scholarly journals Peran pemeriksaan radiologis pada diagnosis Coronavirus disease 2019

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Budi Yanti ◽  
Ulfa Hayatun

Abstrak. Coronavirus Disease 19 (COVID-19) telah menjadi pandemi di seluruh dunia dengan angka kejadian yang terus meningkat di beberapa negara. Kecepatan dan ketepatan diagnosis diperlukan untuk mencegah perburukan kondisi pasien. Real-Time Transcription Polymerase Chain Reaction (RT-PCR) sampai saat ini masih menjadi baku emas untuk menegakkan diagnosis COVID-19, namun uji diagnostik ini dilaporkan banyak menunjukkan hasil negatif palsu. Pemeriksaan radiologi berupa foto toraks dan CT-Scan dada banyak dilakukan untuk  menunjang diagnosis COVID-19. Gambaran foto toraks yang paling sering ditemukan adalah konsolidasi, ground-glass opacity (GGO), distribusi bilateral, perifer dan di lobus bawah paru-paru, namun pemeriksaan ini dianggap tidak sensitif untuk menemukan kelainan paru pada tahap awal penyakit. Meskipun demikian, foto toraks dapat digunakan untuk memantau perkembangan kelainan paru akibat COVID-19, salah satunya dengan metode Brixia Score. Pada sisi lain,CT-scan dada dinilai lebih sensitif daripada foto toraks serta mampu menunjukkan kelainan paru tahap awal pada pasien dengan hasil RT-PCR yang negatif. Gambaran pada CT-scan dada umumnya menunjukkan GGO, konsolidasi, crazy-paving stone, dan air bronchogram.  CT-scan dapat mengurangi angka negatif palsu pada RT-PCR dan sebagai alat skrining pada pasien yang dicurigai COVID-19 di lokasi epidemis saat hasil RT-PCR tidak tersedia. Penggunaan pemeriksaan radiologi dan RT-PCR dapat menghemat waktu serta membantu diagnosis dan manajemen COVID-19. Kata Kunci: Pencitraan COVID-19, Radiologi SARS-CoV-2Abstract. Coronavirus Disease 19 (COVID-19) has become a worldwide pandemic with an increasing incidence in several countries. Speed and accuracy of diagnosis are needed to prevent worsening of patient's condition. Real-Time Transcription Polymerase Chain Reaction (RT-PCR) is still a gold standard of COVID-19 diagnosis, however, this test shown false negative results in several case. Radiological examinations, chest X-Ray (CXR) and CT scan, are used to support the diagnosis. The most commonly found in CXR are consolidation, ground-glass opacity (GGO), bilateral distribution, peripheral and in the lower lobe, but this examination is insensitive to find lung abnormalities in early stages of disease. However, CXR can be used to monitor the development of lung abnormalities due to COVID-19, such as the Brixia Score method. On the other hand, CT-Scan is more sensitive than CXR and able to show early lung abnormalities in negative RT-PCR results. CT scan show the presence of GGO, consolidation, crazy-paving stone, and air bronchogram. CT-scanning can reduce the false-negative rate on RT-PCR and become a screening tool in suspected COVID-19 patients at epidemic area where RT-PCR is not available. The use of radiological examinations and RT-PCR can save the time and help in the diagnosis and management of COVID-19.Keywords: COVID-19’s Radiology, Imaging of SARS-CoV-2

2021 ◽  
Vol 9 (1) ◽  
pp. 44-45
Author(s):  
Dinesh Kumar

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.


2020 ◽  
Vol 9 (3) ◽  
pp. 408-410
Author(s):  
Fatemeh Bahreini ◽  
Rezvan Najafi ◽  
Razieh Amini ◽  
Salman Khazaei ◽  
Saeid Bashirian

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.


2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Dr Sana Abbas ◽  
Aisha Rafique ◽  
Dr Beenish Abbas ◽  
Dr Rashid Iqbal

