scholarly journals COVID-19 Cases Detection: Suspect Case Strategy

2020 ◽  
Vol 9 (3) ◽  
pp. 72
Author(s):  
Zhongliang Ji ◽  
Kailin Lu ◽  
Xuedong Sun
Keyword(s):  
Roc Curve ◽  
Operating Characteristic ◽  
False Negative ◽  
Economic Loss ◽  
Chest Ct ◽  
Reference Standard ◽  
Rt Pcr ◽  
Isolation Ward ◽  
Suspect Case ◽  
Pcr Test

<p><strong>Background and objective:</strong> as COVID-19 has triggered enormous human casualties and disastrous economic loss, the strategies to contain its spread are urgently needed. We aim to assess the value of our suspect case strategy on COVID-19 cases detection and ensure it to be a complement to the RT-PCR test. <strong>Materials and methods:</strong> from January 23 to April 30, 2020, patients admitted to our emergence isolation ward (EIW) were analyzed in this study. With RT-PCR as a reference standard, all participants were assigned to COVID-19 positive and negative groups. We compared the performance of the suspect case strategy, WBC, LYM, and chest radiography on COVID-19 detection. <strong>Results:</strong> one hundred twenty-five cases were analyzed in the study period. The receiver operating characteristic (ROC) curve revealed the sensitivity of WBC and LYM on COVID-19 detection was 92.11% and 76.31%, respectively. The sensitivity of the suspect case was 94.73%, and the sensitivity of chest CT was 53.33%. Statistically significant differences were observed for the suspect case, WBCs, LYM, and chest CT on COVID-19 detection. <strong>Discussion:</strong> suspect case strategy can help identify false negative RT-PCR tests and be a useful complement to RT-PCR in some countries with a tremendous shortage of RT-PCR agents and specialized laboratory during the COVID-19 outbreak.</p>

scholarly journals A case report of COVID-19 with false negative RT-PCR test: necessity of chest CT

2020 ◽  
Vol 38 (5) ◽  
pp. 409-410 ◽  
Author(s):  
Hao Feng ◽  
Yujian Liu ◽  
Minli Lv ◽  
Jianquan Zhong
Keyword(s):  
Case Report ◽  
False Negative ◽  
Chest Ct ◽  
Rt Pcr ◽  
Pcr Test

scholarly journals More Accurate Estimates of the Accuracy of RT-PCR and Chest CT Tests for COVID-19

2021 ◽  
Author(s):  
Lu Wang ◽  
Xueqing Liu ◽  
Chen Xia ◽  
Jun Liu ◽  
Xiao-Hua Zhou
Keyword(s):  
Gold Standard ◽  
False Negative ◽  
Chest Ct ◽  
Rt Pcr ◽  
Original Population ◽  
Verification Bias ◽  
Negative Results ◽  
False Negative Results ◽  
Lower Specificity ◽  
Pcr Test

Abstract In this article, we propose a novel statistical method for estimating the accuracy of chest computed tomography (CT) and reverse transcription polymerase chain reaction (RT-PCR) tests in the diagnosis of coronavirus disease 2019 (COVID-19), with a correction for imperfect gold standard and verification bias simultaneously. These two types of bias are often involved in estimating the diagnostic accuracy of COVID-19 tests. Imperfect gold standard bias arises when estimating accuracy measures of chest CT while using the RT-PCR test as a gold standard, despite its tendency to produce false negative results. Meanwhile, verification bias occurs in some studies where the results from chest CT are verified by RT-PCR test in a subsample of suspected cases that is not representative of the original population. Consequently, the accuracy estimates of chest CT and RT-PCR tests could be seriously biased and lead to invalid inference. Our proposed method is able to correct these two types of bias in providing unbiased and more accurate estimates of sensitivity and specificity of the two tests. Our results suggest that chest CT has higher sensitivity and lower specificity than RT-PCR, and the accuracy estimates can serve as an important reference for assessing and comparing the performance of these two tests in the diagnosis of COVID-19, and could guide policy recommendations for the implementation of these tests.

scholarly journals COVID 19 with false negative RT-PCR test in 4 patients: When Chest CT becomes a need

2020 ◽  
Vol 10 (06) ◽  
pp. 724-730
Author(s):  
Mariam Kassimi ◽  
Rita Filali ◽  
Nabil Chikhaoui ◽  
Mohamed Mahi
Keyword(s):  
False Negative ◽  
Chest Ct ◽  
Rt Pcr ◽  
Pcr Test

scholarly journals Superiority of MALDI-TOF Mass Spectrometry over Real-Time PCR for SARS-CoV-2 RNA Detection

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 730
Author(s):  
Magda Rybicka ◽  
Ewa Miłosz ◽  
Krzysztof Piotr Bielawski
Keyword(s):  
Mass Spectrometry ◽  
Gold Standard ◽  
Viral Genome ◽  
False Negative ◽  
Rt Pcr ◽  
Rna Detection ◽  
Maldi Tof ◽  
Negative Results ◽  
False Negative Results ◽  
Pcr Test

