RT-PCR Results and Chest CT Imaging Features in Patients Hospitalized to Yozgat City Hospital with COVID-19 Suspicion

Abstract Objective: To determine the CT role in the early detection of COVID-19 infection and serial CT changes in disease course in the patients with COVID-19 pneumonia. Methods: From January 21 to February 18, 2020, all the patients who were suspected of novel coronavirus infection and verified by RT-PCR test were retrospectively enrolled in our study. All the patients underwent serial RT-PCR tests and serial CT imaging. The time correlation between serial RT-PCR results (negative conversion to positive, positive to negative) and serial CT imaging was investigated, and serial CT changes were evaluated. Results: One hundred and fifty-five patients with confirmed COVID-19 pneumonia were evaluated. The time of chest CT detection of COVID-19 pneumonia was 2.61 days earlier than RT-PCR test (p=0.000). The time of lung CT improvement was significantly shorter than that of RT-PCR conversion to negative (p=0.000). Three stages were identified from the onset of the initial symptoms: Stage 1 (0-3 days); Stage 2 (4-7 days); and stage 3 (8-14 days and later). Ground glass opacity (GGO) was predominant on stage 1, then consolidation and crazy paving sign were dramatically increased on stage 2. On stage 3, fibrotic lesion was growing largely. There was significant difference for the main CT features (p=0.000), the number of involved lobes (p=0.001), and lesion distribution ( p=0.000) among different stages. Conclusion: Chest CT was earlier to detect COVID-19 pneumonia compared to RT-PCR results and monitor disease course. Combined imaging features with epidemiology history and clinical information could facilitate early diagnosis of COVID-19 pneumonia.

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A Review of COVID-19: Data Obtained from Chest CT Imaging and RT-PCR

Iranian Journal of Radiology ◽

10.5812/iranjradiol.106852 ◽

2021 ◽

Vol 18 (2) ◽

Author(s):

Hossein Akbari-Lalimi ◽

Somayyeh Seyedi ◽

Hadi Akbari-Zadeh ◽

Milad Najafzadeh ◽

Alireza Montazerabadi ◽

...

Keyword(s):

Ct Scan ◽

Ground Glass Opacity ◽

Ct Imaging ◽

Chest Ct ◽

Disease Stage ◽

Imaging Features ◽

Rt Pcr ◽

Bilateral Lung ◽

Risk Of Cancer ◽

Chest Ct Scan

Context: This review aimed to investigate the computed tomography (CT) imaging features of COVID-19. Evidence Acquisition: Bilateral lung involvement (70%), peripheral distribution (67.5%), multifocal involvement (67.3%) and ground glass opacity (66.1%) were observed in most infected patients Results: Evaluation of the number of lobes involved in infected patients showed no abnormalities in 7.2% (85/1177) of the patients. Regarding the performance of RT-PCR and chest CT scan, the sensitivity of RT-PCR and chest CT imaging was estimated at 70% (925/1311) and 89% (6605/7396) upon admission, respectively; nevertheless, the sensitivity of CT imaging increased as the time from the symptom onset increased. The CT image acquisition parameters affecting image quality and patient dose were also discussed. Studies suggested that these factors should be adjusted according to the disease stage. Based on our findings, sensitivity was adequately high eight days after the onset of symptoms. Conclusion: Therefore, there is no need for high-resolution chest CT scan after this interval. Using ImpactDose software, the mean effective doses were 4.38 and 5.71 mSv in male and female groups, respectively. The risk of cancer was 36% higher in females than males, as shown by PCXMC program.

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

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00351-7 ◽

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.

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

Insights into Imaging ◽

10.1186/s13244-020-00957-5 ◽

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.

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COVIDNet-CT: A Tailored Deep Convolutional Neural Network Design for Detection of COVID-19 Cases From Chest CT Images

Frontiers in Medicine ◽

10.3389/fmed.2020.608525 ◽

2020 ◽

Vol 7 ◽

Author(s):

Hayden Gunraj ◽

Linda Wang ◽

Alexander Wong

Keyword(s):