Objective: To assess trends of real-time Polymerase Chain Reaction test in Coronavirus infected Patients. Methods: This cross-sectional analytical study was conducted at Tertiary Care Institute, Rawalpindi from March 2020 to June 2020. All patients confirmed COVID positive by real-time Polymerase Chain Reaction (PCR) with recent travel history, close contact with known diagnosed patients and had symptoms of fever or upper respiratory tract with body aches. Nasopharyngeal swabs were taken and results generated within 48 hours. Positive PCR was admission criteria follow up was carried out at 7th and 8th day, with negative PCR were discharged. However, those who had persistent positive PCR on the 8th day were tested again on 11th and 12th day. Those with persistent positive results beyond 12th day were shifted to specialized quarantine centres. Results: A total of three hundred and ninety-two patients with mild to moderate illness, PCR positive for COVID 19 were included study with age range 9 - 45 and mean 33.22±7.98 years. A total of 8 (2%) patients were females and 384(98%) males. The duration of the negative test result was Mean ± Std. Deviation 9.05±2.00 with 7 – 8 days 152(38.8%)in and 11 – 12 days in 160(40.8%). PCR results on Day 7 and 8 were negative in 144(36.7%) patients whereas positive in 248(63.3%). PCR results on Day 11 and 12 were negative in 312(79.6%) patients whereas positive in 80 (20.4%). Conclusion: To conclude Real-Time Polymerase Chain Reaction (rT-PCR) inclines to give false negative results additionally can stay positive in asymptomatic patients for moderately longer-term. Hence decision to discharge ought to be intricately adjusted between RT-PCR, clinical judgement, radiological examinations, and biochemical assays. doi: https://doi.org/10.12669/pjms.37.1.3000 How to cite this:Abbas S, Rafique A, Abbas B, Iqbal R. Real-Time Polymerase chain reaction trends in COVID-19 patients. Pak J Med Sci. 2021;37(1):180-184. doi: https://doi.org/10.12669/pjms.37.1.3000 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.


2020 ◽  
Vol 7 (1A) ◽  
pp. 207-213
Author(s):  
Omega Mellyana ◽  
Nur Latifah ◽  
Marcella Trixie ◽  
Frederika Mardiana ◽  
Moh Syarofil Anam ◽  
...  

Latar belakang: Kasus Probable Covid-19 adalah kasus penderita  dengan gambaran klinis dan pemeriksaan penunjang yang meyakinkan Covid-19 namun tidak terkonfirmasi dengan  pemeriksaan real-time polymerase chain reaction (RT-PCR). Kasus probable  banyak menimbulkan  kekhawatiran karena risiko penularan dan keraguan  dalam tata laksana baik bagi dokter, perawat, dan  penanggung jawab  pasien. Tujuan penulisan artikel ini adalah untuk melaporkan kasus seorang anak dengan probable Covid-19  dan mendiskusikan  kemungkinan diagnosis banding lain sebagai pemikiran di tengah pandemi Covid-19 guna pengelolaan pasien yang lebih optimal. Kasus:  Anak perempuan 14 tahun 5 bulan dengan keluhan utama batuk selama dua minggu sebelum masuk rumah sakit,  disertai demam, diare dan sesak. Selama perawatan, sesak makin bertambah. Tiga hari perawatan ditemukan oliguria, proteinuria, anemia, leukositosis, trombositopenia, hipersegmentasi neutrofil, limfopenia, peningkatan prokalsitonin, hipoalbuminemia dan penurunan fungsi ginjal (51 ml/menit/1,73 m2). Gambaran rontgen dada menunjukkan bronkopneumonia dan kardiomegali. MSCT dada terdapat gambaran konsolidasi dan ground glass appearance (GGO) di kedua paru mendukung ke arah Covid-19. Pada hari perawatan ke 16 anak mengalami gagal nafas, hemoptoe, penurunan kesadaran  hingga meninggal.   Swab RT-PCR 3 kali negatif (selama perawatan dan post mortem). Ringkasan : Infeksi Covid-19 adalah penyebab infeksi saluran nafas yang serius dan berat. Telah dilaporkan seorang anak perempuan 14 tahun 5 bulan yang meninggal karena Probable Covid-19. Di tengah pandemi Covid-19 ini seorang dokter  perlu meningkatkan kewaspadaan yang tinggi terhadap infeksi virus atau bakteri lain untuk memperbaiki tata laksana dan luaran  pada penderita. Kata kunci: Covid-19, probable, ground glass opacity, RT-PCR   Background: Probable Covid-19 cases are patients with clinical features and convincing investigations for covid-19 but there is  not confirmed by real time polymerase chain reaction (RT-PCR). Probable cases raise many concerns because of the risk of transmission and doubt in good management for the doctor / nurse in charge of the patient. The purpose of writing was to report the child with probable Covid-19 and provide a discussion of possible other differential diagnoses as thoughts in the midst of the Covid-19 pandemic for optimal management of sufferers. Case: A girl 14 years 5 months old had a cough for two weeks before admission, accompanied by fever, diarrhea and breathlessness. During treatment, the shortness of breath increased, three days of treatment found oliguria, proteinuria, hematuria, anemia, leukocytosis, thrombocytopenia, neutrophil hypersegmentation, lymphopenia, increased procalcitonin, hypoalbuminemia and decreased renal function (51 ml / min / 1.73 m2). Chest x-ray of bronchopneumonia and cardiomegaly. In the finding of  chest computed tomography scan showed consolidation and ground glass appearance (GGO) in both lungs supporting the diagnose  of Covid-19. On the 16th day of treatment, the child suffered respiratory failure, hemoptoes, decreased consciousness until death. RT-PCR swabs were 3 times negative (during treatment and post mortem). Summary: Covid-19 is a serious and severe cause of respiratory tract infection. It has been reported that a girl of 14 years and 5 months who died of Probable Covid-19 has been reported. During the Covid-19 pandemic, a doctor  may need  to increase high awareness of other viral or bacterial infections to improve management  and outcome of patients in the future. Key word: Covid-19,  Children,  Ground Glass Opacity, RT_PCR


