Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

Comparison of Chest CT and RT-PCR Assay for Indication of Disease Course of Coronavirus Disease 2019 (COVID-19) Pneumonia

Author(s): Yi-fan Zhang* and Qiong Zhao

Volume 18, Issue 14, 2022

Published on: 13 July, 2022

Article ID: e090522204424 Pages: 8

DOI: 10.2174/1573405618666220509115914

Price: $65

Abstract

Background: COVID-19 patients' courses vary in length, indicating a variable prognosis. The disease duration revealed by different examination methods may differ.

Objective: The study aims to compare the differences in the disease course of patients with COVID-19 by chest computed tomography (CT) and reverse-transcription polymerase chain reaction (RT-PCR) assay and explore the factors that affect the course of the illness.

Methods: 106 patients confirmed with COVID-19 were enrolled and divided into two groups (age <60 years and age ≥60 years). The clinical characteristics of the two groups were analyzed. The intervals from symptoms onset to initial positive time point (ISIP), symptoms onset to the initial negative time point (ISIN), and initial positive to initial negative time point (IIPN) indicated by chest CT and RTPCR assay were analyzed. Multiple regression analysis was performed to assess the correlations between independent factors and the intervals.

Results: Chest CT showed an earlier positive time point, a later negative time point, and a longer disease duration than the RT-PCR assay (P<.001, respectively). Older patients over 60 years old showed a later negative time point and a longer disease duration by chest CT than younger patients (P<.01 vs. P<.05, respectively). The CT score and clinical grades of older patients were greater than those of younger patients (P<.001, respectively). Age and clinical grades were significantly correlated with the disease course shown by chest CT (P<.05, respectively), and CT score was positively correlated with the illness course shown by chest CT and RT-PCR assay (P<.01, respectively).

Conclusion: The disease course revealed by chest CT and RT-PCR assay was asynchronous. Chest CT showed a 17-day longer period compared to the RT-PCR assay. Older patients had a longer duration than younger ones. A prolonged course is predicted by increasing age, CT score, and clinical grades.

Keywords: COVID-19 pneumonia, chest CT, RT-PCR assay, time interval, disease course, age, CT score, clinical grades.

