scholarly journals The role of lung ultrasonography in evaluation of COVID-19 pneumonia

2021 ◽  
Vol 9 (7) ◽  
pp. 2145
Author(s):  
Ali Kemal Erenler ◽  
Seval Komut ◽  
Ahmet Baydin
Keyword(s):  
Ct Scan ◽  
Early Stage ◽  
False Negative ◽  
Cost Effective ◽  
Diagnostic Value ◽  
World Health ◽  
Nasopharyngeal Swab ◽  
Lung Ultrasonography ◽  
Advantages And Disadvantages ◽  
Pcr Test

After a few months it emerged in Wuhan (China), Coronavirus Disease 2019 (COVID-19) caused by 2019 novel coronavirus (2019-nCoV) was declared as a pandemic by the World Health Organization (WHO). Diagnosis of the disease is mainly based on real time polymerase chain reaction (PCR) test by nasopharyngeal swab. However, due to excess of numbers of false-negative PCR test results, chest computed tomography (CT) is commonly used as a supplementary modality. However, CT has some disadvantages. Firstly, a normal chest CT scan does not exclude the diagnosis of COVID-19 pneumonia. Additionally, the radiation exposure and a weak diagnostic value are other challenges. When the infection is limited to upper respiratory system or performed in the early stage, false-negative results may be obtained on CT scan.  Recently lung ultrasonography (LUS) has emerged as a easy-to-use, cost-effective and radiation-free tool in diagnosis, management and follow-up of COVID-19 pneumonia. In this narrative review, our aim is to clarify the utility of LUS in COVID-19 pneumonia with its advantages and disadvantages. We also aimed to guide clinicians to use LUS as a practical tool.

scholarly journals Analysis of factors associated early diagnosis in coronavirus disease 2019 (COVID-19)

2020 ◽  
Author(s):  
Jinwei Ai ◽  
Junyan Gong ◽  
Limin Xing ◽  
Renjiao He ◽  
Fangtao Tian ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Ct Scan ◽  
Lymphocyte Count ◽  
False Negative ◽  
False Negative Rate ◽  
Diagnostic Value ◽  
Rt Pcr ◽  
Likelihood Ratios ◽  
High False Negative Rate ◽  
Pcr Test

AbstractBackgroundThe pandemic of coronavirus disease 2019 (COVID-19) has become the first concern in international affairs as the novel coronavirus (SARS-CoV-2) is spreading all over the world at a terrific speed. The accuracy of early diagnosis is critical in the control of the spread of the virus. Although the real-time RT-PCR detection of the virus nucleic acid is the current golden diagnostic standard, it has high false negative rate when only apply single test.ObjectiveSummarize the baseline characteristics and laboratory examination results of hospitalized COVID-19 patients. Analyze the factors that could interfere with the early diagnosis quantitatively to support the timely confirmation of the disease.MethodsAll suspected patients with COVID-19 were included in our study until Feb 9th, 2020. The last day of follow-up was Mar 20th, 2020. Throat swab real-time RT-PCR test was used to confirm SARS-CoV-2 infection. The difference between the epidemiological profile and first laboratory examination results of COVID-19 patients and non-COVID-19 patients were compared and analyzed by multiple logistic regression. Receiver operating characteristic (ROC) curve and area under curve (AUC) were used to assess the potential diagnostic value in factors, which had statistical differences in regression analysis.ResultsIn total, 315 hospitalized patients were included. Among them, 108 were confirmed as COVID-19 patients and 207 were non-COVID-19 patients. Two groups of patients have significance in comparing age, contact history, leukocyte count, lymphocyte count, C-reactive protein, erythrocyte sedimentation rate (p<0.10). Multiple logistic regression analysis showed age, contact history and decreasing lymphocyte count could be used as individual factor that has diagnostic value (p<0.05). The AUC of first RT-PCR test was 0.84 (95% CI 0.73-0.89), AUC of cumulative two times of RT-PCR tests was 0.92 (95% CI 0.88-0.96) and 0.96 (95% CI 0.93-0.99) for cumulative three times of RT-PCR tests. Ninety-six patients showed typical pneumonia radiological features in first CT scan, AUC was 0.74 (95% CI 0.60-0.73). The AUC of patients’ age, contact history with confirmed people and the decreased lymphocytes were 0.66 (95% CI 0.60-0.73), 0.67 (95% CI 0.61-0.73), 0.62 (95% CI 0.56-0.69), respectively. Taking chest CT scan diagnosis together with patients age and decreasing lymphocytes, AUC would be 0.86 (95% CI 0.82-0.90). The age threshold to predict COVID-19 was 41.5 years, with a diagnostic sensitivity of 0.70 (95% CI 0.61-0.79) and a specificity of 0.59 (95% CI 0.52-0.66). Positive and negative likelihood ratios were 1.71 and 0.50, respectively. Threshold of lymphocyte count to diagnose COVID-19 was 1.53×109/L, with a diagnostic sensitivity of 0.82 (95% CI 0.73-0.88) and a specificity of 0.50 (95% CI 0.43-0.57). Positive and negative likelihood ratios were 1.64 and 0.37, respectively.ConclusionSingle RT-PCR test has relatively high false negative rate. When first RT-PCR test show negative result in suspected patients, the chest CT scan, contact history, age and lymphocyte count should be used combinedly to assess the possibility of SARS-CoV-2 infection.

