Should ct be used for the diagnosis of RT-PCR negative suspected COVID-19 patients?

Link to article at PubMed

Clin Respir J. 2021 Jan 23. doi: 10.1111/crj.13332. Online ahead of print.


INTRODUCTION: The diagnosis of patients with Coronavirus disease 2019 suspicion (COVID-19) but negative reverse transcriptase-polymerase chain reaction (RT-PCR) test is challenging.

OBJECTIVE: We aimed to investigate the diagnostic value of chest computed tomography (CT) in RT-PCR negative patients with suspected COVID-19.

MATERIALS AND METHODS: The study included patients who were admitted to our hospital with suspicion of COVID-19 between April 1 and April 30, 2020, who tested negative after RT-PCR test, and who underwent CT. Initial CT findings were classified as typical, indeterminate, atypical for COVID-19, and negative for pneumonia. Incidental findings on CT were noted.

RESULTS: Of the 338 patients with a mean age of 57 years (min 18 years -max 96 years), 168 (%49.70) were male and 170 (%50.29) were female. The most common symptoms were cough (58.87%), fever (40.82%), and dyspnea (39.34%). The CT findings were typical for COVID-19 in 109 (32.24%) patients, indeterminate in 47 (13.90%) patients, and atypical in 77 (22.78%) patients. The CT findings of 105 (31.06%) patients were negative for pneumonia. Incidental lung nodules suspicious of malignancy were identified in 7 patients. Seventy-seven patients (%22.78) had extrapulmonary incidental findings.

CONCLUSION: The diagnostic value of CT in RT-PCR negative patients with suspected COVID-19 is not very high. Based on clinical, laboratory, and chest x-ray findings, it may be more appropriate to refer patients to CT after the first triage, when necessary.

PMID:33484085 | DOI:10.1111/crj.13332

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