At present, the RT-PCR test remains the gold standard for early diagnosis of SARS-CoV-2. Nevertheless, there is growing evidence demonstrating that this technique may generate false-negative results. Here, we aimed to compare the new mass spectrometry-based assay MassARRAY® SARS-CoV-2 Panel with the RT-PCR diagnostic test approved for clinical use. The study group consisted of 168 suspected patients with symptoms of a respiratory infection. After simultaneous analysis by RT-PCR and mass spectrometry methods, we obtained discordant results for 17 samples (10.12%). Within fifteen samples officially reported as presumptive positive, 13 were positive according to the MS-based assay. Moreover, four samples reported by the officially approved RT-PCR as negative were positive in at least one MS assay. We have successfully demonstrated superior sensitivity of the MS-based assay in SARS-CoV-2 detection, showing that MALDI-TOF MS seems to be ideal for the detection as well as discrimination of mutations within the viral genome.

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.

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.

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.

scholarly journals Evaluation of chest computed tomography features in COVID-19: a single-center retrospective study

2021 ◽  
Vol 4 (4) ◽  
pp. 588-594
Author(s):  
Akshat Sanjay Shukla ◽  
Sanjay Rajendraprasad Shukla ◽  
Feral Ravi Daruwala
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
False Negative ◽  
Chest Ct ◽  
Single Center ◽  
Rt Pcr ◽  
Pulmonary Vessel ◽  
Ct Findings ◽  
Diagnostic Center ◽  
Second Wave

Background: Even though Real-Time Polymerase Chain Reaction (RT-PCR) is a gold standard for confirming COVID-19, it continues to be plagued by a lack of RT-PCR kits and the potential of false-negative results. Hence, during the second wave of COVID-19 in India, Computed Tomography (CT) scan is an emerging diagnostic tool in evaluating the severity of illness in COVID-19 pneumonia. The present study endeavored to assess chest CT features of COVID-19 pneumonia in Indian population. Methods: This was a single-center, retrospective, observational study conducted in 300 consecutive adults RT-PCR confirmed COVID-19 patients from 1, Jan 2021 to 31, March 2021 at a private radio diagnostic center.  Data regarding baseline demographics, clinical and laboratory characteristics, extent, pattern, and type of abnormal CT findings were noted. Results: The study population (204 males and 108 females) had mean age of 43.18 ± 8.27 years.  Our study's most common clinical presentation was cough (48.1%) and fever (47.1%), respectively. Lung parenchymal abnormalities were found in 294 (94.2%) patients. Abnormal CT findings revealed the involvement of bilateral (45.6%) and multilobar (42.9%) with a predominant peripheral (92.3%) and posterior (80.8%) distribution. According to the type of opacity, Ground Glass Opacity (GGO) was the dominant abnormality found in 270 (91.8%) patients, in which pure GGO (36.7%), GGO with crazy paving pattern (39.8%), and GGO mixed with consolidation (52.0 %) were noted. Peri-lesional or intralesional segmental or subsegmental pulmonary vessel enlargement was found in 192 (65.3 %) patients. Conclusion: During the second wave of COVID-19, a chest CT scan is a modality of choice in diagnosing COVID-19 pneumonia and related lung parenchymal changes.

scholarly journals Chest CT changes in COVID-19 patients with hypertension comorbidities

2020 ◽  
Author(s):  
Wei Li ◽  
Wenjun Yu ◽  
Jianwei Liao ◽  
Yijie Fang ◽  
Lin Yao ◽  
...  
Keyword(s):  
Global Health ◽  
Clinical Features ◽  
Clinical Data ◽  
Clinical Characteristics ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ground Glass ◽  
Rt Pcr ◽  
Relationship Of ◽  
Pcr Test

Abstract AIMTo summarize the chest CT and clinical features of COVID-19 pneumonia patients with hypertension comorbidities.METHODSThe initial chest CT imaging and clinical data of 15 confirmed COVID-19 patients with hypertension comorbidities treated in our hospital were analyzed retrospectively from January 1, 2019 to February 14, 2020. The chest CT images and clinical data were reviewed and their relationship of the disease was analyzed.RESULTSTotally 15 COVID-19 patients diagnosed with hypertension comorbidities were included. In terms of clinical characteristics, 14/15 (93.3%) of patients had characteristics of clustering onset, and the positive rates of the first RT-PCR test and the initial CT were 80% and 93% respectively. The most frequent CT abnormality observed was ground glass opacity (GGO) (13/15, 86.7%), including patchy/ punctate GGO and large/multiple GGO. Most of the lesions were multiple, and 60% of them involved 4-5 lobes. Most patients present with bilateral CT onset (12,80.0%), and most present with subpleural distribution (10,66.7%). The average CT score is 13.7, and 40% of the patients exceeded 20 points.CONCLUSIONThe common chest CT findings in COVID-19 patients with hypertension comorbidities are GGO, most of which at present with bilateral CT onset and subpleural distribution. CT is indispensable in the diagnosis and evaluation of this global health emergency.

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