scholarly journals Comparison of saliva with healthcare workers- and patient-collected swabs in the diagnosis of COVID-19 in a large cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mitnala Sasikala ◽  
Yelamanchili Sadhana ◽  
Ketavarapu Vijayasarathy ◽  
Anand Gupta ◽  
Sarala Kumari Daram ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Early Stage ◽  
Cost Effective ◽  
Hospitalized Patients ◽  
Detection Sensitivity ◽  
Nasopharyngeal Swab ◽  
Predictive Values ◽  
Qrt Pcr ◽  
Asymptomatic Patients ◽  
Sensitivity Specificity

Abstract Background A considerable amount of evidence demonstrates the potential of saliva in the diagnosis of COVID-19. Our aim was to determine the sensitivity of saliva versus swabs collected by healthcare workers (HCWs) and patients themselves to assess whether saliva detection can be offered as a cost-effective, risk-free method of SARS-CoV-2 detection. Methods This study was conducted in a hospital involving outpatients and hospitalized patients. A total of 3018 outpatients were tested. Of these, 200 qRT-PCR-confirmed SARS-CoV-2-positive patients were recruited for further study. In addition, 101 SARS-CoV-2-positive hospitalized patients with symptoms were also enrolled in the study. From outpatients, HCWs collected nasopharyngeal swabs (NPS), saliva were obtained. From inpatients, HCWs collected swabs, patient-collected swabs, and saliva were obtained. qRT-PCR was performed to detect SARS-CoV-2 by TAQPATH assay to determine the sensitivity of saliva detection. Sensitivity, specificity and positive/negative predictive values (PPV, NPV) of detecting SARS-CoV-2 were calculated using MedCalc. Results Of 3018 outpatients (asymptomatic: 2683, symptomatic: 335) tested by qRT-PCR, 200 were positive (males: 140, females: 60; aged 37.9 ± 12.8 years; (81 asymptomatic, 119 symptomatic). Of these, saliva was positive in 128 (64%); 39 of 81 asymptomatic (47%),89 of 119 symptomatic patients (74.8%). Sensitivity of detection was 60.9% (55.4–66.3%, CI 95%), with a negative predictive value of 36%(32.9–39.2%, CI 95%).Among 101 hospitalized patients (males:65, females: 36; aged 53.48 ± 15.6 years), with HCW collected NPS as comparator, sensitivity of saliva was 56.1% (47.5–64.5, CI 95%), specificity 63.5%(50.4–75.3, CI95%) with PPV of 77.2% and NPV of 39.6% and that of self-swab was 52.3%(44–60.5%, CI95%), specificity 56.6% (42.3–70.2%, CI95%) with PPV 77.2% and NPV29.7%. Comparison of positivity with the onset of symptoms revealed highest detection in saliva on day 3 after onset of symptoms. Additionally, only saliva was positive in 13 (12.8%) hospitalized patients. Conclusion Saliva which is easier to collect than nasopharyngeal swab is a viable alternate to detect SARS-COV-2 in symptomatic patients in the early stage of onset of symptoms. Although saliva is currently not recommended for screening asymptomatic patients, optimization of collection and uniform timing of sampling might improve the sensitivity enabling its use as a screening tool at community level.

