Comparing The Computed Tomography Findings Of The Covid-19 PCR Positive Patients in Intensive Care Unit and PCR Negative Suspected Patients in Terms of Clinical and Laboratory Data

Year 2022, Volume: 12 Issue: 2, 127 - 134, 31.08.2022

Murathan Köksal Erdem Özkan Elmas Uysal Handan Ankaralı Işıl Özkoçak Turan Özkoçak Turan Adalet Aypak Aypak

Abstract

Aim: There has been an overload in the workload of intensive care units in the hospitals due the Coronavirus disease 2019 (COVID-19) pandemic, which started in 2019 and caused significant changes in the lives of people. In this process, it is not always easy to distinguish whether the patients followed in the intensive care unit with the suspicion of COVID-19 disease are actually infected or not. Our aim in this study was to reveal possible clinical, laboratory and computed tomography findings between polymerase chain reaction (PCR) (+) and PCR (-) patient groups followed up in the intensive care unit with a preliminary diagnosis of COVID-19.
Material and Method: In this study, we evaluated 83 patients who were confirmed to have COVID-19 by reverse transcription polymerase chain reaction (RT-PCR) and 80 patients who were
RT-PCR negative but clinically and radiologically suspicious for COVID-19. The CT results of the patients were classified in accordance with the categories specified by the Radiological Society of
North America (RSNA). Many laboratory values, clinical progress of the disease, the source of infection and the complaints were also documented. We performed a statistical analysis of the data
obtained between the two patient groups.
Results: The typical radiological appearance was significantly higher in the positive group while the atypical appearance was significantly higher in the suspected group (p = 0.001). There was
no significant difference between the two groups in the indeterminate and negative categories. Regarding the laboratory findings, the means of the Sequential Organ Failure Assessment (SOFA)
score, d-dimer, neutrophil, white blood cell, platelet, neutrophile/ lymphocyte ratio (NLR) were significantly lower in the RT-PCR positive group. There was no significant difference between the
two groups in terms of other laboratory findings.
Conclusion: In conclusion, it was determined that it was hard to distinguish the difference between these patients but there may be some clinical, laboratory and CT results that can facilitate this process.

Keywords

COVID-19, Computed Tomography, Intensive Care Unit, RT-PCR

References

• 1. Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P el al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology.2020 Aug;292(2):E115- e117.doi:10.1148/radiol.2020200432.
• 2. Guan CS, Lv ZB, Yan S, Du YN, Chen E, Wei LG et al. Imagıng Features of Coronavırus disease 2019 (COVID-19): Evaluation on Thin-Section CT. Acad Radiol.2020 May;27(5):609-613. doi:10.1016/j.acra.2020.03.002.
• 3. Koo HJ, Lim S, Choe J, Choi SH, Sung H, Do KH. Radiographic and CT Features of Viral Pneumonia. Radiographics. 2018 May-Jun;38(3):719-739. doi: 10.1148/rg.2018170048.
• 4. Colombi D, Bodini FC, Petrini M, Maffi G, Morelli N, Milanese G et al. Well-aerated Lung on Admitting Chest CT to Predict Adverse Outcome in COVID-19 Pneumonia. Radiology. 2020 Aug;296(2):E86-E96. doi: 10.1148/radiol.2020201433.
• 5. Simpson S, Kay FU, Abbara S, Bhalla S, Chung JH, Chung M et al. Radiological Society of North America Expert Consensus Document on Reporting Chest CT Findings Related to COVID-19: Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA. Radiol Cardiothorac Imaging. 2020 Mar 25;2(2):e200152. doi: 10.1148/ryct.2020200152.
• 6. 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 May;38(5):409-410. doi: 10.1007/s11604-020-00967-9. Epub 2020 Apr 7.
• 7. Besutti G, Giorgi Rossi P, Iotti V, Spaggiari L, Bonacini R, Nitrosi A et al. Accuracy of CT in a cohort of symptomatic patients with suspected COVID-19 pneumonia during the outbreak peak in Italy. Eur Radiol. 2020 Dec;30(12):6818-6827. doi: 10.1007/s00330-020-07050-x.
• 8. Gürün, E., Akdulum, İ., & Akyüz, M. (2021). Revealing the dilemma in COVID-19 pneumonia: use of the prone thorax CT imaging in differentiation of opacificities due to dependant zone and pneumonic consolidation. Anatolian Current Medical Journal, 3(1), 78-80. doi:10.38053/acmj.810240
• 9. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W et al. Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology. 2020 Aug;296(2):E32-E40. doi: 10.1148/radiol.2020200642
• 10. Bai HX, Hsieh B, Xiong Z, Halsey K, Choi JW, Tran TML et al. Performance of Radiologists in Differentiating COVID-19 from Non-COVID-19 Viral Pneumonia at Chest CT. Radiology. 2020 Aug;296(2):E46-E54. doi: 10.1148/radiol.2020200823.
• 11. Lascarrou JB, Colin G, Le Thuaut A, Serck N, Ohana M, Sauneuf B et al. Predictors of negative first SARS-CoV-2 RT-PCR despite final diagnosis of COVID-19 and association with outcome. Sci Rep. 2021 Jan 27;11(1):2388. doi: 10.1038/s41598-021-82192-6