Öz
Purpose: The aim of this study was to investigate the relationship of PCR test positivity between suspected COVID-19 patients presenting with pneumonia and upper respiratory tract infection (URTI).
Materials and Methods: The records of 80 patients admitted to the Ondokuz Mayıs University Hospital pandemic clinic suspected COVID-19 were retrospectively analyzed. Eighty patients hospitalized with high suspicion of COVID-19 were divided into URTI and pneumonia by evaluating their thorax CT (computed tomography) results and symptoms. Two experienced radiologists evaluated thoracic CT images taken to the patients. CT findings were classified as negative for typical appearance, indeterminate appearance, atypical appearance, and pneumonia. Demographic characteristics, comorbidities, contact history, treatment, presenting symptoms and laboratory values of the patients were recorded.
Results: Data of 80 patients were analyzed in the study. It was observed that there were 29 patients (36.3%) with normal CT findings and URTI symptoms and 51 patients (63.7%) with typical COVID-19 pneumonia findings on CT. The risk of PCR test results positive was 6,6 times higher in those with URTI than those with pneumonia. Those without shortness of breath were found to have a positive risk of 6,5 times higher than those with shortness of breath.
Conclusion: Although PCR tests are negative in patients presenting with upper respiratory tract symptoms, if there are typical thoracic CT findings consistent with COVID-19 pneumonia, patients should be retested, and necessary measures should be taken to minimize the risk of transmission.
Anahtar Kelimeler
Kaynakça
- 1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
- 2. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.
- 3. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. Jama. 2020;323(11):1061-9.
- 4. Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J (Engl). 2020;133(9):1025-31.
- 5. Özdemir M, Taydaş O, Öztürk MH. COVID-19 Enfeksiyonunda Toraks Bilgisayarlı Tomografi Bulguları. Journal of Biotechnology and Strategic Health Research. 2020;4:91-6.
- 6. Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020;382(12):1177-9.
- 7. Wahidi MM, Lamb C, Murgu S, Musani A, Shojaee S, Sachdeva A, et al. American Association for Bronchology and Interventional Pulmonology (AABIP) Statement on the Use of Bronchoscopy and Respiratory Specimen Collection in Patients With Suspected or Confirmed COVID-19 Infection. J Bronchology Interv Pulmonol. 2020;27(4):e52-e4.
- 8. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology. 2020;296(2):E32-e40.
- 9. 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;296(2):E115-e7.
- 10. Zhao J, Yuan Q, Wang H, Liu W, Liao X, Su Y, et al. Antibody Responses to SARS-CoV-2 in Patients With Novel Coronavirus Disease 2019. Clin Infect Dis. 2020;71(16):2027-34.
- 11. Pakdemirli E, Mandalia U, Monib S. Positive Chest CT Features in Patients With COVID-19 Pneumonia and Negative Real-Time Polymerase Chain Reaction Test. Cureus. 2020;12(8):e9942.
- 12. Li Z, Yi Y, Luo X, Xiong N, Liu Y, Li S, et al. Development and clinical application of a rapid IgM-IgG combined antibody test for SARS-CoV-2 infection diagnosis. J Med Virol. 2020;92(9):1518-24.
- 13. Hao W, Li M. Clinical diagnostic value of CT imaging in COVID-19 with multiple negative RT-PCR testing. Travel Med Infect Dis. 2020;34:101627.
- 14. Wang S, Kang B, Ma J, Zeng X, Xiao M, Guo J, et al. A deep learning algorithm using CT images to screen for Corona virus disease (COVID-19). Eur Radiol. 2021:1-9.
- 15. Zhai P, Ding Y, Wu X, Long J, Zhong Y, Li Y. The epidemiology, diagnosis and treatment of COVID-19. Int J Antimicrob Agents. 2020;55(5):105955.
- 16. Erturk SM. CT of Coronavirus Disease (COVID-19) Pneumonia: A Reference Standard Is Needed. AJR Am J Roentgenol. 2020;215(1):W20.
- 17. Türkiye Cumhuriyeti Sağlık Bakanlığı. COVID-19 Rehberi. Ankara 2020.
- 18. Simpson S, Kay FU, Abbara S, Bhalla S, Chung JH, Chung M, et al. Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA - Secondary Publication. J Thorac Imaging. 2020;35(4):219-27.
