with positive chest CT scan and negative RT-PCR test at baseline underwent repeat RT-PCR assay. In this subgroup, 21.2% (7/33) cases became RT-PCR positive. Conclusion Chest CT imaging has high sensitivity and high NPV for diagnosing COVID-19 and can be considered as an alternative primary screening tool for COVID-19 in epidemic areas. In addition, a negative RT-PCR test, but positive CT findings can still be suggestive of COVID-19 infection.

The Diagnostic Value of CT scans in the Process of Diagnosing COVID-19 in medical Centers

2021 ◽  
Author(s):  
Afshin Ostovar ◽  
Elham Ehsani-Chimeh ◽  
Zeinab Fakoorfard
Keyword(s):  
Ct Scan ◽  
Sensitivity And Specificity ◽  
Clinical Decision Making ◽  
Diagnostic Value ◽  
Chest Ct ◽  
Rapid Review ◽  
Ct Scans ◽  
Rt Pcr ◽  
Medical Centers ◽  
Pcr Test

Background: Coronavirus disease (COVID-19) has spread around the world since the beginning of 2020. The definitive diagnosis of COVID-19 is the RT-PCR laboratory test. However, because of low sensitivity, the chest CT scan has become important for the rapid diagnosis and clinical decision-making. Objectives: This study aims to define CT scan’ diagnostic value in diagnosing COVID-19 in medical centers. Methods: This study is a rapid health technology assessment (HTA) and had two major phases. In phase 1, a rapid review was done for defining the sensitivity and specificity rate of CT. During this phase, studies related to the diagnostic and technical data on the use of CT in the diagnosis of COVID-19 were reviewed, and the sensitivity and specificity of CT in these studies were extracted. In phase 2, sequential testing was run to evaluate the diagnostic value of chest CT to diagnose COVID-19 according to two scenarios before and after adding RT-PCR test results. Results: CT scan has a high sensitivity for diagnosing cases of COVID-19. Due to its low specificity, relying on CT scans to diagnose COVID-19 alone in medical centers can lead to a significant proportion of false-positive cases. This study showed that if the probability of COVID-19 before the CT scan were about 50%, with a positive CT scan, this probability would be between 60 and 70% depending on the CT specificity. Conclusions: With the available evidence, the use of a CT scan alone is not sufficient for diagnosis. The RT-PCR test is also necessary to improve the diagnosis and continue the treatment and isolation of patients.

scholarly journals Comparison of clinical, chest CT and laboratory findings of suspected COVID-19 inpatients with positive and negative RT-PCR

2021 ◽  
Vol 5 (1) ◽  
pp. 019-026
Author(s):  
Perincek Gokhan ◽  
Onal Canver ◽  
Avci Sema
Keyword(s):  
Troponin T ◽  
Clinical Findings ◽  
Chest Ct ◽  
Pcr Analysis ◽  
Rt Pcr ◽  
Laboratory Findings ◽  
Ct Findings ◽  
History Of ◽  
Laboratory Examinations ◽  
Pcr Test

Introduction: COVID-19 is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 and it was first reported in China. The aim of this study was to compare clinical features, chest CT findings and laboratory examinations of suspected COVID-19 inpatients according to RT-PCR analysis. Methods: Demographics, comorbidites, symptoms and signs, laboratory results and chest CT findings were compared between positive and negative groups. The study included 292 patients (134 females, 158 males) suspected of COVID-19. All statistical calculations were performed with SPSS 23.0. Results: 158 (54.1%) of the cases were male and 134 (45.9%) were female. Their ages ranged from 17 to 95 years, with an average of 50.46 ± 20.87. A symptom or sign was detected in 86.3% of all patients. The chest CT images of 278 patients were analyzed. Chest CT was negative in 59.2% of patients with positive RT-PCR and 43.9% of patients with negative RT-PCR results. Chest CT findings were atypical or indeterminate in 22.4% of patients with positive RT-PCR results and 20% of patients with negative RT-PCR analysis. ALP, bilirubine, CRP, eosinophil count, glucose, CK-MB mass and lactate were significantly lower in patients with positive RT-PCR test. LDH, lipase, MCV, monocyte, neutrophil count, NLR, platelet, pO2, pro-BNP, procalcitonin, INR, prothrombin time, sodium, troponin T, urea, WBC were significantly lower in patients with positive RT-PCR test results. Conclusion: The diagnosis of COVID-19 is based on history of patient, typical symptoms or clinical findings. Chest CT, RT-PCR and laboratory abnormalities make the diagnosis of disease stronger.

scholarly journals CT findings of 795 COVID-19 positive cases: a multicenter study in Egypt

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Youssriah Yahia Sabri ◽  
Mohamed Mohsen Tolba Fawzi ◽  
Eman Zaki Nossair ◽  
Safaa Mohamed El-Mandooh ◽  
Amira Aly Hegazy ◽  
...  
Keyword(s):  
Virus Disease ◽  
Chest Ct ◽  
Imaging Features ◽  
Rt Pcr ◽  
Relevant Research ◽  
Non Invasive ◽  
Ct Findings ◽  
Global Pandemic ◽  
Polymerase Chain ◽  
Ct Studies