scholarly journals COVID-19: molecular and serological detection methods

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10180 ◽  
Author(s):  
Ahmed E. Dhamad ◽  
Muna A. Abdal Rhida
Keyword(s):  
Early Detection ◽  
Current Knowledge ◽  
Early Stage ◽  
Diagnostic Methods ◽  
World Health ◽  
Detection Methods ◽  
Gold Standard Method ◽  
Advantages And Disadvantages ◽  
The World ◽  
Health Organization

Since COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared as a pandemic disease by the World Health Organization in early 2020, many countries, organizations and companies have tried to find the best way to diagnose the virus and contain its spreading. SARS-CoV-2 is a positive-sense single RNA (+ssRNA) coronavirus and mainly spreads through droplets, respiratory secretions, and direct contact. The early detection of the virus plays a central role in lowering COVID19 incidents and mortality rates. Thus, finding a simple, accurate, cheap and quick detection approach for SARS-CoV-2 at early stage of the viral infection is urgent and at high demand all around the world. The Food and Drug Administration and other health agencies have declared Emergency Use Authorization to develop diagnostic methods for COVID-19 and fulfill the demand. However, not all developed methods are appropriate and selecting a suitable method is challenging. Among all detection methods, rRT-PCR is the gold standard method. Unlike molecular methods, serological methods lack the ability of early detection with low accuracy. In this review, we summarized the current knowledge about COVID-19 detection methods aiming to highlight the advantages and disadvantages of molecular and serological methods.

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 Is Nasal Endoscopy of Diagnostic Value in Chronic Rhinosinusitis Without Nasal Polyps?

2019 ◽  
pp. 014556131986457
Author(s):  
Raanan Cohen-Kerem ◽  
Tal Marshak ◽  
Nechama Uri ◽  
Maayan Gruber ◽  
Ori Huberfeld ◽  
...  
Keyword(s):  
Ct Scan ◽  
Chronic Rhinosinusitis ◽  
Repeated Measures ◽  
Medical Condition ◽  
Medical Center ◽  
Academic Medical Center ◽  
False Negative ◽  
Diagnostic Value ◽  
Nasal Endoscopy ◽  
Nasal Passage

Endoscopic examination of the nasal cavity is an integral part of the assessment of patients with chronic rhinosinusitis. However, the benefit gained by performing endoscopy with respect to the patient’s medical condition has not been completely assessed. We conducted a prospective cohort in an academic medical center. Thirty-nine patients diagnosed with chronic rhinosinusitis, without polyps, whose ailment was managed conservatively with no surgical intervention. All patients underwent nasal endoscopy, a computed tomography (CT) scan rated for Lund-MacKay score, and completed a sino nasal outcome test (SNOT)-20 questionnaire. This same evaluation was repeated 6 weeks following medical treatment. The CT scan and SNOT-20 questionnaire were independent parameters to evaluate the endoscopy score in each nasal passage. Thirty-nine (28 females) patients completed the follow-up period. A total of 156 endoscopic evaluations were performed, in which 74 nasal cavities were found to have significant pathology and 82 were either normal or displayed mild pathology. The correlation with the Lund-MacKay score was poor with a positive predictive value of 68.9% (31.1% false positive and 28% false negative). However, while looking at the SNOT-20 score, corrected for repeated measures, a higher endoscopy score was associated with a higher SNOT-20 score (odds ratio = 3.53, 95% confidence interval = 1.54-8.09, P = .003). Patients with higher endoscopy scores had a greater probability for exhibiting severe symptoms. However, we could not demonstrate a strong correlation between nasal endoscopy findings and CT scan scores. Therefore, with respect to patients with chronic rhinosinusitis without polyps, nasal endoscopy could be utilized as a beneficial objective tool.

scholarly journals Diagnostic value of FDG PET/CT imaging in patients with surgically managed infective endocarditis: results of a retrospective analysis at a tertiary center

