Concordance of PCR and Early Thorax Computed Tomography Findings in COVID-19 Patients

Year 2020, , 39 - 43, 30.11.2020

Recep Alanlı , Murat Bülent Küçükay , Okan Çiçek Kadir Serkan Yalçın , Bülent Ahmet Beşirbellioğlu

https://doi.org/10.18678/dtfd.780011

Cited By: 1

Abstract

Aim: The aim of this study was to investigate concordance between polymerase chain reaction (PCR) test results and early thorax computed tomography (CT) findings of the patients in whom coronavirus disease 2019 (COVID-19) was suspected after evaluation of their complaints and physical examination findings.
Material and Methods: One hundred and fourteen patients with suspicion of COVID-19, evaluated for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) existence with PCR test and performed thorax CT in the first 48 hours, between April and July 2020, were enrolled in this study retrospectively. Demographic characteristics, laboratory parameters and thorax CT findings of PCR positive and negative patients were compared. If patients had negative PCR test results, but clinical suspicion for COVID-19 persisted, additional PCR samples were tested at 48-hour intervals.
Results: Interlobular septal thickening was more frequent in PCR positive patients (p=0.043). There was no significant thorax CT finding in 16 (28.6%) PCR positive and 14 (24.1%) PCR negative patients. Bilateral, peripheral and multilobar ground glass opacifications, consolidation and interlobular septal thickening were the most frequent findings in both groups. Neutrophil (p<0.001) and platelet counts (p=0.038) were significantly lower in PCR positive group.
Conclusion: The thorax CT findings of the patients whose PCR tests were positive or negative were greatly similar except for interlobular septal thickening, thus thorax CT should not be used alone in the diagnosis of COVID-19 especially in early stages. In decision making, symptoms, laboratory and CT findings and PCR tests of patients must be evaluated all together.

Keywords

COVID 19, ground glass opacity, interlobular septal thickening, thorax computed tomography, polymerase chain reaction

Supporting Institution

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Project Number

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Thanks

Authors of this study thank to Mr. Fatih ACIKGOZ for statistical analysis and advices.

COVID-19 Hastalarında Erken Dönemde Çekilen Akciğer Bilgisayarlı Tomografi Bulguları ile PCR Testinin Uyumluluğu

Abstract

Amaç: Bu çalışmanın amacı yakınmaları ve fizik muayene bulgularının değerlendirilmesi sonrasında koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) ön tanısı konulan hastaların erken dönemde çekilen akciğer bilgisayarlı tomografi (BT) bulguları ile polimeraz zincir reaksiyonu (polymerase chain reaction, PCR) testi sonuçları arasındaki uyumluluğun araştırılmasıdır.
Gereç ve Yöntemler: Nisan ile Temmuz 2020 tarihleri arasında COVID-19 şüphesi olan, PCR testi ile şiddetli akut solunum yolu sendromu koronavirüsü 2 (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) varlığı açısından değerlendirilen ve ilk 48 saatte akciğer BT yapılan 114 hasta geriye dönük olarak bu çalışmaya alındı. PCR testi pozitif ve negatif olan hastaların demografik özellikleri, laboratuvar parametreleri ve akciğer BT bulguları karşılaştırıldı. PCR testi negatif saptanıp klinik şüphesi devam eden hastalarda 48 saatlik aralıklar ile yeni PCR örnekleri alındı.
Bulgular: PCR pozitif hastalarda interlobüler septal kalınlaşma daha fazla bulundu (p=0,043). PCR pozitif olan 16 (%28,6) ve PCR negatif olan 14 (%24,1) hastada tomografide anlamlı bir bulgu saptanmadı. Her iki grupta da en sık bulgular; bilateral, periferal ve multilober yerleşimli buzlu cam görünümü, konsolidasyon ve interlobuler septal kalınlaşma idi. PCR pozitif olan grupta nötrofil (p<0,001) ve trombosit sayısı (p=0,038) anlamlı olarak daha düşük saptandı.
Sonuç: PCR testi pozitif veya negatif saptanan hastaların interlobular septal kalınlaşma dışındaki akciğer BT bulguları oldukça benzer idi, dolayısıyla COVID-19 tanısında özellikle erken dönemlerde akciğer BT tek başına kullanılmamalıdır. Karar verme esnasında, hastaların semptom, laboratuvar ve BT bulguları ile PCR testi hep birlikte değerlendirilmelidir.

Keywords

COVID 19, buzlu cam görünümü, interlobüler septal kalınlaşma, akciğer bilgisayarlı tomografi, polimeraz zincir reaksiyonu

Project Number

yok

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