Neural Network ◽

Convolutional Neural Network ◽

Network Architecture ◽

Ct Images ◽

Ct Imaging ◽

Chest Ct ◽

Deep Convolutional Neural Network ◽

Screening Tools ◽

Screening Methods ◽

Rt Pcr

The coronavirus disease 2019 (COVID-19) pandemic continues to have a tremendous impact on patients and healthcare systems around the world. In the fight against this novel disease, there is a pressing need for rapid and effective screening tools to identify patients infected with COVID-19, and to this end CT imaging has been proposed as one of the key screening methods which may be used as a complement to RT-PCR testing, particularly in situations where patients undergo routine CT scans for non-COVID-19 related reasons, patients have worsening respiratory status or developing complications that require expedited care, or patients are suspected to be COVID-19-positive but have negative RT-PCR test results. Early studies on CT-based screening have reported abnormalities in chest CT images which are characteristic of COVID-19 infection, but these abnormalities may be difficult to distinguish from abnormalities caused by other lung conditions. Motivated by this, in this study we introduce COVIDNet-CT, a deep convolutional neural network architecture that is tailored for detection of COVID-19 cases from chest CT images via a machine-driven design exploration approach. Additionally, we introduce COVIDx-CT, a benchmark CT image dataset derived from CT imaging data collected by the China National Center for Bioinformation comprising 104,009 images across 1,489 patient cases. Furthermore, in the interest of reliability and transparency, we leverage an explainability-driven performance validation strategy to investigate the decision-making behavior of COVIDNet-CT, and in doing so ensure that COVIDNet-CT makes predictions based on relevant indicators in CT images. Both COVIDNet-CT and the COVIDx-CT dataset are available to the general public in an open-source and open access manner as part of the COVID-Net initiative. While COVIDNet-CT is not yet a production-ready screening solution, we hope that releasing the model and dataset will encourage researchers, clinicians, and citizen data scientists alike to leverage and build upon them.

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Prevalence of COVID-19 Diagnostic Output with Chest Computed Tomography: A Systematic Review and Meta-Analysis

Diagnostics ◽

10.3390/diagnostics10121023 ◽

2020 ◽

Vol 10 (12) ◽

pp. 1023

Author(s):

Temitope Emmanuel Komolafe ◽

John Agbo ◽

Ebenezer Obaloluwa Olaniyi ◽

Kayode Komolafe ◽

Xiaodong Yang

Keyword(s):

Computed Tomography ◽

Meta Analysis ◽

Age Groups ◽

Disease Prevalence ◽

Chest Ct ◽

Imaging Features ◽

Rt Pcr ◽

Chest Computed Tomography ◽

Pooled Prevalence ◽

History Of

Background: The pooled prevalence of chest computed tomography (CT) abnormalities and other detailed analysis related to patients’ biodata like gender and different age groups have not been previously described for patients with coronavirus disease 2019 (COVID-19), thus necessitating this study. Objectives: To perform a meta-analysis to evaluate the diagnostic performance of chest CT, common CT morphological abnormalities, disease prevalence, biodata information, and gender prevalence of patients. Methods: Studies were identified by searching PubMed and Science Direct libraries from 1 January 2020 to 30 April 2020. Pooled CT positive rate of COVID-19 and RT-PCR, CT-imaging features, history of exposure, and biodata information were estimated using the quality effect (QE) model. Results: Out of 36 studies included, the sensitivity was 89% (95% CI: 80–96%) and 98% (95% CI: 90–100%) for chest CT and reverse transcription-polymerase chain reaction (RT-PCR), respectively. The pooled prevalence across lesion distribution were 72% (95% CI: 62–80%), 92% (95% CI: 84–97%) for lung lobe, 88% (95% CI: 81–93%) for patients with history of exposure, and 91% (95% CI: 85–96%) for patients with all categories of symptoms. Seventy-six percent (95% CI: 67–83%) had age distribution across four age groups, while the pooled prevalence was higher in the male with 54% (95% CI: 50–57%) and 46% (95% CI: 43–50%) in the female. Conclusions: The sensitivity of RT-PCR was higher than chest CT, and disease prevalence appears relatively higher in the elderly and males than children and females, respectively.

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Early chest computed tomography to diagnose COVID-19 from suspected patients: A multicenter retrospective study

10.1101/2020.03.24.20042432 ◽

2020 ◽

Cited By ~ 3

Author(s):

Congliang Miao ◽

Mengdi Jin ◽

Li Miao ◽

Xinying Yang ◽

Peng Huang ◽

...

Keyword(s):

Ground Glass Opacity ◽

High Specificity ◽

Diagnostic Value ◽

Chest Ct ◽

Imaging Features ◽

Rt Pcr ◽

Polymerase Chain ◽

Low Sensitivity ◽

Chest Ct Scan ◽

Ct Features

AbstractObjectiveThe purpose of this study is to distinguish the imaging features of COVID-19 with other chest infectious diseases and evaluate diagnostic value of chest CT for suspected patients.MethodsAdult suspected patients aged>18 years within 14 days who underwent chest CT scan and reverse-transcription polymerase-chain-reaction (RT-PCR) tests were enrolled. The enrolled patients were confirmed and grouped according to results of RT-PCR tests. The data of basic demographics, single chest CT features, and combined chest CT features were analyzed for confirmed and non-confirmed groups.ResultsA total of 130 patients were enrolled with 54 cases positive and 76 cases negative. The typical CT imaging features of positive group were ground glass opacity (GGO), crazy-paving pattern and air bronchogram. The lesions were mostly distributed bilaterally, close to the lower lungs or the pleura. When features combined, GGO with bilateral pulmonary distribution and GGO with pleural distribution were more common, of which were 31 cases (57.4%) and 30 cases (55.6%) respectively. The combinations were almost presented statistically significant (P<0.05) except for the combination of GGO with consolidation. Most combinations presented relatively low sensitivity but extremely high specificity. The average specificity of these combinations is around 90%.ConclusionsThe combinations of GGO could be useful in the identification and differential diagnosis of COVID-19, which alerts clinicians to isolate patients for treatment promptly and repeat RT-PCR tests until incubation ends.