2020 ◽  
Vol 14 (suppl 1) ◽  
pp. 911-920 ◽  
Author(s):  
Muhammad Shahzeb ◽  
Areena Khan ◽  
Anees Muhammad

An outbreak of Coronavirus disease 2019 (COVID-19) occurred in China. The causative agent of COVID-19 is Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease rapidly spreads from China to the world by trading and traveling. Until April 24, 2020, approximately 2,544,792 cases were confirmed with 175,694 deaths throughout the world. The highest number of cases were identified from the United States of America (USA) whereas the mortality rate is high in Portugal. The diagnosis of COVID-19 is based on Computed Tomography Scanning (CT Scan) and Real-Time Reverse Transcription Polymerase Chain Reaction (qRT-PCR). Assessing the extension of pathology, the exact location of the area involved, and assessment of the disease severity makes CT scan superior to other modalities. This review shows that real-time polymerase chain reaction and imaging technology both play an important role in the diagnosis of COVID-19. However, imaging modalities have more importance in diagnosis and screening than qRT-PCR. The qRT-PCR was positive in 81.3% whereas CT scan abnormality was observed in 89.8%. Bilateral lobe (51.4%) abnormality was found more than a single lobe (21.5%) in COVID-19 infected patients. The CT scan reports show a high-level abnormality in right lower lung lobe than others in COVID-19 infected patients. The CT scan evaluates different manifestations such as the presence of ground-glass opacities, consolidations, crazy paying linear, cavitation, discrete nodules, pleural effusion, and lymphadenopathy. It is concluded that imaging technology especially CT scan and X-rays play an important role in the screening and diagnosis of COVID-19 infected patients in limited access to qRT-PCR regions. The common radiological manifestation was also determined, which will be helpful for the radiologist to diagnosed COVID-19 infected patients in the early stages. Follow up studies required regarding the radiological examinations.


2006 ◽  
Vol 175 (4S) ◽  
pp. 485-486
Author(s):  
Sabarinath B. Nair ◽  
Christodoulos Pipinikas ◽  
Roger Kirby ◽  
Nick Carter ◽  
Christiane Fenske

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Fatemeh Khatami ◽  
Mohammad Saatchi ◽  
Seyed Saeed Tamehri Zadeh ◽  
Zahra Sadat Aghamir ◽  
Alireza Namazi Shabestari ◽  
...  

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.


Author(s):  
Rajeev Kumar Jain ◽  
Nagaraj Perumal ◽  
Rakesh Shrivastava ◽  
Kamlesh Kumar Ahirwar ◽  
Jaya Lalwani ◽  
...  