2020 ◽  
Author(s):  
Sabine Julia Maria Sag ◽  
Karin Menhart ◽  
Jirka Grosse ◽  
Florian Hitzenbichler ◽  
Frank Hanses ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Ct Scan ◽  
Retrospective Analysis ◽  
Real World ◽  
Fdg Pet ◽  
False Negative ◽  
Diagnostic Value ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

Abstract Background We assessed the diagnostic value of FDG PET/CT in a real-world cohort of patients with surgically managed infective endocarditis (IE). Methods We performed a retrospective analysis of all patients hospitalized in a tertiary IE referral medical center from January 2014 to October 2018 fulfilling the following criteria: ICD-10 code for IE and OPS code for both, heart surgery and FDG PET/CT. Results Final analysis included 29 patients, whereof 28 patients had surgically proven IE. FDG PET/CT scan was true-positive in 15 patients (sensitivity (SEN) 56%) and false-negative in 12 patients. Combination of Duke criteria (DC) with FDG PET/CT scan resulted in gain of SEN for all patients with confirmed IE (SEN of DC 79% vs SEN of combination DC and FDG PET/CT 89%), driven by a relevant gain in PVE patients only (SEN of DC 78% vs SEN of combination DC and FDG PET/CT 94%). Interestingly, higher prosthesis age was observed in patients with false-negative scans. Conclusions We found a SEN of 56% for FDG PET/CT in a real-world cohort of patients with surgically proven IE which was associated with a 16% gain of IE diagnosis in patients with PVE when combined with DC.

scholarly journals Meta-analysis: COVID-19 diagnosis in chest CT—master key for radiologists

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Soheil Hassanipour ◽  
Omid Azadbakht ◽  
Zari Dehnavi ◽  
Mohsen Shafiee ◽  
Ahmad Badeenezhad ◽  
...  
Keyword(s):  
Ct Scan ◽  
Early Stage ◽  
Meta Analysis ◽  
Chest Ct ◽  
Observation Level ◽  
Test Sensitivity ◽  
Medical Centers ◽  
Sensitivity Level ◽  
Correct Location ◽  
Pcr Test

Abstract Background COVID-19 was discovered in February in China. Due to the high prevalence of the disease, early detection and rapid isolation of patients are the vital points for controlling the outbreak. The purpose of this study was to determine the correct location of chest CT scan in the diagnosis of COVID-19. Main text The current study is a systematic review and meta-analysis. 2959 papers were found in all national and international databases. The study has been reported based on the PRISMA checklist. All analyses were done by CMA Ver. 2 software. The statistical analysis results show that the GGO observation level in the available shape was 46% in CT scan results, and the consolidation observation level in the general form was 33% in CT scan results. Pleural effusion was 7%, and linear opacity observation level was 24% in CT scan results in the general form. The CT scan test sensitivity level was gained 94.7%, and PCR test sensitivity level was achieved as 94.8%. This level was 89% in the early stage. Conclusion The chest CT has about 24% higher diagnostic sensitivity than the PCR test, in the early stage. GGO revealed a declining process and also indicates that GGO is an early symptom of the disease in CT scan. Linear opacity is the reason behind the initial dyspnea in coronavirus suffering patients referring to the medical centers. The extra-pulmonary lesions increase in the last stage of the disease that makes the patient’s worse.

scholarly journals Image-Guided Localization Techniques for Surgical Excision of Non-Palpable Breast Lesions: An Overview of Current Literature and Our Experience with Preoperative Skin Tattoo

2021 ◽  
Vol 11 (2) ◽  
pp. 99
Author(s):  
Gianluca Franceschini ◽  
Elena Jane Mason ◽  
Cristina Grippo ◽  
Sabatino D’Archi ◽  
Anna D’Angelo ◽  
...  
Keyword(s):  
Early Stage ◽  
Cost Effective ◽  
Standard Of Care ◽  
Surgical Excision ◽  
Breast Conserving Surgery ◽  
Advantages And Disadvantages ◽  
Seed Localization ◽  
Technological Developments ◽  
Palpable Breast ◽  
Best Localization