- 19. Fu L, Wang B, Yuan T, Chen X, Ao Y, Fitzpatrick T, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis. J Infect. 2020;80(6):656-65.
- 20. Tian S, Hu N, Lou J, Chen K, Kang X, Xiang Z, et al. Characteristics of COVID-19 infection in Beijing. J Infect. 2020;80(4):401-6.
- 21. Sümer Ş, Ural O, Aktuğ-Demir N, Çifci Ş, Türkseven B, Kılınçer A, et al. Selçuk Üniversitesi Tıp Fakültesi Hastanesi'nde İzlenen COVID-19 Olgularının Klinik ve Laboratuvar Özellikleri. Klimik Journal/Klimik Dergisi. 2020;33(2).
- 22. Zhang ZL, Hou YL, Li DT, Li FZ. Laboratory findings of COVID-19: a systematic review and meta-analysis. Scand J Clin Lab Invest. 2020;80(6):441-7.
- 23. Kovács A, Palásti P, Veréb D, Bozsik B, Palkó A, Kincses ZT. The sensitivity and specificity of chest CT in the diagnosis of COVID-19. Eur Radiol. 2020:1-6.
- 24. Chen D, Jiang X, Hong Y, Wen Z, Wei S, Peng G, et al. Can chest CT features distinguish patients with negative from those with positive initial RT-PCR results for coronavirus disease (COVID-19)? American Journal of Roentgenology. 2021;216(1):66-70.
- 25. Patel R, Babady E, Theel ES, Storch GA, Pinsky BA, St George K, et al. Report from the American Society for Microbiology COVID-19 International Summit, 23 March 2020: Value of Diagnostic Testing for SARS-CoV-2/COVID-19. mBio. 2020;11(2).
Öz
Amaç: Bu çalışmada, pnömoni ve üst solunum yolu enfeksiyonu (ÜSYE) kliniği ile başvuran şüpheli COVID-19 hastaları arasındaki PCR testi pozitifliğinin ilişkisinin araştırılması amaçlanmıştır.
Gereç ve Yöntem: Ondokuz Mayıs Üniversitesi Hastanesi pandemi kliniğine COVID-19 şüphesiyle yatırılan 80 hastanın kayıtları retrospektif olarak incelendi. COVID-19 şüphesi ile yatırılan 80 hasta, Toraks BT (Bilgisayarlı Tomografi) sonucu ve semptomları değerlendirilerek ÜSYE ve pnömoni olarak iki gruba ayrıldı. Hastalara çekilen Toraks BT görüntüleri, deneyimli iki radyolog tarafından değerlendirildi. BT bulguları, tipik görünüm, belirsiz görünüm, atipik görünüm ve pnömoni için negatif olarak sınıflandırıldı. Hastaların, demografik özellikleri, ek hastalıkları, temas öyküsü, verilen tedavi, geliş semptomları ve laboratuvar değerleri kaydedildi.
Bulgular: Çalışmada 80 hastanın verileri incelendi. Normal BT bulguları ve ÜSYE semptomları olan 29 hasta (%36.3) ve BT’de tipik COVID-19 pnömonisi bulguları olan 51 hasta (%63.7) olduğu gözlendiYapılan analiz sonucunda PCR pozitifliğine etki eden faktörler incelenmiş ve analiz sonucunda ÜSYE olanların pnömoni olanlara göre PCR test sonucunun pozitif çıkma riskinin 6,6 kat daha fazla olduğu tespit edilmiştir. Nefes darlığı olmayanların olanlara göre pozitif çıkma riski de 6,5 kat fazla bulunmuştur ).
Sonuç: Üst solunum yolu semptomları ile başvuran hastalarda PCR testleri negatif olsa da COVID-19 pnömonisiyle uyumlu tipik Toraks BT bulguları varsa hastalara tekrar test yapılmalı ve bulaş riskini en aza indirmek için gerekli önlemler alınmalıdır.
Anahtar Kelimeler
Kaynakça
- 1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
- 2. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.
- 3. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. Jama. 2020;323(11):1061-9.
- 4. Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J (Engl). 2020;133(9):1025-31.
- 5. Özdemir M, Taydaş O, Öztürk MH. COVID-19 Enfeksiyonunda Toraks Bilgisayarlı Tomografi Bulguları. Journal of Biotechnology and Strategic Health Research. 2020;4:91-6.
