Diagnostic Accuracy of High-Resolution CT in Early Diagnosis of COVID-19 Patients with Comparison to Reverse Transcriptase-PCR

Authors

  • Usman Khan
  • Sana Sharif
  • Fareeha Khalid
  • Asif Rehman
  • Hussain Rashid

DOI:

https://doi.org/10.51985/GSPD1787

Keywords:

COVID-19, HRCT, PCR, Diagnostic accuracy

Abstract

Objective: To determine the accuracy of high-resolution CT (HRCT) in early diagnosis of COVID-19 in comparison to
Reverse-Transcription Polymerase Chain Reaction (RT-PCR).
Study Design and Setting: This was a retrospective study, conducted in Department of Radiology, PNS Shifa Hospital,
Karachi from April 2020 to June 2020.
Methodology: A total of 115 patients were included in the study who presented with symptoms. Patient’s data such as
demographic details, clinical presentations, RT-PCR reports and HRCT reports were collected from the record of the
hospital. Data was entered and analyzed using SPSS-25.
Results: Out of 115 study participants, 98(85.2%) were male and 17(14.8%) were female with the average age of 50.53
(±18.64) years. Fever along with cough was the most common clinical presentation, presented by 91(79.1%) subjects. In
comparison to RT-PCR, sensitivity of HRCT was 96.2%, its specificity standing at 60% with the overall accuracy of 93.19%.
Moreover, mortality Rate of these symptomatic patients was 11.30% (13 out of 115). The average age of the expired patients
was 67.07 (±11.45) years and the age of discharged patients was 48.31 (±17.92) years. The difference in age was statistically
significant (p-value <0.001).
Conclusion: Highly specific and sensitive diagnostic tests for COVID-19 have not yet been developed. High resolution
CT chest has high sensitivity for early diagnosis of COVID-19, hence HRCT should be incorporated as a primary tool in
assessment criteria of hospitalized patients for early diagnosis of COVID-19.

References

Lai MM, Cavanagh D. The molecular biology of coronaviruses. InAdvances in virus research 1997 Jan 1 (Vol. 48, pp. 1-100). Academic Press.

Cui J, Li F, Shi ZL. Origin and evolution of pathogenic coronaviruses. Nature Reviews Microbiology. 2019 ;17(3):181-92.

Li W, Shi Z, Yu M, Ren W, Smith C, Epstein JH, Wang H, Crameri G, Hu Z, Zhang H, Zhang J. Bats are natural reservoirs of SARS-like coronaviruses. Science. 2005;310(5748):676-9.

Saqlain M, Munir MM, Ahmed A, Tahir AH, Kamran S. Is Pakistan prepared to tackle the coronavirus epidemic?. Drugs & Therapy Perspectives. 2020:1-2.

Wu J, Wu X, Zeng W, Guo D, Fang Z, Chen L, Huang H, Li C. Chest CT findings in patients with coronavirus disease 2019 and its relationship with clinical features. Investigative radiology. 2020;55(5):257.

Diao K, Han P, Pang T, Li Y, Yang Z. HRCT imaging features in representative imported cases of 2019 novel coronavirus pneumonia. Precision Clinical Medicine. 2020;3(1):9-13.

Tahamtan A, Ardebili A. Real-time RT-PCR in COVID-19 detection: issues affecting the results.

Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, Fan Y, Zheng C. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. The Lancet Infectious Diseases. 2020 Feb 24.

Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, Tao Q, Sun Z, Xia L. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. 2020:200642.

Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, Ji W. Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology. 2020 Feb 19:200432.

Schoeman D, Fielding BC. Coronavirus envelope protein: current knowledge. Virology journal. 2019;16(1):1-22.

Liu Y, Sun W, Li J, Chen L, Wang Y, Zhang L, Yu L. Clinical features and progression of acute respiratory distress syndrome in coronavirus disease 2019. MedRxiv. 2020 Jan 1.

Kakodkar P, Kaka N, Baig MN. A comprehensive literature review on the clinical presentation, and management of the pandemic coronavirus disease 2019 (COVID-19). Cureus. 2020;12(4).

Li B, Li X, Wang Y, Han Y, Wang Y, Wang C, Zhang G, Jin J, Jia H, Fan F, Ma W. Diagnostic value and key features of computed tomography in Coronavirus Disease 2019. Emerging Microbes & Infections. 2020;9(1):787-93.

Xiong Y, Sun D, Liu Y, Fan Y, Zhao L, Li X, Zhu W. Clinical and high-resolution CT features of the COVID-19 infection: comparison of the initial and follow-up changes. Investigative radiology. 2020.

Cao Y, Han X, Gu J, Li Y, Liu J, Alwalid O, Cui Y, Zhang X, Zheng C, Fan Y, Wu H. Prognostic Value of Baseline Clinical and HRCT Findings in 101 Patients with Severe COVID-19 in Wuhan, China.

Deng M, Sun W, Hu J, Mei L, Weng D, Liu B, Xu H. Radiological Features on HRCT and RT-PCR Testing for the Diagnosis of Coronavirus Disease 2019 (COVID-19) in China: A Comparative Study of 78 Cases in Pregnant Women.

Liu Y, Du X, Chen J, Jin Y, Peng L, Wang HH, Luo M, Chen L, Zhao Y. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. Journal of Infection. 2020 Apr 10.

Rivera-Izquierdo M, del Carmen Valero-Ubierna M, R-delAmoJL, Fernández-GarcíaMÁ, Martínez-Diz S, Tahery-Mahmoud A, Rodríguez-Camacho M, Gámiz-Molina AB, Barba-Gyengo N, Gámez-Baeza P, Cabrero-Rodríguez C. Sociodemographic, clinical and laboratory factors on admission associated with COVID-19 mortality in hospitalized patients: A retrospective observational study. PloS one. 2020;15(6)235107.

Khan AN, Din NU, Umer US. COVID-19 National Pakistan Guidelines: Radiological Society of Pakistan (RSP) Recommendations Regarding Utilisation of Chest Imaging. JPMA. The Journal of the Pakistan Medical Association. 2020;70(5):S7-10.

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Published

2021-04-05

How to Cite

Khan, U. ., Sharif, S. ., Khalid, F. ., Rehman, A. ., & Rashid, H. . (2021). Diagnostic Accuracy of High-Resolution CT in Early Diagnosis of COVID-19 Patients with Comparison to Reverse Transcriptase-PCR. Journal of Bahria University Medical and Dental College, 11(2), 50–53. https://doi.org/10.51985/GSPD1787

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Original Articles