Document Type : Case Series

Authors

1 Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran

2 Depts of Medicine and Diagnostic Radiology, McGill University Health Center -Research Institute, Canada

3 Babak Imaging Center, Pars Hospital, Tehran, Iran

4 Professor, Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran

Abstract

Coronavirus disease 2019 (COVID–19), reported pandemic in March 2020, is the current health problem with no definite prevention or treatment. As a newly emerging disease, new cases are reported each day to add to the physician’s knowledge about the best clinical approach. One of the controversies in this regard is the gold standard diagnostic method. Evidence suggests that polymerase chain reaction (RT–PCR) for Coronavirus nucleic acid has a low sensitivity and computed tomography (CT) has been suggested for more accurate diagnosis. Yet, CT has the disadvantage of radiation and is not safe in all patients. Here, we present a case series of 23 patients who underwent both RT–PCR and CT and report the outcome.

Keywords

  1. Singhal T. A review of coronavirus disease-2019 (COVID-19). Indian J Pediatr 2020; 87(4):281-6.
  2. Hu Y, Sun J, Dai Z, Deng H, Li X, Huang Q, et al. Prevalence and severity of corona virus disease 2019 (COVID-19): a systematic review and meta-analysis. J Clin Virol 2020; 127:104371.
  3. Hellewell J, Abbott S, Gimma A, Bosse NI, Jarvis CI, Russell TW, et al. Feasibility of controlling COVID-19 outbreaks by isolation of cases and contacts. The Lancet Global Health 2020; 8(4):1-9.
  4. WHO. Coronavirus disease 2019 (COVID-19). [cited 2020 May 22] Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200330-sitrep-70-covid-19.pdf?sfvrsn=7e0fe3f8_4.
  5. Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, et al. Coronavirus disease 2019 (COVID-19): a perspective from China. Radiology 2020; 296(2):E15-25.
  6. Nishiura H, Kobayashi T, Miyama T, Suzuki A, Jung SM, Hayashi K, et al. Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19). Int J Infect Dis 2020; 94:154-5.
  7. Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DK, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill 2020; 25(3):2000045.
  8. Bustin SA, Nolan T. Pitfalls of quantitative real-time reverse-transcription polymerase chain reaction. J Biomol Tech 2004; 15(3):155-66.
  9. Tahamtan A, Ardebili A. Real-time RT-PCR in COVID-19 detection: issues affecting the results. Expert Rev Mol Diagn 2020; 20(5):453-4.
  10. Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, et al. Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology 2020; 296(2):E115-7.
  11. Huang P, Liu T, Huang L, Liu H, Lei M, Xu W, 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(1):22-3.
  12. 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(2):E41-5.
  13. Kalra MK, Maher MM, Rizzo S, Kanarek D, Shephard JA. Radiation exposure from chest CT: issues and strategies. J Korean Med Sci 2004; 19(2):159-66.
  14. European Society of Cardiology (ESC). ESC Guidance for the Diagnosis and Management of CV Disease during the COVID-19 Pandemic. [cited 2020 June 29] Available from: https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Guidance.
  15. Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19) imaging reporting and data system (COVID-RADS) and common lexicon: a proposal based on the imaging data of 37 studies. Eur Radiol 2020; 30(9):4930-42.
  16. Bai Y, Yao L, Wei T, Tian F, Jin DY, Chen L, et al. Presumed asymptomatic carrier transmission of COVID-19. JAMA 2020; 323(14):1406-7.
  17. Hu Z, Song C, Xu C, Jin G, Chen Y, Xu X, et al. Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China. Sci China Life Sci 2020 ;63(5):706-11.
  18. Tang YW, Schmitz JE, Persing DH, Stratton CW. The laboratory diagnosis of COVID-19 infection: current issues and challenges. J Clin Microbiol 2020; 58(6):e00512-20.
  19. Winichakoon P, Chaiwarith R, Liwsrisakun C, Salee P, Goonna A, Limsukon A, et al. Negative nasopharyngeal and oropharyngeal swabs do not rule out COVID-19. J Clin Microbiol 2020; 58(5):e00297-20.
  20. Radpour A, Bahrami-Motlagh H, Taaghi MT, Sedaghat A, Karimi MA, Hekmatnia A, et al. COVID-19 evaluation by low-dose high resolution CT scans protocol. Acad Radiol 2020; 27(6):901.
  21. 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(5):409-10.
  22. Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N, et al. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology 2020; 295(3):685-91.
  23. Committee GOoNH. Office of state administration of traditional Chinese medicine. Notice on the issuance of a program for the diagnosis and treatment of novel coronavirus (2019-nCoV) infected pneumonia (trial version 6)[text in Chinese. 2020.
  24. Yang W, Yan F. Patients with RT-PCR-confirmed COVID-19 and normal chest CT. Radiology 2020; 295(2):E3.
  25. Lan L, Xu D, Ye G, Xia C, Wang S, Li Y, et al. Positive RT-PCR test results in patients recovered from COVID-19. JAMA 2020; 323(15):1502-3.
  26. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, 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):E32-40.
  27. Costello JE, Cecava ND, Tucker JE, Bau JL. CT radiation dose: current controversies and dose reduction strategies. AJR Am J Roentgenol 2013; 201(6):1283-90.
  28. Forrester JD, Nassar AK, Maggio PM, Hawn MT. Precautions for operating room team members during the COVID-19 pandemic. J Am Coll Surg 2020; 230(6):1098-101.
  29. West CP, Montori VM, Sampathkumar P. COVID-19 testing: the threat of false-negative results. Mayo Clin Proc 2020; 95(6):1127-9.