Breast conserving surgery has become the standard of care and is more commonly performed than mastectomy for early stage breast cancer, with recent studies showing equivalent survival and lower morbidity. Accurate preoperative lesion localization is mandatory to obtain adequate oncological and cosmetic results. Image guidance assures the precision requested for this purpose. This review provides a summary of all techniques currently available, ranging from the classic wire positioning to the newer magnetic seed localization. We describe the procedures and equipment necessary for each method, outlining the advantages and disadvantages, with a focus on the cost-effective preoperative skin tattoo technique performed at our centre. Breast surgeons and radiologists have to consider ongoing technological developments in order to assess the best localization method for each individual patient and clinical setting.

scholarly journals The Need of Non-traditional Techniques to Screen for the Virus

2020 ◽  
Vol 8 (T1) ◽  
pp. 1-2
Author(s):  
Davide Borroni ◽  
Kunal Gadhvi
Keyword(s):  
Early Stage ◽  
False Negative ◽  
Cost Effective ◽  
The United States ◽  
Viral Metagenomics ◽  
Present Moment ◽  
Rt Pcr ◽  
Viral Genomes ◽  
Reverse Transcription Pcr ◽  
Positive Rate

BACKGROUND: At the present moment, the etiological diagnosis of SARS-CoV-2 is based on the polymerase chain reaction (PCR). False negative cases are increasingly reported in several studies using reverse transcription-PCR (RT-PCR). For example, the positive rate of RT-PCR for throat swabs was reported to be about 60% in early stage of COVID-19. AIM: We aimed to present metagenomic next-generation sequencing (mNGS) as a potential tool to detect pathogens. METHODS: In the recent year, mNGS is shown the potential to detect pathogens without the need of hypothesis guided approach and is proven to be highly effective. RESULTS: A recent prospective study in the United States compared the diagnostic performance of routine diagnostic tests with mNGS and showed that mNGS detected a bacteria or virus in the CSF of 13 of 58 patients presenting with meningoencephalitis who were negative for or not assessed with routine diagnostic test including PCR. NGS also has the advantage to cover entire viral genomes. CONCLUSION: As viral metagenomics has significantly improved in recent years and become more cost effective, we think that a change in the approach toward a shot-gun metagenomic testing should be explored and could potentially aid the diagnosis of COVID-19 cases and the management of this pandemic.

scholarly journals "Multimodal" Imaging Performance and Clinical Application of Coronavirus Disease 2019 (COVID-19)

2020 ◽  
Author(s):  
Guohong Li ◽  
Qijian Zhou ◽  
Jintian Li ◽  
Lin Zhu ◽  
Yan Chen ◽  
...  
Keyword(s):  
Ct Scan ◽  
False Negative ◽  
Diagnostic Value ◽  
Ground Glass ◽  
Digital Tomosynthesis ◽  
Diagnostic Efficiency ◽  
Imaging Methods ◽  
Examination Methods ◽  
Equal Capacity ◽  
Novel Coronavirus

Abstract Background: To investigate the diagnostic value of three different examination methods of chest radiography (CXR), digital tomosynthesis (DTS) and Computed tomography (CT) scan on the diagnosis of novel coronavirus pneumonia (COVID-19).Methods: A retrospective analysis of three examination methods of chest: CXR, DTS, and CT scan of COVID-19 pneumonia patients diagnosed in our hospital from January, 23, 2020 to February, 29, 2020. And we compared three different imaging methods to COVID-19 display ability of pneumonia intrapulmonary lesions.Results: A total of 37 patients diagnosed as COVID-19 by nucleic acid testing were included. The CXR group (10/37) and DTS group (21/28) of 37 patients with COVID-19 pneumonia showed significant differences in intrapulmonary ground glass opacities (P<0.05); DTS group (21/28) and CT group (25/27) showed no statistically significant differences in intrapulmonary ground glass opacities (P> 0.05). Conclusion: Comparison of the three imaging methods of COVID-19 pneumonia, the diagnostic efficiency of CXR is low, which is easy to be false negative and miss lesions; diagnostic resolutions of DTS are higher than CXR, which can improve the ability to display the fine structure of intrapulmonary lesions; CT scan shows the intrapulmonary of COVID-19 pneumonia low-density ground glass opacities and internal structures have equal capacity compared with DTS. Therefore, DTS and CT are the best choices for the image diagnosis of COVID-19 pneumonia.

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