International Journal of Tropical Medicine
ISSN: Online 1818-779XISSN: Print 1816-3319
Abstract
The outbreak of an unknown viral pneumonia in December 2019 in Wuhan City, Hubei Province, China, led to the identification of a novel coronavirus, later named SARS‐CoV‐2 by the World Health Organization (WHO) on March 13, 2020. This virus rapidly spread worldwide, causing the COVID‐19 pandemic. By the time the pandemic was declared, over 2 million infections and 100,000 deaths had been reported globally, with numbers escalating, particularly in the United States and Europe. As of October 1, 2021, India alone reported over 33.7 million cases and 447,062 deaths, underscoring the virus's widespread impact. The rapid transmission of SARS‐CoV‐2, with an average doubling time of 3‐4 days, placed immense pressure on healthcare systems. Early detection and isolation of infected individuals became crucial in controlling the spread of COVID‐19. The reference standard for diagnosing COVID‐19 is the RT‐PCR test, which detects viral nucleic acid in respiratory specimens. The Centers for Disease Control and Prevention (CDC) developed two key tests: the CDC 2019‐Novel Coronavirus Real‐Time RT‐PCR Diagnostic Panel for COVID‐19, introduced in February 2020 and the CDC Influenza SARS‐CoV‐2 Multiplex Assay, which simultaneously diagnoses COVID‐19, influenza A and influenza B. Despite being the gold standard, RT‐PCR has limitations, with sensitivity ranging from 50‐62% due to various factors such as viral load, specimen source and timing. False negatives are a significant concern, particularly in patients with strong clinical suspicion and typical chest CT findings. This has led to ongoing transmission and increased strain on healthcare facilities. Chest CT scans have been proposed as a complementary diagnostic tool due to their ability to detect pneumonia with typical viral infection patterns, including ground‐glass opacities (GGO), patchy consolidations and crazy‐paving patterns. Some studies report sensitivity rates for CT imaging as high as 98%, making it a valuable tool in diagnosing COVID‐19, especially when RT‐PCR results are inconclusive. This study aimed to analyze the correlation between RT‐PCR results and chest CT findings in patients with COVID‐19 pneumonia. After obtaining ethical approval, patients suspected of having COVID‐19 who were referred for chest CT between April 2020 and April 2022 were included. Exclusion criteria included incomplete clinical or laboratory information, excessive motion artifacts in imaging and age below 18 years. RT‐PCR tests were performed on respiratory specimens, with patients classified as COVID‐19 positive or negative based on these results. Chest CT scans were conducted without contrast and images were evaluated by experienced radiologists for typical COVID‐19 findings. Among 362 patients with suspected COVID‐19 pneumonia, 174 tested positive on the initial RT‐PCR test and 92 were positive on retesting. There were 229 males and 135 females, with ages ranging from 18 to 87 years (mean age 49.28 ± 16.15 years). Common symptoms included fever (47.52%), cough (45.32%), and shortness of breath (17.58%). CT findings were categorized by lobe involvement and included GGO (76.3%), consolidation (24.8%) and crazy paving (7.9%). Bilateral lung involvement was observed in 73.3% of patients. CO‐RADS classification was used to assess the severity of findings, with most patients falling into CO‐RADS categories 6 and 1. Despite RT‐PCR being positive, 33.1% of patients showed no abnormalities on chest CT.
How to cite this article:
Krishnakanth Pallem, Santosh P. Patil, H.M. Chakit Kumar and Priyanka . Correlation of CT Chest Findings with RT‐PCR in Suspected Cases of Covid‐19 Pneumonia.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.4.105.112
URL: https://www.makhillpublications.co/view-article/1816-3319/10.36478/makrjms.2024.4.105.112