Chest X-Ray in Coronavirus Disease 2019 (COVID-19) Infection: Findings and Correlation with Clinical Outcome at Level-3 Nepalgunj Medical College and Teaching Hospital Kohalpur

Introduction: At the end of 2019 a novel virus, named SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), expanded globally from China. A new coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was identified as the cause of this outbreak of viral pneumonia that causes coronavirus disease 2019 (COVID-19). Aims: The aim of this study is to find out the chest radiological features of corona virus disease patients and correlate them with clinical outcome. Methods: This is a Hospital based study involving patients with clinical-epidemiological aspect of all reverse transcription polymerase chain reaction (RT-PCR) corona virus disease (COVID-19) positive patients, who performed Chest X-Rays at the emergency department of Nepalgunj Medical College, Teaching Hospital from March to June, 2020. All patients performed reverse transcription polymerase chain reaction from nasopharyngeal and throat swab, Chest X-Ray at the Emergency Department and clinical-epidemiological data. Results: Patients with a reverse transcription polymerase chain reaction positive results for corona virus disease infection were 32 out of these, 22 were females (68.75%) and 10 males (31.25%), with a mean age of 40.78 years (range 20–74 years). Only 2 Chest X-Rays were negative for radiological thoracic involvement (6.25%). The following alterations were more commonly observed among 30 patients: 18 patients with lung consolidations (56.25%), 19 (59.37%) with Ground Glass Opacities, 7 (21.87%) with nodules and 21 (65.6%) with reticular–nodular opacities. Patients with consolidations and Ground Glass Opacities coexisting in the same radiography were 34.37% of total. In reverse transcription polymerase chain reaction positive patients, we found also signs nonspecific for corona virus disease pneumonia as hilar or vascular congestion (37.5%), cardiomegaly (28.12%), pleural effusion (15.6%) and pneumothorax (3.12%). Peripheral (56.25%) and lower zone distribution (56.25%) were the most common predominance. Bilateral involvement (68.75%) was most frequent than unilateral one. Given the results, baseline Chest X-Rays sensitivity in our experience is about 65.62%. Conclusion: In this study, COVID-19 CXRs generally manifested a spectrum of pure ground glass, mixed ground glass opacities to consolidation in bilateral peripheral middle and lower lung zones. BSTI CXR reporting classification of COVID-19 is valid and sensitive in our patients with addition of middle zonal involvement in classical COVID-19 criteria as opposed to just lower zone involvement.

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Sensitivity and Specificity of Lateral Flow Antigen Test Kits for COVID-19 in Asymptomatic Population of Quarantine Centre of Province 3

Kathmandu University Medical Journal ◽

10.3126/kumj.v18i2.32942 ◽

2020 ◽

Vol 18 (2) ◽

pp. 36-39

Author(s):

B. Shrestha ◽

A.K. Neupane ◽

S. Pant ◽

A. Shrestha ◽

A. Bastola ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Sensitivity And Specificity ◽

Reverse Transcription ◽

Virus Disease ◽

High Risk Population ◽

Antigen Test ◽

Chain Reaction ◽

Corona Virus ◽

Test Kit ◽

Polymerase Chain

Background Nearly after 6 months of the spread of Corona Virus Disease 19, along with the world Nepal is still trying to control the spread and prevent general population from acquiring it. With limited resources in manpower, technology and evidence it has been a difficult battle. But with time and more understanding of the virus new technology to detect the virus are coming up. It is a major breakthrough in the diagnostic field as this helps us in not only detecting the virus but also helps us to mobilize our human resources. This comes in a time where the cases are increasing at an alarming rate. Although numbers of Polymerase Chain Reaction testing have increased but due to the time consuming and the cost wise, we need a faster and equally reliable alternative. Antigen test approved by different countries can be used for point of care, screening and surveillance depending upon the requirements after calculating its sensitivity, specificity and accuracy. Objective To find out sensitivity and specificity of the Antigen test kit for COVID-19. Method Antigen tests were compared with Reverse Transcription Polymerase Chain Reaction as a reference standard in calculated sample size of 113 subjects in a high risk population. Both Reverse Transcription Polymerase Chain Reaction and antigen test were performed in a same subject with in maximum of 2 days’ interval. Convenience sampling technique was used to select the subjects. Ethical approval was taken from Nepal Health Research Council before data collection. Study was done from August to September 2020 from Quarantine center of Province 3. Result There were total of 113 test carried out, among those 47 were positive and 66 were negative in Reverse Transcription Polymerase Chain Reaction. After preparing two by two table, Sensitivity and specificity of the tested was calculated which came out to be 85% and 100% respectively, with accuracy of 93.80%. Conclusion Even though the sensitivity and specificity came to be higher, this test should be interpreted cautiously depending upon the prevalence of Corona Virus Disease 19 in that particular community and the clinical and epidemiological context of the person who has been tested. When in doubt by clinical correlation should be confirmed with Reverse Transcription Polymerase Chain Reaction.