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A false alarm of COVID-19 pneumonia in lung cancer: a case report of anti-PD-1 related pneumonitis and literature review

10.21203/rs.3.rs-41095/v1 ◽

2020 ◽

Author(s):

Ying Dai ◽

Sha Liu ◽

Zhiyan Zhao ◽

...

Keyword(s):

Lung Cancer ◽

Clinical Symptoms ◽

Close Contact ◽

Ct Imaging ◽

Chest Ct ◽

Radiographic Feature ◽

Rt Pcr ◽

Lung Lobe ◽

History Of ◽

Novel Coronavirus

Abstract Background: The fatal toxicity of anti-PD-1/PD-L1 agents is pneumonitis. The diagnosis consists of the history of immunotherapy, clinical symptoms and presentation of computed tomography (CT) imaging. The typical CT findings include ground-glass opacities. Based on the similar radiographic feature with 2019 Novel Coronavirus (COVID-19) pneumonia, clinicians are cautious to evaluate diagnosis especially in COVID-19 epidemic areas. Case presentation: Herein we report a 67-year-old male patient with advanced non-small cell lung cancer developed pneumonitis post Sintilimab injection. The dyspnea appeared at the 15th day of close contact with his son who returned from Wuhan, but not accompanied with fever. The chest CT indicated peripherally subpleural lattice opacities at the inferior right lung lobe and bilateral thoracic infusion. The real-time reverse-transcription polymerase-chain-reaction (RT-PCR) from double swab samples within 72 hours remained negative. The patient was thereafter treated with prednisolone and antibiotics for over two weeks. Thereafter the chest CT demonstrated the former lesion almost absorbed, in line with prominently falling CRP level. The anti-PD-1 related pneumonitis with bacterial infection was diagnosed finally based on the clinical evidence and good response to the prednisolone and antibiotics. Conclusion: Both ani-PD-1 related pneumonitis and COVID-19 pneumonia harbor the common clinical symptom and the varied features of CT imaging. Differential diagnosis was based on the epidemiological and immunotherapy histories, RT-PCR tests. The response to glucocorticoid can indirectly help the diagnosis.

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Clinical characteristics and chest CT imaging features of critically ill COVID-19 patients

European Radiology ◽

10.1007/s00330-020-06955-x ◽

2020 ◽

Vol 30 (11) ◽

pp. 6151-6160 ◽

Cited By ~ 5

Author(s):

Nan Zhang ◽

Xunhua Xu ◽

Ling-Yan Zhou ◽

Gang Chen ◽

Yu Li ◽

...

Keyword(s):

Critically Ill ◽

Clinical Characteristics ◽

Ct Imaging ◽

Chest Ct ◽

Imaging Features

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Chest CT imaging of pediatric COVID-19 infection: a case report

10.21203/rs.3.rs-21613/v1 ◽

2020 ◽

Author(s):

Huayan Xu ◽

Keke Hou ◽

Na Zhang ◽

Ming Yang ◽

Yingkun Guo

Keyword(s):

Cell Count ◽

Laboratory Tests ◽

Pediatric Patients ◽

White Cell Count ◽

Chest Ct ◽

White Cell ◽

The Other ◽

Imaging Features ◽

Rt Pcr ◽

Small Nodule

Abstract Background: Coronavirus Disease 2019 (COVID-19) outbreak in Wuhan, China spreading rapidly worldwide. Over 100 countries have reported surpassing 100,000 laboratory-confirmed cases of COVID- 19, and in which 2.1% were under aged 19 years. However, little is known about the imaging features about pediatric COVID-19 patients. Herein, we report two cases about COVID-19 involving the clinical data as well as chest images.Case presentation: Two pediatric patients admitted to hospital because of high fever or dry cough. Both children had been recent exposure to the COVID-19 confirmed patients of their family members. Real-time polymerase chain reaction(RT-PCR) test of these two patients’ sputum were positive for SARS-CoV-2 nucleic acid, and diagnosed as COVID-19 infection. Laboratory tests indicate normal white cell count (5.02 x10^9/L) and neutrophils (40.8%) in one case, and slightly increased white cell count (11.86 x10^9/L) and normal neutrophils (16.1%)in the other one. CRP of both cases were within the normal range. Computed tomography (CT) was used to evaluate the novel coronavirus pneumonia (NCP) of these two pediatric patients. Small nodule was found in the upper right lobe of one case; and bilateral peripheral ground-glass opacities were observed in the other patient.Conclusion: In summary, clinical symptoms and signs, laboratory tests and chest CT images of pediatric patients were untypical. Epidemic exposure history and RT-PCR results still play an important role in the precise diagnosis of COVID-19 children.

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