Tests with proven value in diagnosis of COVID-19

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Abstract

COVID-19 has literally ravaged the entire world. People from all walks of life are badly affected because of compulsory lockdown around the world. Timely diagnosis is a problem as there is no single test that can achieve the highest acceptable sensitivity. Some of the tests are indeed costly and footing the bill by the governments can cause a tremendous load on the Treasury. As it stands, the current tests are beyond patient means and, thus, the patient would never have it performed. Lastly, there is no consensus as to whether everyone should be tested for COVID-19 and not based on presence of clinical features. Unfortunately, since the disease has been declared a pandemic, all should be considered to be infected unless provenother-wise by the tests that are performed.

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Most cited references 6

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Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases

Tao Ai, Zhenlu Yang, Hongyan Hou … (2020)

Background Chest CT is used for diagnosis of 2019 novel coronavirus disease (COVID-19), as an important complement to the reverse-transcription polymerase chain reaction (RT-PCR) tests. Purpose To investigate the diagnostic value and consistency of chest CT as compared with comparison to RT-PCR assay in COVID-19. Methods From January 6 to February 6, 2020, 1014 patients in Wuhan, China who underwent both chest CT and RT-PCR tests were included. With RT-PCR as reference standard, the performance of chest CT in diagnosing COVID-19 was assessed. Besides, for patients with multiple RT-PCR assays, the dynamic conversion of RT-PCR results (negative to positive, positive to negative, respectively) was analyzed as compared with serial chest CT scans for those with time-interval of 4 days or more. Results Of 1014 patients, 59% (601/1014) had positive RT-PCR results, and 88% (888/1014) had positive chest CT scans. The sensitivity of chest CT in suggesting COVID-19 was 97% (95%CI, 95-98%, 580/601 patients) based on positive RT-PCR results. In patients with negative RT-PCR results, 75% (308/413) had positive chest CT findings; of 308, 48% were considered as highly likely cases, with 33% as probable cases. By analysis of serial RT-PCR assays and CT scans, the mean interval time between the initial negative to positive RT-PCR results was 5.1 ± 1.5 days; the initial positive to subsequent negative RT-PCR result was 6.9 ± 2.3 days). 60% to 93% of cases had initial positive CT consistent with COVID-19 prior (or parallel) to the initial positive RT-PCR results. 42% (24/57) cases showed improvement in follow-up chest CT scans before the RT-PCR results turning negative. Conclusion Chest CT has a high sensitivity for diagnosis of COVID-19. Chest CT may be considered as a primary tool for the current COVID-19 detection in epidemic areas. A translation of this abstract in Farsi is available in the supplement. - ترجمه چکیده این مقاله به فارسی، در ضمیمه موجود است.

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CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV)

Michael Chung, Adam Bernheim, Xueyan Mei … (2020)

In this retrospective case series, chest CT scans of 21 symptomatic patients from China infected with the 2019 novel coronavirus (2019-nCoV) were reviewed, with emphasis on identifying and characterizing the most common findings. Typical CT findings included bilateral pulmonary parenchymal ground-glass and consolidative pulmonary opacities, sometimes with a rounded morphology and a peripheral lung distribution. Notably, lung cavitation, discrete pulmonary nodules, pleural effusions, and lymphadenopathy were absent. Follow-up imaging in a subset of patients during the study time window often demonstrated mild or moderate progression of disease, as manifested by increasing extent and density of lung opacities. © RSNA, 2020

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Improved Molecular Diagnosis of COVID-19 by the Novel, Highly Sensitive and Specific COVID-19-RdRp/Hel Real-Time Reverse Transcription-PCR Assay Validated In Vitro and with Clinical Specimens

Jasper Chan, Cyril Yip, Kelvin Kai-Wang To … (2020)

On 31 December 2019, the World Health Organization was informed of a cluster of cases of pneumonia of unknown etiology in Wuhan, China. Subsequent investigations identified a novel coronavirus, now named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), from the affected patients. Highly sensitive and specific laboratory diagnostics are important for controlling the rapidly evolving SARS-CoV-2-associated coronavirus disease 2019 (COVID-19) epidemic. In this study, we developed and compared the performance of three novel real-time reverse transcription-PCR (RT-PCR) assays targeting the RNA-dependent RNA polymerase (RdRp)/helicase (Hel), spike (S), and nucleocapsid (N) genes of SARS-CoV-2 with that of the reported RdRp-P2 assay, which is used in >30 European laboratories.

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Author and article information

Journal

Journal ID (nlm-ta): Iran J Microbiol

Journal ID (iso-abbrev): Iran J Microbiol

Journal ID (publisher-id): IJM

Journal ID (pmc): IJM

Title: Iranian Journal of Microbiology

Publisher: Tehran University of Medical Sciences

ISSN (Print): 2008-3289

ISSN (Electronic): 2008-4447

Publication date (Print): June 2020

Volume: 12

Issue: 3

Pages: 261-262

Affiliations

Department of Anesthesiology and Intensive Care, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Author notes

[* ]Corresponding author: Zahid Hussain Khan, MD, FCCM, Department of Anesthesiology and Intensive Care, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-21-61192828, Fax: +98-21-66581537, Email: khanzh51@ 123456yahoo.com

Article

Publisher ID: ijm-12-261

PMC ID: 7340600

PubMed ID: 32685124

SO-VID: d99958aa-99e6-496a-b3be-c8b91e3bf192

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.