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Ebola Virus Disease Diagnostics, Sierra Leone: Analysis of Real-time Reverse Transcription–Polymerase Chain Reaction Values for Clinical Blood and Oral Swab Specimens

The Journal of Infectious Diseases ◽

10.1093/infdis/jiw296 ◽

2016 ◽

Vol 214 (suppl 3) ◽

pp. S258-S262 ◽

Cited By ~ 14

Author(s):

Bobbie R. Erickson ◽

Tara K. Sealy ◽

Tim Flietstra ◽

Laura Morgan ◽

Brima Kargbo ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Real Time ◽

Sierra Leone ◽

Reverse Transcription ◽

Ebola Virus ◽

Virus Disease ◽

Chain Reaction ◽

Oral Swab ◽

Disease Diagnostics ◽

Polymerase Chain

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Seorang Anak Perempuan Probable Covid-19 dengan Keterlibatan Ginjal (Laporan kasus)

Medica Hospitalia : Journal of Clinical Medicine ◽

10.36408/mhjcm.v7i1a.480 ◽

2020 ◽

Vol 7 (1A) ◽

pp. 207-213

Author(s):

Omega Mellyana ◽

Nur Latifah ◽

Marcella Trixie ◽

Frederika Mardiana ◽

Moh Syarofil Anam ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Real Time ◽

Bacterial Infections ◽

Ground Glass Opacity ◽

Ground Glass ◽

Post Mortem ◽

Rt Pcr ◽

Chain Reaction ◽

Chest X Ray ◽

Polymerase Chain

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

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KARAKTERISTIK DOKTER MUDA FK UNJANI TERKONFIRMASI POSITIF COVID-19 BERDASARKAN HASIL SWAB RT-PCR

EDISI PIT X KG 2018 - Medika Kartika Jurnal Kedokteran dan Kesehatan ◽

10.35990/mk.v4n4.p421-432 ◽

2021 ◽

pp. 421-432

Author(s):

Asti Kristianti ◽

Susanti Ratunanda ◽

Iis Inayati

Keyword(s):

Polymerase Chain Reaction ◽

Virus Disease ◽

Rt Pcr ◽

Chain Reaction ◽

Corona Virus ◽

Polymerase Chain

Corona Virus Disease 19 (COVID-19) adalah penyakit pernafasan yang saat ini menjadi pandemi di dunia. Jawa Barat adalah salah satu provinsi dengan kasus COVID-19 terbanyak di Indonesia. Gejala yang timbul adalah demam, batuk, sesak, malaise, myalgia, sakit tenggorokan, anosmia, dan disgeusia. Polymerase Chain Reaction (PCR) swab adalah pemeriksaan baku emas untuk COVID-19. Pekerja kesehatan termasuk dokter muda adalah kelompok yang memiliki risiko sangat tinggi terinfeksi COVID-19. Penelitian ini dilakukan untuk mengetahui karakteristik dokter muda Fakultas Kedokteran Universitas Jenderal Achmad Yani (FK Unjani) yang terkonfirmasi COVID-19 berdasarkan hasil swab RT-PCR (Agustus 2020–Januari 2021). Penelitian ini dirancang sebagai penelitian deskriptif dengan pendekatan potong lintang. Dari pemeriksaan swab RT-PCR terhadap 303 dokter muda FK Unjani didapatkan 35 orang terkonfirmasi positif COVID-19, rentang usia 23-24 tahun, dan 85,71% perempuan. Karakteristik berdasarkan gejala klinis 62,86% tidak bergejala, 25,71% demam, 17,14% gangguan penghidu, 11,43% gangguan pengecap, 5,71% batuk dan nyeri badan, 2,86% sesak, sakit kepala, hidung beringus, dan diare. Sebanyak 42,86% sedang persiapan pembelajaran luar jaringan (luring), 22,86% stase di Laboratorium Ilmu Kesehatan Masyarakat (IKM), 17,14% Radiologi, 11,43% Neurologi, dan 2,86% di Laboratorium Mata dan Anak. Sebanyak 74,29% tidak ada riwayat kontak dan sebanyak 25,71% ada riwayat kontak. Tata laksana yang dilakukan, yaitu 31 orang (62,86%) isolasi mandiri, tiga orang (8,57%) dirawat di rumah sakit, dan satu orang (2,86%) dirawat di fasilitas isolasi milik pemerintah. Kesimpulan pada penelitian ini adalah karakteristik dokter muda FK Unjani yang terkonfirmasi positif COVID-19, yaitu sebagian besar perempuan, tanpa gejala, sedang persiapan luring, tidak ada riwayat kontak, dan ditatalaksana dengan isolasi mandiri.

