Öz
Aim: We aimed to examine the diagnostic power of chest computerized tomography (CT) comparing with ‘Clinical Decision’ and RT-PCR results among the patients admitted to the hospital with COVID-19 disease suspicion.
Material and Method: This study included 162 patients who applied to the pandemic outpatient clinic between March 11 and April 11, 2020, suspected of new coronavirus infection, and had chest CT and RT-PCR tests at the same time. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and positive odds ratio of RT-PCR and chest CT imaging are investigated for the diagnosis of COVID-19.
Results: It was found that 56.8% (92 patients) of chest CT scans taken at admission were compatible with viral pneumonia. With the ‘Clinical Decision’, which we accept as the gold standard diagnostic method, 61.1% of the patients (99 patients) were evaluated as COVID-19 positive and treatment was started. According to clinical decision, sensitivity of chest CT was 92.9%.
Conclusion: COVID-19 pneumonia is a serious life-threatening condition. Rapid diagnosis and early treatment are very important in terms of reducing mortality and morbidity. The chest CT might create an early diagnosis and treatment opportunity.
Anahtar Kelimeler
COVID-19 Coronavirus pneumonia chest computerized tomography
Destekleyen Kurum
YOK
Proje Numarası
YOK
Teşekkür
Thank you to ‘Dilek Yapar’ from Department of Biostatistics and Medical informatics, Akdeniz University Faculty of Medicine, Antalya, Turkey and ‘Hacer DEMİRKÖSE’ from Department Of Public Health, Turkish Ministry of Public Health, Pursaklar District Health Directorate, Ankara, Turkey for their medical statistics support.
Kaynakça
- Öztürk Durmaz Ş, Sümer Coşkun A, Yalçın AN. Clinical and prognostic evaluation of patients admitted to the COVID-19 pandemic unit of the emergency department. J Health Sci Med 2021; 4: 835-9.
- Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet 2020; 395: 470-3.
- Wang,W, Tang J, Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China. J Med Virol 2020; 92: 441–7.
- Sreepadmanabh M, Sahu AK, Chande A. COVID-19: Advances in diagnostic tools, treatment strategies, and vaccine development. J Biosci 2020; 45: 148.
- Akçay Ş, Özlü T, Yılmaz A. Radiological approaches to COVID-19 pneumonia. Turk J Med Sci 2020; 50: 604-10.
- Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol 2020; 30: 4381-9.
- Kesmez Can F, Alay H, Yılmaz S, et al. The thorax tomography correlation in COVID-19 RT-PCR positive patients. Anatolian Curr Med J 2021; 3: 145-50.
- Chung M, Bernheim A, Mei X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology 2020; 295: 202-7.
- 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; 296: 115-7.
- Huang P, Liu T, Huang L, et al. Use of chest CT in combination with negative RT-PCR assay for the 2019 novel coronavirus but high clinical suspicion. Radiology 2020; 295: 22-3.
- Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507-13.
- Ai T, Yang Z, Hou H, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology 2020; 296: 32-40.
- Guan W, Ni Z, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020; 382: 1708-20.
- Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for typical 2019-nCoV pneumonia: relationship to negative RT-PCR testing. Radiology 2020; 296: 41-5.
- Xiao AT, Tong YX, Zhang S. False negative of RT-PCR and prolonged nucleic acid conversion in COVID-19: Rather than recurrence. J Med Virol October 2020; 92: 1755-6.
- Long C, Xu H, Shen Q, Zhang X, Fan B, Wang C, Zeng B, Li Z, Li X, Li H. Diagnosis of the Coronavirus disease (COVID-19): rRT-PCR or CT? Eur J Radiol 2020 May; 126: 108961.
- Feng H, Liu Y, Lv M, Zhong J. A case report of COVID-19 with false negative RT-PCR test: necessity of chest CT. Jpn J Radiol 2020; 38: 409-10.
- Waller JV, Kaur P, Tucker A, et al. Diagnostic tools for coronavirus disease (COVID-19): comparing CT and RT-PCR viral nucleic acid testing. AJR Am J Roentgenol 2020; 215: 834-8.
- Tenda ED, Yulianti M, Asaf MM, et al. The Importance of Chest CT Scan in COVID-19. Acta Med Indones 2020; 52: 68-73.
- Li Y, Xia L. Coronavirus disease 2019 (COVID-19): role of chest CT in diagnosis and management. Am J Roentgenol 2020; 1-7.
Öz
Amaç: COVID-19 hastalığı şüphesiyle hastaneye başvuran hastalarda göğüs bilgisayarlı tomografi (BT)’sinin ‘Klinik Karar’ ve RT-PCR sonuçları ile karşılaştırmalı olarak tanısal gücünü incelemeyi amaçladık.
Gereç ve Yöntem: Bu çalışmaya 11 Mart - 11 Nisan 2020 tarihleri arasında pandemi polikliniğine başvuran, yeni koronavirüs enfeksiyonu şüphesi olan ve aynı anda göğüs BT ve RT-PCR tetkikleri yapılan 162 hasta dahil edildi. COVID-19 tanısı için RT-PCR ve göğüs BT görüntülemenin duyarlılığı, özgüllüğü, pozitif öngörü değeri (PPV), negatif öngörü değeri (NPV), doğruluğu ve pozitif olasılık oranı araştırılmaktadır.
Bulgular: Başvuru sırasında çekilen akciğer tomografilerinin %56,8’inin (92 hasta) viral pnömoni ile uyumlu olduğu bulundu. Altın standart tanı yöntemi olarak kabul ettiğimiz ‘Klinik Karar’ ile hastaların %61,1’i (99 hasta) COVID-19 pozitif olarak değerlendirildi ve tedaviye başlandı. Klinik karara göre göğüs BT’nin duyarlılığı %92,9 idi.
Sonuç: COVID-19 pnömonisi hayatı tehdit eden ciddi bir durumdur. Hızlı tanı ve erken tedavi, mortalite ve morbiditeyi azaltmak açısından çok önemlidir. Göğüs BT erken tanı ve tedavi fırsatı yaratabilir.
Anahtar Kelimeler
Proje Numarası
YOK
Kaynakça
- Öztürk Durmaz Ş, Sümer Coşkun A, Yalçın AN. Clinical and prognostic evaluation of patients admitted to the COVID-19 pandemic unit of the emergency department. J Health Sci Med 2021; 4: 835-9.
- Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet 2020; 395: 470-3.
- Wang,W, Tang J, Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China. J Med Virol 2020; 92: 441–7.
- Sreepadmanabh M, Sahu AK, Chande A. COVID-19: Advances in diagnostic tools, treatment strategies, and vaccine development. J Biosci 2020; 45: 148.
- Akçay Ş, Özlü T, Yılmaz A. Radiological approaches to COVID-19 pneumonia. Turk J Med Sci 2020; 50: 604-10.
- Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol 2020; 30: 4381-9.
- Kesmez Can F, Alay H, Yılmaz S, et al. The thorax tomography correlation in COVID-19 RT-PCR positive patients. Anatolian Curr Med J 2021; 3: 145-50.
- Chung M, Bernheim A, Mei X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology 2020; 295: 202-7.
- 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; 296: 115-7.
- Huang P, Liu T, Huang L, et al. Use of chest CT in combination with negative RT-PCR assay for the 2019 novel coronavirus but high clinical suspicion. Radiology 2020; 295: 22-3.
- Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507-13.
- Ai T, Yang Z, Hou H, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology 2020; 296: 32-40.
- Guan W, Ni Z, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020; 382: 1708-20.
- Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for typical 2019-nCoV pneumonia: relationship to negative RT-PCR testing. Radiology 2020; 296: 41-5.
- Xiao AT, Tong YX, Zhang S. False negative of RT-PCR and prolonged nucleic acid conversion in COVID-19: Rather than recurrence. J Med Virol October 2020; 92: 1755-6.
- Long C, Xu H, Shen Q, Zhang X, Fan B, Wang C, Zeng B, Li Z, Li X, Li H. Diagnosis of the Coronavirus disease (COVID-19): rRT-PCR or CT? Eur J Radiol 2020 May; 126: 108961.
- Feng H, Liu Y, Lv M, Zhong J. A case report of COVID-19 with false negative RT-PCR test: necessity of chest CT. Jpn J Radiol 2020; 38: 409-10.
- Waller JV, Kaur P, Tucker A, et al. Diagnostic tools for coronavirus disease (COVID-19): comparing CT and RT-PCR viral nucleic acid testing. AJR Am J Roentgenol 2020; 215: 834-8.
- Tenda ED, Yulianti M, Asaf MM, et al. The Importance of Chest CT Scan in COVID-19. Acta Med Indones 2020; 52: 68-73.
- Li Y, Xia L. Coronavirus disease 2019 (COVID-19): role of chest CT in diagnosis and management. Am J Roentgenol 2020; 1-7.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Research Articles [en] Araştırma Makaleleri [tr] |
| Yazarlar | |
| Proje Numarası | YOK |
| Yayımlanma Tarihi | 24 Mart 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 3 Sayı: 1 |
Cited By
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