COMPUTED TOMOGRAPHY VERSUS PCR TEST: EVALUATING THE DIAGNOSTIC PRECISION OF CHEST COMPUTED TOMOGRAPHY IN COVID-19 PATIENTS
Abstract
The aim of the study is to analyze the lesions detected on chest computed-tomography in case of patients with suspicion of COVID-19 infection in comparison with RT-PCR (+), exploring the correlation between demographic factors and disease progression. Materials and methods: We retrospectively studied 830 patients suspected to have COVID-19 infection, who underwent computed tomography at “Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania, from January to December 2021, and found 108 patients with lung lesions consistent with COVID-19 infection. We explored the correlation between demographic factors and disease progression, established CO -RADS classification and the correlation with PCR test. Results: Among 108 patients who had chest CT lesions consistent with COVID-19 infection, 92 patients had a positive RT-PCR test. Our study found a slight male predominance (54.63%), with moderate to severe cases more common among males, and an increased incidence in patients over 50, peaking in the 50-59 age group (33.33%). Severe cases being prevalent in the 60-69 age group (9.26%), suggesting a higher risk in these age ranges. Ground glass opacity was the most common CT finding (96.30%), while less common findings included pericardial effusion and halo signs (2.78%). A significant correlation was observed between CO-RADS classification and disease severity, with 53.70% of the most severe cases associated with CO-RADS 5. These findings suggest that CO-RADS classification helps also in assessing COVID-19 severity. Conclusions: Patients above 50 years old have a high risk of developing pulmonary lesions in case of COVID-19 infection; most of the patients with severe course were between 50 and 69 years old suggesting this age range is a risk factor. Ground glass appearance was the most common finding depicted on CT, seen in a majority of the cases, the other findings (pericardial effusion, halo sign and reversed halo sign) being less frequent. In our study the majority of the patients that had positive RT-PCR test, as well as severe disease, had also CO-RADS 5, which may suggest a positive correlation between the CO-RADS classification and the severity and the likelihood of having COVID-19 infection.
References
2. Cui J, Li F, Shi ZL. Origin and evolution of pathogenic coronaviruses. Nat Reviews Microbiology 2019; 17(3), 181-192.
3. Zuo T, Zhan H, Zhang F, et al. Alterations in Fecal Fungal Microbiome of Patients With COVID-19 During Time of Hospitalization until Discharge. Gastroenterol 2020; 159(4), 1302-1310.
4. Cascella M, Rajnik M, Aleem A, Dulebohn S C, Di Napoli R. Features, Evaluation, and Treatment of Coronavirus (COVID-19). Treasure Island, Florida: StatPearls Publishing, 2020.
5. Villapoll S, Saavedra JM. Neuroprotective effects of angiotensin receptor blockers. Am J Hypertens 2015; 28(3): 289-299.
6. Gheorghe L, Jari I, Naum AG. Neuroendocrine tumors: Choosing the appropriate imaging methods. Rev Med Chir Soc Med Nat Iasi 2018; 122 (1): 16-22.
7. Moisii P, Jari I, Ursu AM, Naum AG. The Relationship between Job Strain and Ischemic Heart Disease Mediated by Endothelial Dysfunction Markers and Imaging. Medicina 2024; 60 (7): 1048.
8. Kanne JP. Chest CT Findings in 2019 Novel Coronavirus (2019-nCoV) Infections from Wuhan, China: Key Points for the Radiologist. Radiology 2020; 295(1): 16-17.
9. Kanne JP, Little BP, Chung J H, Elicker BM, Ketai LH. Essentials for Radiologists on COVID-19: An Update. Radiology 2020; 296(2): E113-E114.
10. Timpau AS, Miftode RS, Costache II, et al. An Overview of the Impact of Bacterial Infections and the Mortality Predictors in Patients with COVID-19 Admitted to a tertiary Center from Eastern Europe Antibiot Chemother 2023; 12 (1): 144.
11. Ursuleanu TF, Luca AR, Gheorghe L, et al. Deep learning Application for Analyzing of Constituents and their Correlations in the Interpretations of Medical Images. Diagnostics, 2021; 11(8): 137.
12. Volovat SR, Ursulescu-Lupascu CV, Gheorghe ML, et al. The landscape of nano-vectors for modulation in cancer immunotherapy 2022 Pharmaceutics 14 (2): 397
13. Chowdhury MA, Hossain N, Kashem MA, Shahid MA, Alam A. Immune response in COVID-19: A review, J Inf Pub Health 2020;13(11):1619-1629.
14. Galesanu C, Buzduga C, Florescu A, Moisii L, Ciubotaru V. Diabetes mellitus, chronic complication in patients with acromegaly: case report and review of the literature. Rev Med Chir Soc Med Nat Iasi 2015; 119 (1): 92-96.
15. Savin ML, Mihai F, Gheorghe L, et al. Proposal of a Preoperative CT-Based Score to Predict the Risk of Clinically Relevant Pancreatic Fistula after Cephalic Pancreatoduodenectomy Medicina Lithuania 2021; 57(7): 650.
16. Lukasz Szarpak et al. POST-COVID19 and the pancreas. Am J Emerg Med. 2022, 59: 174-175.
17. Ursaru M, Jari I, Naum A, Scripcariu V, Negru D. Causes of death in patients with stage 0-II breast cancer. Rev Med Chir Soc Med Nat Iasi 2015; 119(2): 374-378.
18. Manafu EG, Filimon RM, Jari I, Petrariu FD, Manole A. Clinical epidemiological study on the incidence of Escherichia coli infections in the cancer patients admitted to Surgery Department II of the Iasi Regional Oncology Institute. Med Surg J Rev Med Chir Soc Med Nat Iasi 2018; 118(3): 796-800.
19. Diaconu IE, Irimie-Baluta RE, Vata A, et al. COVID-19 neurological manifestations - the experience of a tertiary hospital from Northeastern Romania. Med Surg J - Rev Med Chir Soc Med Nat Iasi 2022; 126(4): 496-504.
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