The Relation of Polymerase Chain Reaction and Computed Tomography Infiltrations of Suspected Covid-19 Patients in Emergency Department

Authors : Saltuk Bugra Karaca, Betül Gülalp, Murat Muratoglu, Rahime Sezer, Hale Turnaoğlu, M Şule Akçay, Elif Küpeli, Eylem Gül Ateş, Meriç Yavuz Çolak

Pages : 56-62

Doi:10.54996/anatolianjem.1438230

View : 89 | Download : 101

Publication Date : 2024-06-29

Article Type : Research Paper

Abstract :Aim: Considering the limitations of Polymerase Chain Reaction (PCR) in the Emergency Department (ED), alternative confirmation methods for assessing COVID-19 are needed. This study aimed to evaluate the performance of Thorax-Computed Tomography (TCT), following Radiological Society of North America (RSNA) recommendations, for suspected COVID-19 patients with pulmonary infiltrations. Material and Methods: From March to August 2020, 324 ED patients with suspected COVID-19 underwent T-CT scans. Blinded radiologists independently assessed T-CT scans based on RSNA guidelines. Reverse transcriptase polymerase chain reaction (RTPCR) served as the reference test. Results: Of 324 patients, 35% tested positive via RT-PCR. T-CT categories were typical (35.2%), indeterminate (47.5%), and atypical (11.1%). Using a typical T-CT category threshold resulted in 66% sensitivity, 81% specificity, 65% positive predictive value (PPV), 82% negative predictive value (NPV), and 76% accuracy. Subgroup analysis of repeat RT-PCR tests improved performance: 80% sensitivity, 79% specificity, 76% PPV, 83% NPV, and 79% accuracy. Combining RT-PCR and T-CT in the ED achieved 95.5% sensitivity, 79% PPV, and 86.4% accuracy. Conclusion: Following RSNA guidelines, T-CT exhibits moderatesensitivity and high specificity for detecting COVID-19. In EDsettings with suspected cases, T-CT aids in recommending retesting after an initial negative RT-PCR result, facilitating early management and timely isolation measures. The combined use of RT-PCR and T-CT enhances diagnostic performance, emphasizing the potential benefits of integrating these methods.
Keywords : Bilgisayarlı Tomografi, COVID 19, Acil Servis, RT PCR