Abstract Background Corona Virus Disease 2019 (COVID-19) outbreak was officially announced as a global pandemic by the WHO on March 11th 2020. Thorough understanding of CT imaging features of COVID-19 is essential for effective patient management; rationalizing the need for relevant research. The aim of this study was to analyze the chest CT findings of patients with real-time polymerase chain reaction (RT-PCR) proved COVID-19 admitted to four Egyptian hospitals. The recently published RSNA expert consensus statement on reporting COVID-19 chest CT findings was taken into consideration. Results Normal CT “negative for COVID-19” was reported in 26.1% of our RT-PCR proved COVID-19 cases. In descending order of prevalence, imaging findings of the positive CT studies (73.9%) included GGO (69%), consolidation (49.7%), crazy paving (15.4%), and peri-lobular fibrosis (40.6%). These showed a dominantly bilateral (68.2%), peripheral (72.4%), and patchy (64.7%) distribution. Remarkably, thymic hyperplasia was identified in 14.3% of studies. According to the RSNA consensus, CT findings were classified as typical in 68.9%, indeterminate in 3.6%, and atypical in 1.4% of the evaluated CT studies. Conclusion Although COVID-19 cannot be entirely excluded by chest CT, it can be distinguished in more than two-thirds of cases; making CT a widely available, non-invasive, and rapid diagnostic tool.

The Role of CO-RADS Scoring System in the Diagnosis of COVID-19 Infection and its Correlation with Clinical Signs

2021 ◽  
Vol 17 ◽  
Author(s):  
Şenol Çomoğlu ◽  
Sinan Öztürk ◽  
Ahmet Topçu ◽  
Fatma Kulalı ◽  
Aydın Kant ◽  
...  
Keyword(s):  
Scoring System ◽  
Clinical Signs ◽  
Assessment System ◽  
Symptom Duration ◽  
Shortness Of Breath ◽  
Laboratory Findings ◽  
Ct Findings ◽  
Chronic Pulmonary Diseases ◽  
Ct Evaluation ◽  
The Difference

Background: Computed tomography (CT) evaluation systematics has become necessary to eliminate the difference of opinion among radiologists in evaluating COVID-19 CT findings. Introduction: The objectives of this study were to evaluate the efficiency of CO-RADS scoring system in our patients with COVID-19 as well as to examine its correlation with clinical and laboratory findings. Method: The CO-RADS category of all patients included in the study was determined by a radiologist who did not know the rtRT-PCR test result of the patients, according to the Covid-19 reporting and data system of Mathias Prokop et al. Results: A total of 1338 patients were included. CT findings were positive in 66.3%, with a mean CO-RADS score of 3,4 ± 1,7. 444 (33.1%) of the patients were in the CO-RADS 1-2, 894 (66.9%) were in the CO-RADS 3-5 group. There were positive correlations between CO-RADS score and age, CMI, hypertension, diabetes mellitus, chronic pulmonary diseases presence of symptoms, symptom duration, presence of cough, shortness of breath, malaise, CRP, and LDH, while CO-RADS score was negatively correlated with lymphocyte count. The results of the ROC analysis suggested that those with age ≥40 years, symptom duration >2 days, CMI score >1 and/or comorbid conditions were more likely to have a CO-RADS score of 3-5. Conclusion: The CO-RADS classification system is a CT findings assessment system that can be used to diagnose COVID-19 in patients with symptoms of cough, shortness of breath, myalgia and fatigue for more than two days.

DIAGNOSTIC ROLE OF CHEST CT USING CO-RADS CATEGORIZATION IN SARS-COV-2 INFECTION WITH EMPHASIS ON IMPACT OF CT IN PATIENTS WITH DELAYED OR NEGATIVE INITIAL RTPCR TEST

2021 ◽  
pp. 51-52
Author(s):  
Tharani Putta ◽  
Kaushik Deconda
Keyword(s):  
Diagnostic Performance ◽  
Virus Disease ◽  
Vital Role ◽  
Chest Ct ◽  
Lung Involvement ◽  
Test Results ◽  
Rt Pcr ◽  
Diagnostic Role ◽  
Pcr Test

BACKGROUND AND OBJECTIVE: Role of chest CT in diagnosis of corona virus disease 2019 (COVID-19) has been controversial. The purpose of this study is to evaluate the diagnostic performance of chest CT when utilizing COVID-19 Reporting and Data System (CO-RADS). METHODOLOGY: Retrospective study including consecutive patients with positive SARS-CoV-2 RT-PCR test (initial or repeat test) and chest CT done in our institute between June and September 2020. Spectrum of CT ndings, CO-RADS score and 25 point CT severity score (CTSS) were recorded. RESULTS: A total of 300 consecutive patients with SARS-CoV-2 infection were included in the analysis. Out of the 168 patients who underwent CT prior to positive RT-PCR result, 125 (74.4%) had CO-RADS 3, 4 or 5 score on chest CT. 32 study patients (10.6%) had initial negative RT-PCR of which 24 (75%) had CO-RADS 4 or 5 score. Of the total patients with CO-RADS 3 to 5 score (227), 20 (8.8%) had severe lung involvement (CTSS 18-25), 83 (36.6%) had moderate lung involvement (CTSS 8-17) and 124 (54.6%) had mild lung involvement (CTSS 1-7). The mean CTSS was 7.9 with mean lobar score being higher in lower lobes (RLL=1.82, LLL=1.78) compared to the upper and middle lobes (RUL=1.61, RML=1.19, LUL=1.53). CONCLUSION:CT using CO-RADS scoring system has good diagnostic performance. In addition to assessing disease severity, it plays a vital role in triage of patients with suspected COVID-19 especially when there is limited availability of SARS-CoV-2 RT-PCR tests, delay in RT-PCR test results or in negative RT-PCR cases when there is high index of clinical suspicion.

