Clinical diagnostic value of CT imaging in COVID-19 with multiple negative RT-PCR testing

Hao, Wendong; Li, Manxiang

doi:10.1016/j.tmaid.2020.101627

Cited by 74 publications

(70 citation statements)

References 4 publications

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“…In this study, the PPV of CT was 95.12%, which was also consistent with the explanations proffered above. In our study, there were still some patients with positive CT and negative RT-PCR results [19,20]. We also noticed that the rate of positivity on RT-PCR was not high; this may be related to our sampling time, specimen source, and different stages of pneumonia [21].…”

Section: Discussionmentioning

confidence: 59%

Radiological Features on HRCT and RT-PCR Testing for the Diagnosis of Coronavirus Disease 2019 (COVID-19) in China: A Comparative Study of 78 Cases in Pregnant Women

Deng

Sun

et al. 2020

Preprint

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BackgroundIn the past four months, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global health threat. In the context of the coronavirus disease 2019 (COVID-19) epidemic, pneumonia is a critical disease that threatens the health of pregnant women and fetuses. We aimed to evaluate the quantitative parameters of CT scans performed on pregnant women with COVID-19 who had different reverse transcription-polymerase chain reaction (RT-PCR) results.MethodsPregnant women with suspected cases of COVID-19 pneumonia (confirmed by next-generation sequencing or RT-PCR) who underwent high-resolution lung CT scans were retrospectively enrolled. Patients were grouped based on the results of the RT-PCR and the first CT scan: group 1 (double positive patients; positive RT-PCR and CT scan) and group 2 (negative RT-PCR and positive CT scan). The imaging features and their distributions were extracted and compared between the two groups.ResultsSeventy-eight patients were admitted to the hospital between Dec 20, 2019, and Feb 29, 2020. The mean age of the patients was 31.82 years (SD 4.1, ranged from 21 to 46 years). The cohort included 14 (17.95%) patients with a positive RT-PCR test and 64 (82.05%) with a negative RT-PCR test, there were 37 (47.44%) patients with a positive CT scan, and 41 (52.56%) patients with a negative CT scan. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT-based diagnosis of COVID-19 were 85.71%, 60.94%, 32.40%, 95.12% and 65.38%, respectively. COVID-19 pneumonia mainly involved the right lower lobe of the lung. There were 53 semi-quantitative and 59 quantitative parameters, which were compared between the two groups. There were no significant differences in the quantitative parameters. However, the Hellinger distance was significantly different between the two groups, albeit with a limited diagnostic value (AUC = 0.63).ConclusionsPregnant women with pneumonia usually present with typical abnormal signs on CT. Although multidimensional CT quantitative parameters are somewhat different between groups of patients with different RT-PCR results, it is still impossible to accurately predict whether the RT-PCR will be positive, which would allow for the earlier detection of SARS-CoV-2 infection.

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Section: Discussionmentioning

confidence: 59%

Radiological Features on HRCT and RT-PCR Testing for the Diagnosis of Coronavirus Disease 2019 (COVID-19) in China: A Comparative Study of 78 Cases in Pregnant Women

Deng

Sun

et al. 2020

Preprint

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“…Though the clinical features of the participants continued return to normal after negative throat swab nuclear acids test with treatment, the imaging features still abnormal and further isolation and treatment for patients after the negative for throat swab nuclear acids test is necessary. Studies has indicated that if patients had clinical symptoms, epidemiological characteristics, and chest CT imaging characteristics of viral pneumonia that were compatible with COVID-19 infection, careful consideration of the isolation and treatment of these patients is still needed even if the RT-PCR test is negative [24].…”

Section: Discussionmentioning

confidence: 99%

Clinical and CT features of mild-to-moderate COVID-19 cases after two sequential negative nucleic acid testing results: a retrospective analysis

Yan

Wang

Tian

et al. 2020

Preprint

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Background Numerous studies have been focused on the clinical and imaging features among COVID-19 patients positive for SARS-CoV-2, but the data after negative is limited. We aims to describe these features after negative respiratory nucleic acid testing results.Methods From January 31 to February 28, 2020, 51 mild-to-moderate COVID-19 cases (median: 34.0 years and 47.1% male) were retrospectively enrolled. Demographic, clinical, laboratory, and CT imaging data were collected before and after two sequential negative results for respiratory SARS-CoV-2 .Results After negative for respiratory SARS-CoV-2, the clinical symptoms continued to recover and the abnormal imaging were observed for all of the moderate cases. 77.4% of the moderate patients had multi-lobar involvement and lesions were more frequent in the lower lobes. The most common CT imaging manifestations were ground glass opacity (51.6%) and fibrous stripes (54.8%%). Among 12 out of 31 moderate patients with repeated chest CT scan after negative for SARS-CoV-2, 7 patients (58.3%) with ground-glass absorption reduced over 60% within one week, but there were still 4 cases (13.8%) with absorption less than 5%.Conclusions The clinical symptoms and abnormal imaging persisted but continued to recover after negative for respiratory SARS-CoV-2.

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“…As CT plays an important role in the diagnosis of COVID-19, it is useful to explore the CT characteristics of asymptomatic and atypical patients. Hao et al [36] found that, when the initial RT-PCR results of some patients were negative, chest CT showed typical radiographic findings, including GGO and/or mixed consolidation. Ai et al [10] also reported the CT signs (bilateral lung lesions, GGO, and consolidations) of suspected COVID-19 patients with negative RT-PCR testing.…”

Section: ) Ct Characteristics In Asymptomatic Covid-19mentioning

confidence: 99%

The Role of Imaging in the Detection and Management of COVID-19: A Review

Dong

Tang

Wang

et al. 2021

IEEE Rev. Biomed. Eng.

341

247

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Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading rapidly around the world, resulting in a massive death toll. Lung infection or pneumonia is the common complication of COVID-19, and imaging techniques, especially computed tomography (CT), have played an important role in diagnoses and treatment assessment of the disease. Herein, we review the use of imaging characteristics and computing models that have been applied for the management of COVID-19. CT, positron emission tomography -CT (PET/CT), lung ultrasound, and magnetic resonance imaging (MRI) have been used for detection, treatment, and follow-up. The quantitative analysis of imaging data using artificial intelligence (AI) is also explored. Our findings indicate that typical imaging characteristics and their changes can play an important role in the detection and management of COVID-19. In addition, AI or other quantitative image analysis methods are urgently needed to maximize the value of imaging in the management of COVID-19.

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Clinical diagnostic value of CT imaging in COVID-19 with multiple negative RT-PCR testing

Cited by 74 publications

References 4 publications

Radiological Features on HRCT and RT-PCR Testing for the Diagnosis of Coronavirus Disease 2019 (COVID-19) in China: A Comparative Study of 78 Cases in Pregnant Women

Radiological Features on HRCT and RT-PCR Testing for the Diagnosis of Coronavirus Disease 2019 (COVID-19) in China: A Comparative Study of 78 Cases in Pregnant Women

Clinical and CT features of mild-to-moderate COVID-19 cases after two sequential negative nucleic acid testing results: a retrospective analysis

The Role of Imaging in the Detection and Management of COVID-19: A Review

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