- 6. Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020;382(12):1177-9.
- 7. Wahidi MM, Lamb C, Murgu S, Musani A, Shojaee S, Sachdeva A, et al. American Association for Bronchology and Interventional Pulmonology (AABIP) Statement on the Use of Bronchoscopy and Respiratory Specimen Collection in Patients With Suspected or Confirmed COVID-19 Infection. J Bronchology Interv Pulmonol. 2020;27(4):e52-e4.
- 8. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology. 2020;296(2):E32-e40.
- 9. 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;296(2):E115-e7.
- 10. Zhao J, Yuan Q, Wang H, Liu W, Liao X, Su Y, et al. Antibody Responses to SARS-CoV-2 in Patients With Novel Coronavirus Disease 2019. Clin Infect Dis. 2020;71(16):2027-34.
- 11. Pakdemirli E, Mandalia U, Monib S. Positive Chest CT Features in Patients With COVID-19 Pneumonia and Negative Real-Time Polymerase Chain Reaction Test. Cureus. 2020;12(8):e9942.
- 12. Li Z, Yi Y, Luo X, Xiong N, Liu Y, Li S, et al. Development and clinical application of a rapid IgM-IgG combined antibody test for SARS-CoV-2 infection diagnosis. J Med Virol. 2020;92(9):1518-24.
- 13. Hao W, Li M. Clinical diagnostic value of CT imaging in COVID-19 with multiple negative RT-PCR testing. Travel Med Infect Dis. 2020;34:101627.
- 14. Wang S, Kang B, Ma J, Zeng X, Xiao M, Guo J, et al. A deep learning algorithm using CT images to screen for Corona virus disease (COVID-19). Eur Radiol. 2021:1-9.
- 15. Zhai P, Ding Y, Wu X, Long J, Zhong Y, Li Y. The epidemiology, diagnosis and treatment of COVID-19. Int J Antimicrob Agents. 2020;55(5):105955.
- 16. Erturk SM. CT of Coronavirus Disease (COVID-19) Pneumonia: A Reference Standard Is Needed. AJR Am J Roentgenol. 2020;215(1):W20.
- 17. Türkiye Cumhuriyeti Sağlık Bakanlığı. COVID-19 Rehberi. Ankara 2020.
- 18. Simpson S, Kay FU, Abbara S, Bhalla S, Chung JH, Chung M, et al. Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA - Secondary Publication. J Thorac Imaging. 2020;35(4):219-27.
- 19. Fu L, Wang B, Yuan T, Chen X, Ao Y, Fitzpatrick T, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis. J Infect. 2020;80(6):656-65.
- 20. Tian S, Hu N, Lou J, Chen K, Kang X, Xiang Z, et al. Characteristics of COVID-19 infection in Beijing. J Infect. 2020;80(4):401-6.
- 21. Sümer Ş, Ural O, Aktuğ-Demir N, Çifci Ş, Türkseven B, Kılınçer A, et al. Selçuk Üniversitesi Tıp Fakültesi Hastanesi'nde İzlenen COVID-19 Olgularının Klinik ve Laboratuvar Özellikleri. Klimik Journal/Klimik Dergisi. 2020;33(2).
- 22. Zhang ZL, Hou YL, Li DT, Li FZ. Laboratory findings of COVID-19: a systematic review and meta-analysis. Scand J Clin Lab Invest. 2020;80(6):441-7.
- 23. Kovács A, Palásti P, Veréb D, Bozsik B, Palkó A, Kincses ZT. The sensitivity and specificity of chest CT in the diagnosis of COVID-19. Eur Radiol. 2020:1-6.
- 24. Chen D, Jiang X, Hong Y, Wen Z, Wei S, Peng G, et al. Can chest CT features distinguish patients with negative from those with positive initial RT-PCR results for coronavirus disease (COVID-19)? American Journal of Roentgenology. 2021;216(1):66-70.
- 25. Patel R, Babady E, Theel ES, Storch GA, Pinsky BA, St George K, et al. Report from the American Society for Microbiology COVID-19 International Summit, 23 March 2020: Value of Diagnostic Testing for SARS-CoV-2/COVID-19. mBio. 2020;11(2).
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Eylül 2021 |
| Kabul Tarihi | 5 Mayıs 2021 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 46 Sayı: 3 |