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CT FINDINGS IN INITIAL RT-PCR NEGATIVE TESTING COVID 19: BASED ON STUDY IN A LARGEST TERTIARY CARE CENTRE OF CENTRAL INDIA.

10.36106/ijsr/3901556 ◽

2020 ◽

pp. 33-36

Author(s):

Shyam Chhadi ◽

Aarti Anand ◽

Ravi Kumar

Keyword(s):

Polymerase Chain Reaction ◽

Reverse Transcription ◽

Ground Glass ◽

Imaging Findings ◽

Rt Pcr ◽

Chain Reaction ◽

Negative Results ◽

Polymerase Chain ◽

Ct Features ◽

Pcr Test

SUMMARY STATEMENT CT imaging findings in patients of suspected 2019-nCoV infection, who have initial negative results of reverse transcription–polymerase chain reaction (RT-PCR) testing. OBJECTIVE The purpose of this study is to explore the diagnostic value of CT over RT-PCR in the diagnosis of corona virus disease (COVID-19) pneumonia, especially for patients who have initial negative results of reverse transcription–polymerase chain reaction (RT-PCR) testing. MATERIALS AND METHODS Patients with suspected COVID-19 pneumonia from April 1, 2020, to September 30, 2020, were included. They are initially underwent RT-PCR followed by HRCT thorax after 1 day of negative initial RT-PCR testing. The imaging findings were obtained and compared with CT findings of those patients who have confirmed initial reverse transcription–polymerase chain reaction (RT-PCR) testing. RESULTS Total sixty (40 men, 20 women) patients who have initial negative RT-PCR testing but are highly suspicious for 2019-nCoV infection were included in our study and their age range between 22 years to 70 years. In our study most of the findings were seen involved the multiple( 70%) lobes in both lungs. The main CT features were ground-glass opacity (90%) and consolidation (60%) with a sub pleural (100%) and peri hilar or central distribution. The other CT features included air bronchograms (60%), vascular enlargement and interlobular septal thickening (50%), tree in bud appearance and pleural effusions (10%). when CT of patient with initial negative RT-PCR test were compared with CT of patients with initial positive RT-PCR test , it was found that most of the findings like ground glass opacities and consolidatory changes were also likely present in these group (p>0.05). CONCLUSION Chest CT is an important tools for screening and diagnosing the patients who are initial negative RT-PCR however they are highly suspicious and having symptoms like 2019-nCoV infection.

