Role of HRCT for Rapid Triage of Patients with COVID-19 Pneumonia

  • Hina Hafeez Abbasi employ/registrar
  • Misbah Durrani
  • Umme Kalsoom
  • Anum Zahoor
  • Fizza Batool
  • Shawana Sharif
Keywords: Coronavirus, High resolution Computed Tomography, RT-PCR, Sensitivity and Specificity, Positive predictive value, negative predictive value.

Abstract

Background:

 

To assess the diagnostic performances of HRCT for COVID 19 pneumonia for efficient triage of patients, in comparison with RT-PCR reverse transcription polymerase chain reaction test.

 

Method:

 

It is retrospective comparative study conducted in Benazir Bhutto hospital affiliated with Rawalpindi medical university from March 25th to April 25th, 2021.  HRCT of 500 patients were selected from central computer server and their RT-PCR results were also obtained from the HMS system of the hospital. HRCT were reported as “Definitely COVID positive”, “Possible COVID positive” or “COVID negative” by experienced radiologists. Sensitivity, Specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated using the final RT-PCR test as standard of reference.

Results:

 

RT-PCR test of 207 patients was positive, whereas 293 were reported negative. HRCT was reported as “Definitely COVID positive” in 222 cases (44.4 %), “Possible COVID positive” in 24 cases (4.8%) and “COVID negative” in 254 cases (50.8%). Comparing only Definitely COVID positive category with RT-PCR results sensitivity, specificity. PPV and NPV were 90.3%, 88%,84.2% and 92.8%

 

Conclusion:

 

CT chest is the most reliable, sensitive and rapid tool for triaging of patients as COVID positive or negative in busy emergency departments as compared to RT-PCR which is time consuming and has limitations such as faulty sampling technique, limited kits and variable sensitivity

References

1.A.R. Sahin, A. Erdogan, P.M. Agaoglu, Y. Dineri, A.Y. Cakirci, M.E. Senel, A.M. Tasdog
2019 novel corona virus (COVID-19) outbreak: a review of the current literature
EJMO, 4 (1) (2020), pp. 1-7

2. Khullar D, Bond AM, Schpero WL. COVID-19 and the Financial Health of US Hospitals. JAMA. 2020 Jun 2;323(21):2127–2128

3.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. 2020:200432

4.Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, et al. Coronavirus Disease 2019 (COVID-19): A Perspective from China. Radiology. 2020:200490.

5. Rubin GD, Haramati LB, Kanne JP, Schluger NW, Yim JJ, Anderson DJ, et al. The Role of Chest Imaging in Patient Management during the COVID-19 Pandemic: A Multinational Consensus Statementfrom the Fleischner Society. Radiology. 2020:201365.

6..Mareiniss DP (2020) The impending storm: COVID-19, pandemics and our overwhelmed emergency departments. Am J Emerg Med 38(6), 1293-1294,2020https://doi.org/10.1016/j.ajem.2020.03.033

7.Zhou Z, Guo D, Li C, et al (2020) Coronavirus disease 2019: initial chest CT findings. European Radiology,1-9,2020 https://doi.org/10.1007/s00330-020-06816-7

8.Li M, Lei P, Zeng B, Li Z, Yu P, Fan B, et al. Coronavirus Disease (COVID-19): Spectrum of CT Findings and Temporal Progression of the Disease. Academic Radiology 27(5), 603-608, 2020.

9.Kanne JP, Little BP, Chung JH, Elicker BM, Ketai LH. Essentials for Radiologists on COVID-19: An Update-RadiologyScientific Expert Panel. Radiology. 2020:200527.

10.Mareiniss DP (2020) The impending storm: COVID-19, pandemics and our overwhelmed emergency departments. Am J Emerg Med. https://doi.org/10.1016/j.ajem.2020.03.033


11.Mitchell R, Banks C, authoring working party (2020) Emergency departments and the COVID-19 pandemic: making the most of limited resources. Emergency Medicine Journal 37(5), 258-259,2020. https://doi.org/10.1136/emermed-2020-209660

12.Ng K, Poon BH, KiatPuar TH, Shan Quah JL, Loh WJ, Wong YJ, et al. COVID-19 and the Risk to Health Care Workers: A Case Report. Annals of Internal Medicine 172(11), 766-767,2020.

13.CDC 2019-Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel; Division of Viral Diseases, U.S. Centers for Disease Control and Prevention: Atlanta, GA, 2020.

14.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. 2020:200343. doi: 10.1148/radiol.2020200343. pmid:32049601

15.Chen C, Gao G, Xu Y, et al (2020) SARS-CoV-2-positive sputum and feces after conversion of pharyngeal samples in patients with COVID-19. Ann Intern Med. https://doi.org/10.7326/M20-0991

16.AnitaKovács 1, PéterPalásti 1, DánielVeréb 1, BenceBozsik 1, AndrásPalkó 1, ZsigmondTamásKincses 2) The sensitivity and specificity of chest CT in the diagnosis of COVID-19 EurRadiol 2021 May;31(5):2819-2824.

17.Y, Xia L. Coronavirus Disease 2019 (COVID-19): Role of Chest CT in Diagnosis and Management. AJR Am J Roentgenol. 2020:1–7.

18. Peiris JS, Chu CM, Cheng VC, Chan KS, Hung IFN, Poon LLM, et al. Clinical progression and viral load in a communityoutbreak of corona virus-associated SARS pneumonia: a prospective study. Lancet. 2003;361:1767–72 10.1016/S0140-6736(03)13412-5

19. Lin C, Xiang J, Yan M, Li H, Huang S, et al. (2020) Comparison of throat swabs and sputum specimens for viral nucleic acid detection in 52 cases of novel corona virus (SARS-Cov-2) infected pneumonia (COVID-19). medRxiv: 2020.2002.2021.20026187
Published
2021-08-31
How to Cite
1.
Abbasi H, Durrani M, Kalsoom U, Zahoor A, Batool F, Sharif S. Role of HRCT for Rapid Triage of Patients with COVID-19 Pneumonia. JRMC [Internet]. 31Aug.2021 [cited 25Oct.2021];25(1):110-6. Available from: http://www.journalrmc.com/index.php/JRMC/article/view/1657

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