Tissue Expression of TNF-alpha and IL-18 by Real Time PCR in Initiated Atherosclerosis in Wistar Male Rats

2020 ◽  
Author(s):  
H. Srinivasa Naik ◽  
Ch. Srilatha ◽  
K. Sujatha ◽  
B. Sreedevi ◽  
TNVKV Prasad
Keyword(s):  
Real Time ◽  
Real Time Pcr ◽  
Density Lipoprotein ◽  
Tissue Expression ◽  
The Body ◽  
Male Rats ◽  
Tnf Alpha ◽  
Albino Rats ◽  
Group I ◽  
Group Ii

Background: Atherosclerosis is diverse disease with heterogenous mechanisms of progression and is an oxidative, chronic inflammatory and thrombotic disease produced by elevated level of low density lipoprotein cholesterol (LDL-C) in the blood. Initiation of atherosclerosis begins with the production of various inflammatory cytokines and adhesive molecules on the endothelium of the large muscular arteries like aorta. The present study was carried out to know the expression of TNF-Alpha and IL-18 by real time PCR (Polymerase chain reaction). Methods: Procured 24 Wistar albino rats and divided into two groups consisting of 12 rats in each. Atherosclerosis was induced by addition of 1% cholesterol and 15% saturated oil to the 1000g of standard rat diet and given to group II rats. Group I kept as control and maintained for 90 days. Result: Group II rats clinically showed obesity with significant increase (p less than 0.05) in the body weight. TC, TG, LDL-C, VLDL-C were significantly (p less than 0.05) higher, whereas HDL-C was significantly (p less than 0.05) reduced. Atherogenic diet induced the initiation of atherosclerosis in the aorta with degeneration of endothelial cells, sub intimal lipid laden macrophages (foam cells), slight thickening of the tunica intima with proliferation of few SMCs in group I rats. Present study revealed positive expression of TNF- alpha and no expression of IL-18 cytokine in the aorta of group II rats by RT-PCR.

scholarly journals Perspective of Arguments in Public Health

2021 ◽  
Vol 9 (1) ◽  
pp. 44-45
Author(s):  
Dinesh Kumar
Keyword(s):  
Polymerase Chain Reaction ◽  
Real Time ◽  
Respiratory Symptoms ◽  
False Negative ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Negative Report ◽  
Polymerase Chain ◽  
Time Of Admission ◽  
Pcr Test

Recently, an argument was put forth because a symptomatic and positive patient for CoVID-19 turned tested negative after 7 days, so discharged from the hospital. Both at the time of admission and discharge real-time reverse transcriptase Polymerase Chain Reaction (RT-PCR) was done for testing of CoVID-19. Immediately, patient again developed respiratory symptoms and was admitted to hospital again. Amidst of current CoVID-19 pandemic, a question was asked “What is the specificity of the Real Time-Polymerase Chain Reaction (RT-PCR) test for COVID-19?” with an assumption that what if at the time of discharge the disease is present in patient but test turned out to be negative? In response to that a counter statement was posed that “It is the sensitivity that should be asked rather than specificity”. It was based on the implication of primary question that was implying false negative report of the RT-PCR. It means, since patient was discharged with negative result that could be false negative.

scholarly journals Reducing False Negative PCR Test for COVID-19

2020 ◽  
Vol 9 (3) ◽  
pp. 408-410
Author(s):  
Fatemeh Bahreini ◽  
Rezvan Najafi ◽  
Razieh Amini ◽  
Salman Khazaei ◽  
Saeid Bashirian
Keyword(s):  
Polymerase Chain Reaction ◽  
Real Time ◽  
False Negative ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Creative Commons ◽  
Negative Results ◽  
False Negative Results ◽  
Polymerase Chain ◽  
Pcr Test

As the SARS-CoV-2 (COVID-19) pandemic spreads rapidly, there is need for a diagnostic test with high accuracy to detect infected individuals especially those without symptoms. Real-time polymerase chain reaction (RT-PCR) is a common molecular test for diagnosing SARS-CoV-2. If some factors are not taken into consideration when performing this test, it can have a relatively large number of false negative results. In this article, we discuss important considerations that could lead to false negative test reduction. Key words: • SARS-CoV-2 • COVID-19 • Real time polymerase chain reaction • RT-PCR test • Diagnosis • False negatives • Genetics • Emerging disease   Copyright © 2020 Bahreini et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0)which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

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