Introduction: The whole world is facing an ongoing global health emergency of COVID-19 disease caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Real-Time Reverse Transcription-Polymerase Chain Reaction (RT-PCR) is a gold standard in the detection of SARS-CoV-2 infection. Presently, many single tube multiple gene target RT-PCR kits have been developed and are commercially available for Coronavirus Disease 2019 (COVID-19) diagnosis. Aim: To evaluate the performance of seven COVID-19 RT-PCR kits (DiagSure, Meril, VIRALDTECT II, TruPCR, Q-line, Allplex and TaqPath) which are commercially available for COVID-19 RT-PCR diagnosis. Materials and Methods: This observational study was conductedat the State Virology Laboratory (SVL), Gandhi Medical College, Bhopal, Madhya Pradesh, India. Seven commercially available kits have been evaluated on the basis of: (i) number of SARS-CoV-2 specific gene target; (ii) human housekeeping genes as internal control; (iii) RT-PCR run time; and (iv) kit performances to correctly detect SARS-CoV-2 positive and negative RNA samples. A total of 50 RNA samples (left over RNA) were included, master mix preparation, template addition and RT-PCR test has been performed according to kits literature. At the end of PCR run, mean and standard deviation of obtained cut-off of all kits were calculated using Microsoft Excel. Results: All seven RT-PCR kits performed satisfactory regarding the reproducibility and they could correctly identify 30 positive and 20 negative RNA samples. RNA samples (group C) having low viral loads with a high Cycle threshold (Ct) value (>30) were also detected by all these seven kits. Obtained Ct values of each group was in parallel range in comparison with the initial testing Ct values. Kits were found to be superior which contains primers and probes for three SARS-CoV-2 specific gene targets, have human housekeeping gene as internal control and taking less time to complete RT-PCR. Conclusion: All seven COVID-19 RT-PCR kits included in this study demonstrated satisfactory performance and can be used for the routine molecular diagnosis of COVID-19 disease.


2018 ◽  
Vol 6 (1) ◽  
pp. 2 ◽  
Author(s):  
David De la Torre ◽  
Claudete Astolfi-Ferreira ◽  
Ruy Chacon ◽  
Antonio Piantino Ferreira

Avian rotavirus A (ARtV-A) is a virus that affects young birds, causing acute diarrhea and economic losses in the poultry industry worldwide. The techniques used for the diagnosis of ARtV-A include electron microscopy, isolation in cell culture, and serology, as well as molecular techniques, such as the reverse transcription-polymerase chain reaction (RT-PCR). The objective of this work was to standardize a real-time RT-polymerase chain reaction (RT-qPCR) using SYBR Green chemistry for the rapid detection and quantification of ARtV-A from bird tissues and materials fixed on FTA cards on the basis of the nucleotide sequence of segment 6 (S6), which codes for the structural VP6 protein of ARtV-A. The results show the efficient amplification of the proposed target, with a limit of detection (LoD) of one copy gene (CG) per microliter of cDNA and a limit of quantification (LoQ) of 10 CGs per microliter. The efficiency of the primers was determined to be 95.66% using a standard curve, with an R2 value of 0.999 and a slope of −3.43. The specificity was determined using samples coinfected with ARtV-A, the chicken parvovirus, the chicken astrovirus, and the avian nephritis virus as positive controls and commercially available vaccines of the infectious bronchitis virus, infectious bursa disease virus, avian reovirus and healthy organs as negative controls. This technique, which lacks nonspecific PCR products and dimers, demonstrated greater sensitivity and specificity than conventional RT-PCR, and it reduced the analysis time by more than 50%.


Parasitology ◽  
2020 ◽  
Vol 147 (10) ◽  
pp. 1140-1148
Author(s):  
Fernanda do Carmo Magalhães ◽  
Samira Diniz Resende ◽  
Carolina Senra ◽  
Carlos Graeff-Teixeira ◽  
Martin Johannes Enk ◽  
...  

AbstractDue to the efforts to control schistosomiasis transmission in tropical countries, a large proportion of individuals from endemic areas present low parasite loads, which hinders diagnosis of intestinal schistosomiasis by the Kato-Katz (KK) method. Therefore, the development of more sensitive diagnostic methods is essential for efficient control measures. The aim was to evaluate the accuracy of a real-time polymerase chain reaction (RT-PCR) to detect Schistosoma mansoni DNA in fecal samples of individuals with low parasite loads. A cross-sectional population-based study was conducted in a rural community (n = 257) in Brazil. POC-CCA® was performed in urine and feces were used for RT-PCR. In addition, fecal exams were completed by 18 KK slides, saline gradient and Helmintex techniques. The combined results of the three parasitological tests detected schistosome eggs in 118 participants (45.9%) and composed the consolidated reference standard (CRS). By RT-PCR, 117 out of 215 tested samples were positive, showing 91.4% sensitivity, 80.2% specificity and good concordance with the CRS (kappa = 0.71). RT-PCR identified 86.9% of the individuals eliminating less than 12 eggs/g of feces, demonstrating much better performance than POC-CCA® (50.8%). Our results showed that RT-PCR is a valuable alternative for the diagnosis of intestinal schistosomiasis in individuals with very low parasite loads.


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