The Evaluation of CT Images for COVID-19 Prior to Reporting of the First Case

Abstract

Purpose: It is possible to evaluate the accuracy of the onset date of the disease with CT images with high diagnostic rates. The aim of our study is to evaluate the possibility of the presence of the disease in the dates before the diagnosis of COVID-19 in our country with imaging findings.

Materials and Methods: The first Covid-19 diagnosis in our country was made on March 11, 2020, and in our city on March 26, 2020. A total of patients whose thorax bt was taken in a period of 45 days from 26 March 2020 backwards and in the same period of the previous year were included in the study. The images were evaluated by two radiologists according to The Radiological Society of North America consensus statement. In order to evaluate the pre-existing disease with higher accuracy, the images were divided into two groups: 1) Typical and indeterminate, 2) Atypical and negative for pneumonia,

Results: Before the beginning of pandemic, there were a total of 502 patients who had chest CT scans, including 365 patients from 2019 and 137 patients from 2020. There was a statistically significant difference between negative for pneumonia subgroups of 2019 and 2020.

Conclusion: In our study, the number of patients with typical COVID-19 findings according to CT scans in the pre-pandemic period was determined similar to the previous year. This may be an indication that the disease has not started before the specified date in our country.

Keywords

• COVID-19
• computed tomography
• diagnosis
• disease reporting

İlk Vakanın Raporlanmasından Önce Bilgisayarlı Tomografi Görüntülerinin COVID-19 için Değerlendirilmesi

Abstract

Amaç: Yüksek tanı koyma oranları sahip BT görüntüleri ile hastalığın başlangıç tarihinin doğruluğunu değerlendirmek mümkündür. Çalışmamızın amacı ülkemizde PCR ile Covid-19 tanısı konulmadan önceki tarihlerde hastalığın var olma ihtimalini görüntüleme bulguları ile değerlendirmektir.

Araçlar ve Yöntem: Ülkemizde PCR ile ilk Covid-19 tanısı 11 Mart 2020’de, ilimizde ise 26 Mart 2020 tarihinde konulmuştur. 26 Mart 2020 tarihinden geriye doğru 45 günlük bir dönem ile bir önceki yıl aynı dönemde Toraks BT’leri çekilen toplam hastalar çalışmaya dahil edildi. Görüntüler Kuzey Amerika Radyoloji Derneği konsensus beyanına göre 2 radyolog tarafından değerlendirildi. Hastalığın önceden var olup olmadığını daha yüksek doğrulukla değerlendirmek amacıyla BT bulgularına göre tipik ve belirsiz ile atipik ve negatif pnömoni olmak üzere iki gruba ayrıldı.

Bulgular: Pandemi öncesi dönemde toraks BT’si çekilen 2019 yılından 365 hasta ile 2020 yılından 137 hasta olmak üzere toplam 502 hasta mevcut idi. 2019 ve 2020 yıllarındaki pnömoni için negatif subgrubları karşılaştırıldığında istatistiksel olarak anlamlı fark vardı (p<0.05).

Sonuç: Çalışmamızda covid öncesi dönemde BT bulgularına göre tipik COVID-19 olan hasta sayısı bir önceki yılla benzer şekilde saptanmıştır. Bu durum ülkemizde hastalığın belirtilen tarihten daha önce başlamadığına dair bir gösterge olabilir.

Keywords

• COVID-19
• bilgisayarlı tomografi
• tanısal
• hastalık raporlama

References

1. 1. Tırmıkçıoğlu, Z. COVID-19 Enfeksiyonu Olan Gebelerde İlaç Kullanımı. Anadolu Klin. 2020;25(1):51-58.
2. 2. Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8(4):420-422.
3. 3. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retro-spective cohort study. Lancet. 2020;395(10229):1054-1062.
4. 4. Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for Typical Coronavirus Disease 2019 (COVID-19) Pneumonia: Rela-tionship to Negative RT-PCR Testing. Radiology. 2020;296(2):41-45.
5. 5. Ufuk F, Savaş R. Chest CT features of the novel coronavirus disease (COVID-19). Turk J Med Sci. 2020;50(4):664–678.
6. 6. Nair A, Rodrigues J, Hare S, et al. A British Society of Thoracic Imaging statement: considerations in designing local imaging diag-nostic algorithms for the COVID-19 pandemic. Clin Radiol. 2020;75(5):329-334.
7. 7. 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(2):32-40.
8. 8. Wen Z, Chi Y, Zhang L, et al. Coronavirus Disease 2019: Initial Detection on Chest CT in a Retrospective Multicenter Study of 103 Chinese Subjects. Radiology: Cardiothoracic Imaging. 2020;2(2):e200092.

9. 9. Inui S, Fujikawa A, Jitsu M, et al. Chest CT Findings in Cases from the Cruise Ship “Diamond Princess” with Coronavirus Disease 2019 (COVID-19). Radiology: Cardiothoracic Imaging. 2020;2(2): e200110.
10. 10. Bai HX, Hsieh B, Xiong Z, et al. Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Radiol-ogy. 2020;296(2):46-54.
11. 11. Simpson S, Kay FU, Abbara S, et al. Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA- Secondary Publication. J Thorac Imaging. 2020;35(4):219-227.
12. 12. Koca F. Promotion of scientific research on COVID-19 in Turkey. Lancet. 2020;396(10253):25-26.
13. 13. World Health Organization, Islamic Republic of Iran situation. https://covid19.who.int/rgion/emro/coutry/ir Accessed July 15, 2020.
14. 14. World Health Organization, Iraq situation. https://covid19.who.int/region/emro/country/iq Accessed July 15, 2020.
15. 15. World Health Organization, Georgia situation. https://covid19.who.int/region/euro/country/ge Accessed July 15, 2020.
16. 16. World Health Organization, Armenia Situation. https://covid19.who.int/region/euro/country/am Accessed July 15, 2020.
17. 17. Demirbilek Y, Pehlivantürk G, Özgüler ZÖ, et al. COVID-19 outbreak control, example of ministry of health of Turkey. Turk J Med Sci. 2020;50(SI-1):489-494.