tetano
Editor, Senior Moderator
Acad Radiol
. 2020 Sep 21;S1076-6332(20)30542-0.
doi: 10.1016/j.acra.2020.09.003. Online ahead of print.
Correlation Between Low-Dose Chest Computed Tomography and RT-PCR Results for the Diagnosis of COVID-19: A Report of 27,824 Cases in Tehran, Iran
Alireza Zali[SUP] 1 [/SUP], Mohammad-Reza Sohrabi[SUP] 2 [/SUP], Ali Mahdavi[SUP] 3 [/SUP], Nastaran Khalili[SUP] 4 [/SUP], Morteza Sanei Taheri[SUP] 5 [/SUP], Ali Maher[SUP] 6 [/SUP], Mohammadmehdi Sadoughi[SUP] 7 [/SUP], Afshin Zarghi[SUP] 8 [/SUP], Seyed Ali Ziai[SUP] 9 [/SUP], Abbas Arjmand Shabestari[SUP] 10 [/SUP], Mehrdad Bakhshayeshkaram[SUP] 11 [/SUP], Hamidreza Haghighatkhah[SUP] 12 [/SUP], Babak Salevatipour[SUP] 13 [/SUP], Alireza Abrishami[SUP] 14 [/SUP], Masoomeh Raoufi[SUP] 15 [/SUP], Pooneh Dehghan[SUP] 16 [/SUP], Arash Khameneh Bagheri[SUP] 17 [/SUP], Reza Jalili Khoshnoud[SUP] 18 [/SUP], Khatereh Hanani[SUP] 19 [/SUP]
Affiliations
Abstract
Rationale and objectives: Real-time polymerase chain reaction (RT-PCR) remains the gold standard for confirmation of Coronavirus Disease 2019 (COVID-19) despite having many disadvantages. Here, we investigated the diagnostic performance of chest computed tomography (CT) as an alternative to RT-PCR in patients with clinical suspicion of COVID-19 infection.
Methods: In this descriptive cross-sectional study, 27,824 patients with clinical suspicion of COVID-19 infection who underwent unenhanced low-dose chest CT from 20 February, 2020 to 21 May, 2020 were evaluated. Patients were recruited from seven specifically designated hospitals for patients with COVID-19 infection affiliated to Shahid Beheshti University of Medical Sciences. In each hospital, images were interpreted by two independent radiologists. CT findings were considered as positive/negative for COVID-19 infection based on RSNA diagnostic criteria. Then, the correlation between the number of daily positive chest CT scans and number of daily PCR-confirmed cases and COVID-19-related deaths in Tehran province during this three-month period was assessed. The trends of admission rate and patients with positive CT scans were also evaluated.
Results: A strong positive correlation between the numbers of daily positive CT scans and daily PCR-confirmed COVID-19 cases (r = 0.913, p < 0.001) was observed. Furthermore, in hospitals located in regions with a lower socioeconomic status, the admission rate and number of positive cases within this three-month period was higher as compared to other hospitals.
Conclusion: Low-dose chest CT is a safe, rapid and reliable alternative to RT-PCR for the diagnosis of COVID-19 in high-prevalence regions. In addition, our study provides further evidence for considering patients' socioeconomic status as an important risk factor for COVID-19.
Keywords: COVID-19; RT-PCR; computed tomography; correlation; diagnosis; polymerase chain reaction; socioeconomic.
. 2020 Sep 21;S1076-6332(20)30542-0.
doi: 10.1016/j.acra.2020.09.003. Online ahead of print.
Correlation Between Low-Dose Chest Computed Tomography and RT-PCR Results for the Diagnosis of COVID-19: A Report of 27,824 Cases in Tehran, Iran
Alireza Zali[SUP] 1 [/SUP], Mohammad-Reza Sohrabi[SUP] 2 [/SUP], Ali Mahdavi[SUP] 3 [/SUP], Nastaran Khalili[SUP] 4 [/SUP], Morteza Sanei Taheri[SUP] 5 [/SUP], Ali Maher[SUP] 6 [/SUP], Mohammadmehdi Sadoughi[SUP] 7 [/SUP], Afshin Zarghi[SUP] 8 [/SUP], Seyed Ali Ziai[SUP] 9 [/SUP], Abbas Arjmand Shabestari[SUP] 10 [/SUP], Mehrdad Bakhshayeshkaram[SUP] 11 [/SUP], Hamidreza Haghighatkhah[SUP] 12 [/SUP], Babak Salevatipour[SUP] 13 [/SUP], Alireza Abrishami[SUP] 14 [/SUP], Masoomeh Raoufi[SUP] 15 [/SUP], Pooneh Dehghan[SUP] 16 [/SUP], Arash Khameneh Bagheri[SUP] 17 [/SUP], Reza Jalili Khoshnoud[SUP] 18 [/SUP], Khatereh Hanani[SUP] 19 [/SUP]
Affiliations
- PMID: 33020043
- DOI: 10.1016/j.acra.2020.09.003
Abstract
Rationale and objectives: Real-time polymerase chain reaction (RT-PCR) remains the gold standard for confirmation of Coronavirus Disease 2019 (COVID-19) despite having many disadvantages. Here, we investigated the diagnostic performance of chest computed tomography (CT) as an alternative to RT-PCR in patients with clinical suspicion of COVID-19 infection.
Methods: In this descriptive cross-sectional study, 27,824 patients with clinical suspicion of COVID-19 infection who underwent unenhanced low-dose chest CT from 20 February, 2020 to 21 May, 2020 were evaluated. Patients were recruited from seven specifically designated hospitals for patients with COVID-19 infection affiliated to Shahid Beheshti University of Medical Sciences. In each hospital, images were interpreted by two independent radiologists. CT findings were considered as positive/negative for COVID-19 infection based on RSNA diagnostic criteria. Then, the correlation between the number of daily positive chest CT scans and number of daily PCR-confirmed cases and COVID-19-related deaths in Tehran province during this three-month period was assessed. The trends of admission rate and patients with positive CT scans were also evaluated.
Results: A strong positive correlation between the numbers of daily positive CT scans and daily PCR-confirmed COVID-19 cases (r = 0.913, p < 0.001) was observed. Furthermore, in hospitals located in regions with a lower socioeconomic status, the admission rate and number of positive cases within this three-month period was higher as compared to other hospitals.
Conclusion: Low-dose chest CT is a safe, rapid and reliable alternative to RT-PCR for the diagnosis of COVID-19 in high-prevalence regions. In addition, our study provides further evidence for considering patients' socioeconomic status as an important risk factor for COVID-19.
Keywords: COVID-19; RT-PCR; computed tomography; correlation; diagnosis; polymerase chain reaction; socioeconomic.