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Chest . First Detection of SARS-CoV-2 by Real-Time Reverse-Transcriptase-Polymerase-Chain-Reaction (RT-PCR) Assay in Pleural Fluid

tetano

Editor, Senior Moderator
Chest


. 2020 Jun 11;S0012-3692(20)31660-3.
doi: 10.1016/j.chest.2020.05.583. Online ahead of print.
First Detection of SARS-CoV-2 by Real-Time Reverse-Transcriptase-Polymerase-Chain-Reaction (RT-PCR) Assay in Pleural Fluid


Federico Mei[SUP] 1 [/SUP], Martina Bonifazi[SUP] 2 [/SUP], Stefano Menzo[SUP] 3 [/SUP], Alessandro Di Marco Berardino[SUP] 4 [/SUP], Michele Sediari[SUP] 4 [/SUP], Luca Paolini[SUP] 4 [/SUP], Antonina Re[SUP] 4 [/SUP], Francesca Gonnelli[SUP] 4 [/SUP], Martina Grilli[SUP] 4 [/SUP], Giacomo Spurio Vennarucci[SUP] 4 [/SUP], Maria Agnese Latini[SUP] 4 [/SUP], Lina Zuccatosta[SUP] 4 [/SUP], Stefano Gasparini[SUP] 2 [/SUP]



Affiliations
Free PMC article

Abstract

COVID-19 is a pandemic infection due to a novel coronavirus (SARS-CoV-2) spreading, resulting in a wide range of clinical features, from asyntomatic carriers to acute respiratory distress syndrome. The gold standard for diagnosis is nucleic acid detection by real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) in naso-pharyngeal swabs, but, due to limitations in its sensitivity, thoracic imaging plays a crucial, complementary role in diagnostic work-up and it allows also to reveal atypical findings and potential alternative target for sampling, such as pleural effusion. Although not common, pleural involvement has been described in a minority of patients. Here, we describe the first case of SARS-CoV-2 RT-PCR detection in pleural fluid obtained by means of ultrasound-guided thoracentesis and report its main characteristics. Pleural effusion is not a common finding in COVID-19 infection, but a prompt recognition of this potential localization may be useful to optimize diagnostic work-up as well as management of these patients.

Keywords: computed tomography-guided biopsy; diagnostic yield; meta-analysis; pleural lesions; safety; ultrasound-guided biopsy.
 
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