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Pan-filovirus one-step reverse transcription-polymerase chain reaction screening assay

10.1101/579458 ◽

2019 ◽

Cited By ~ 1

Author(s):

Katharina Kopp ◽

Ina Smith ◽

Reuben Klein ◽

Shawn Todd ◽

Glenn A. Marsh ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Reverse Transcription ◽

Disease Ecology ◽

Virus Disease ◽

Virus Species ◽

Rt Pcr ◽

Chain Reaction ◽

Screening Assay ◽

One Step ◽

Polymerase Chain

ABSTRACTFive species within the genera Ebolavirus and Marburgvirus of the family Filoviridae are known to cause severe hemorrhagic fever with high mortality rates in humans and non-human primates. Recent large outbreaks of Ebola virus disease in West Africa (2014 - 2016) and the Democratic Republic of the Congo (2018 - ongoing) have demonstrated the epidemic potential with devastating public health consequences. Several known and novel filovirus species have been found in bats in recent years. However, the role of each virus species in the disease ecology of human disease is still unclear. In particular, the transmission mechanism from potential animal hosts to humans is not known. Therefore, a simple, flexible, cost-effective screening tool for detecting the presence of any (putative) member of the filovirus family in animal samples is needed. In this study, a one-step conventional pan-filovirus RT-PCR assay was developed. The designed universal consensus primers of this screening test target two highly conserved regions of the nucleoprotein (NP) of all currently known filoviruses. The assay was capable of specific amplification of viral RNA of all six primate-pathogenic (human and non-human) filovirus species and resulted in 317 bp long RT-PCR products. This amplicon length renders the assay suitable for flexible application as conventional reverse transcription polymerase chain reaction (RT-PCR) as well as for future use as rapid real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR).

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Chest X-Ray Findings in COVID-19 Patients Presenting to Primary Care during the Peak of the First Wave of the Pandemic in Qatar: Their Association with Clinical and Laboratory Findings

Pulmonary Medicine ◽

10.1155/2021/4496488 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Abdelwahed Abougazia ◽

Ahmed Alnuaimi ◽

Amal Mahran ◽

Tamer Ali ◽

Ahmed Khedr ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Reverse Transcription ◽

Chest Radiography ◽

Cross Sectional Study ◽

Chain Reaction ◽

Laboratory Findings ◽

Cross Sectional ◽

X Ray ◽

Chest X Ray ◽

Polymerase Chain

When managing coronavirus disease 2019 (COVID-19) patients, radiological imaging complements clinical evaluation and laboratory parameters. We aimed to assess the sensitivity of chest radiography findings in detecting COVID-19, describe those findings, and assess the association of positive chest radiography findings with clinical and laboratory findings. A multicentre, cross-sectional study was conducted involving all primary health care corporation-registered patients (2485 patients) enrolled over a 1-month period during the peak of the 2020 pandemic wave in Qatar. These patients had reverse transcription-polymerase chain reaction-confirmed COVID-19 and underwent chest radiography within 72 hours of the swab test. A positive result on reverse transcription-polymerase chain reaction was the gold standard for diagnosing COVID-19. The sensitivity of chest radiography was calculated. The airspace opacities were mostly distributed in the peripheral and lower lung zones, and most of the patients had bilateral involvement. Pleural effusion was detected in some cases. The risk of having positive chest X-ray findings increased with age, Southeast Asian nationality, fever, or a history of fever and diarrhoea. Patients with cardiac disease, obesity, hypertension, diabetes, and chronic kidney disease were at a higher risk of having positive chest X-ray findings. There was a statistically significant increase in the mean serum albumin, white blood cell count, neutrophil count, and serum C-reactive protein, hepatic enzymes, and total bilirubin with an increase in the radiographic severity score.

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Hypothetical model of disease course of COVID-19 patients and their exit plan

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v7i1.28864 ◽

2020 ◽

Vol 7 (1) ◽

pp. 58-61

Author(s):

Abhishek Tiwary ◽

Bimal Pandey

Keyword(s):

Polymerase Chain Reaction ◽

Virus Disease ◽

Scientific Basis ◽

Disease Course ◽

Chain Reaction ◽

Hypothetical Model ◽

Illness Onset ◽

Corona Virus ◽

Polymerase Chain ◽

Pcr Test

In view of preparing ourselves for the possible rise of Corona Virus Disease (COVID-19) cases, we have proposed a hypothetical model of disease course in COVID-19 patients admitted in Patan Hospital and the exit plan based on available evidences. This will give us a scientific basis of planning discharge of our future cases. According to it, patients are subjected to repeat Polymerase chain reaction (PCR) on day 20 of illness onset and then every 4 days till negative result. Patients with two negative PCR test repeated 24 hours apart are discharged and advised for 14 days’ home quarantine.

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