Graphical Abstract
[1]
World Health Organization. Novel coronavirus – China. 2020. Available from: https://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/ (Accessed April 15, 2020).
[2]
Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet 2020; 395(10223): 470-3.
[http://dx.doi.org/10.1016/S0140-6736(20)30185-9] [PMID: 31986257]
[3]
Ai T, Yang Z, Hou H, 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): E32-40.
[http://dx.doi.org/10.1148/radiol.2020200642] [PMID: 32101510]
[4]
Wu D, Rao Q, Zhang W. The natural course of COVID-19 patients without clinical intervention. J Med Virol 2021; 93(9): 5527-37.
[http://dx.doi.org/10.1002/jmv.27087] [PMID: 33990975]
[5]
Waller JV, Kaur P, Tucker A, et al. Diagnostic tools for coronavirus disease (COVID-19): Comparing CT and RT-PCR viral nucleic acid testing. AJR Am J Roentgenol 2020; 215(4): 834-8.
[http://dx.doi.org/10.2214/AJR.20.23418] [PMID: 32412790]
[6]
Alsharif W, Qurashi A. Effectiveness of COVID-19 diagnosis and management tools: A review. Radiography 2021; 27(2): 682-7.
[http://dx.doi.org/10.1016/j.radi.2020.09.010] [PMID: 33008761]
[7]
Martín J, Tena N, Asuero AG. Current state of diagnostic, screening and surveillance testing methods for COVID-19 from an analytical chemistry point of view. Microchem J 2021; 167: 106305.
[http://dx.doi.org/10.1016/j.microc.2021.106305] [PMID: 33897053]
[8]
Yun Y, Wang Y, Hao Y, Xu L, Cai Q. The time course of chest CT lung changes in COVID-19 patients from onset to discharge. Eur J Radiol Open 2020; 8: 100305.
[http://dx.doi.org/10.1016/j.ejro.2020.100305] [PMID: 33392360]
[9]
National Health Committee. General Office of National Health Committee. Notice on the issuance of the novel coronavirus pneumonia (COVID-19) treatment programme. 2020. Available from:. http://www.nhc.gov.cn/xcs/zhengcwj/202008/0a7bdf12bd4b46e5bd28ca7f9a7f5e5a.shtml. (Accessed August 18, 2020).
[10]
Ooi GC, Khong PL, Müller NL, et al. Severe acute respiratory syndrome: Temporal lung changes at thin-section CT in 30 patients. Radiology 2004; 230(3): 836-44.
[http://dx.doi.org/10.1148/radiol.2303030853] [PMID: 14990845]
[11]
Han X, Cao Y, Jiang N, et al. Novel coronavirus disease 2019 (COVID-19) Pneumonia progression course in 17 discharged patients: Comparison of clinical and thin-section computed tomography features during recovery. Clin Infect Dis 2020; 71(15): 723-31.
[http://dx.doi.org/10.1093/cid/ciaa271] [PMID: 32227091]
[12]
Pan F, Ye T, Sun P, et al. Time course of lung changes at chest CT during recovery from coronavirus disease 2019 (COVID-19). Radiology 2020; 295(3): 715-21.
[http://dx.doi.org/10.1148/radiol.2020200370] [PMID: 32053470]
[13]
World Health Organization. Tracking SARS-CoV-2 variants. Available from: https://www.who.int/en/activities/tracking-SARS-CoV-2-variants/ (Accessed August 15, 2021).
[14]
Li F, Li W, Farzan M, Harrison SC. Structure of SARS coronavirus spike receptor-binding domain complexed with receptor. Science 2005; 309(5742): 1864-8.
[http://dx.doi.org/10.1126/science.1116480] [PMID: 16166518]
[15]
Yan R, Zhang Y, Li Y, Xia L, Guo Y, Zhou Q. Structural basis for the recognition of SARS-CoV-2 by full-length human ACE2. Science 2020; 367(6485): 1444-8.
[http://dx.doi.org/10.1126/science.abb2762] [PMID: 32132184]
[16]
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497-506.
[http://dx.doi.org/10.1016/S0140-6736(20)30183-5] [PMID: 31986264]
[17]
Yang Y, Yang M, Shen C, et al. Evaluating the accuracy of different respiratory specimens in the laboratory diagnosis and monitoring the viral shedding of 2019-nCoV infections. 2020.
[http://dx.doi.org/10.1101/2020.02.11.20021493]
[18]
Salamanna F, Maglio M, Landini MP, Fini M. Body localization of ACE-2: On the trail of the keyhole of SARS-CoV-2. Front Med (Lausanne) 2020; 7: 594495.
[http://dx.doi.org/10.3389/fmed.2020.594495] [PMID: 33344479]
[19]
Lin HXJ, Cho S, Meyyur Aravamudan V, et al. Remdesivir in coronavirus disease 2019 (COVID-19) treatment: A review of evidence. Infection 2021; 49(3): 401-10.
[http://dx.doi.org/10.1007/s15010-020-01557-7] [PMID: 33389708]
[20]
Nojomi M, Yassin Z, Keyvani H, et al. Effect of Arbidol (Umifenovir) on COVID-19: A randomized controlled trial. BMC Infect Dis 2020; 20(1): 954.
[http://dx.doi.org/10.1186/s12879-020-05698-w] [PMID: 33317461]
[21]
Sreekanth Reddy O, Lai WF. Tackling COVID-19 using remdesivir and favipiravir as therapeutic options. ChemBioChem 2021; 22(6): 939-48.
[http://dx.doi.org/10.1002/cbic.202000595] [PMID: 33031623]
[22]
Ahmed S, Karim MM, Ross AG, et al. A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness. Int J Infect Dis 2021; 103: 214-6.
[http://dx.doi.org/10.1016/j.ijid.2020.11.191] [PMID: 33278625]
[23]
Ahmed S, Zimba O, Gasparyan AY. COVID-19 and the clinical course of rheumatic manifestations. Clin Rheumatol 2021; 40(7): 2611-9.
[http://dx.doi.org/10.1007/s10067-021-05691-x] [PMID: 33733315]
[24]
Tian S, Hu W, Niu L, Liu H, Xu H, Xiao SY. Pulmonary pathology of early-phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer. J Thorac Oncol 2020; 15(5): 700-4.
[http://dx.doi.org/10.1016/j.jtho.2020.02.010] [PMID: 32114094]
[25]
Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med 2020; 8(4): 420-2.
[http://dx.doi.org/10.1016/S2213-2600(20)30076-X] [PMID: 32085846]
[26]
Whitsett JA. Airway epithelial differentiation and mucociliary clearance. Ann Am Thorac Soc 2018; 15 (Suppl. 3): S143-8.
[http://dx.doi.org/10.1513/AnnalsATS.201802-128AW] [PMID: 30431340]
[27]
Whitsett JA, Alenghat T. Respiratory epithelial cells orchestrate pulmonary innate immunity. Nat Immunol 2015; 16(1): 27-35.
[http://dx.doi.org/10.1038/ni.3045] [PMID: 25521682]
[28]
George PM, Wells AU, Jenkins RG. Pulmonary fibrosis and COVID-19: The potential role for antifibrotic therapy. Lancet Respir Med 2020; 8(8): 807-15.
[http://dx.doi.org/10.1016/S2213-2600(20)30225-3] [PMID: 32422178]
[29]
Zhang T, Sun LX, Feng RE. Comparison of clinical and pathological features between severe acute respiratory syndrome and coronavirus disease 2019. Zhonghua Jie He He Hu Xi Za Zhi 2020; 43(6): 496-502.
[PMID: 32241072]
[30]
Boban M. Novel coronavirus disease (COVID-19) update on epidemiology, pathogenicity, clinical course and treatments. Int J Clin Pract 2021; 75(4): e13868.
[http://dx.doi.org/10.1111/ijcp.13868] [PMID: 33244856]
[31]
Chen N, Zhou M, Dong X, 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.
[http://dx.doi.org/10.1016/S0140-6736(20)30211-7] [PMID: 32007143]
[32]
Lu R, Zhao X, Li J, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding. Lancet 2020; 395(10224): 565-74.
[http://dx.doi.org/10.1016/S0140-6736(20)30251-8] [PMID: 32007145]
[33]
Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): A pictorial review. Eur Radiol 2020; 30(8): 4381-9.
[http://dx.doi.org/10.1007/s00330-020-06801-0] [PMID: 32193638]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy