Diagnosis of the Coronavirus disease (COVID-19): rRT-PCR or CT?
Diagnosis of the Coronavirus disease (COVID-19): rRT-PCR or CT?
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DOI：
10.1016/j.ejrad.2020.108961
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发表时间：
2020-05-01
影响因子：
3.3
通讯作者：
Li, Honglu
中科院分区：
文献类型：
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作者：
Long, Chunqin;Xu, Huaxiang;Li, Honglu
目的：目的：探讨CT和实时荧光定量RT-PCR对COVID-19肺炎的诊断价值。方法：本回顾性研究包括所有疑似COVID-19肺炎的患者，在最初就诊时均进行CT和RT-PCR检查。然后比较两种试验的灵敏度。结果：36例患者最终确诊为COVID-19肺炎，其中36例患者的临床表现、实验室检查及CT影像学检查均符合诊断标准。35例患者在就诊时CT表现异常，而1例患者CT正常。使用rRT-PCR，30例患者检测为阳性，6例最初漏诊。在这6例患者中，3例在第二次rRT-PCR检测中（分别在2天、2天和3天后）呈阳性，另3例仅在第三轮rRT-PCR检测中（分别在5天、6天和8天后）呈阳性。结论：rRT-PCR可产生假阴性结果，CT诊断敏感性为97.2%，而rRT-PCR诊断敏感性仅为83.3%。我们建议对CT表现典型但rRT-PCR结果阴性的患者应进行隔离，并重复进行rRT-PCR，以避免误诊。
Purpose: To evaluate the diagnostic value of computed tomography (CT) and real-time reverse-transcriptase-polymerase chain reaction (rRT-PCR) for COVID-19 pneumonia.Methods: This retrospective study included all patients with COVID-19 pneumonia suspicion, who were examined by both CT and rRT-PCR at initial presentation. The sensitivities of both tests were then compared. For patients with a final confirmed diagnosis, clinical and laboratory data, in addition to CT imaging findings were evaluated.Results: A total of 36 patients were finally diagnosed with COVID-19 pneumonia. Thirty-five patients had abnormal CT findings at presentation, whereas one patient had a normal CT. Using rRT-PCR, 30 patients were tested positive, with 6 cases initially missed. Amongst these 6 patients, 3 became positive in the second rRT-PCR assay(after 2 days, 2 days and 3 days respectively), and the other 3 became positive only in the third round of rRT-PCR tests(after 5 days, 6 days and 8 days respectively). At presentation, CT sensitivity was therefore 97.2%, whereas the sensitivity of initial rRT-PCR was only 83.3%.Conclusion: rRT-PCR may produce initial false negative results. We suggest that patients with typical CT findings but negative rRT-PCR results should be isolated, and rRT-PCR should be repeated to avoid misdiagnosis.