scholarly journals Comparison of chest HRCT severity score in PCR positive and PCR negative clinically suspected COVID-19 Patients

2021 ◽  
Vol 21 (4) ◽  
pp. 1558-66
Author(s):  
Hina Hanif Mughal ◽  
Syed Muhammad Jawad Zaidi ◽  
Hamza Waqar Bhatti ◽  
Madiha Maryum ◽  
Maria Khaliq ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Severity Score ◽  
Clinical Symptoms ◽  
False Negative ◽  
Left Lung ◽  
Lung Damage ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Severity Scores ◽  
Polymerase Chain

Background: The limitations and false-negative results of Real-time Polymerase chain reaction (RT PCR) in diagnosing COVID-19 infection demand the need for imaging modalities such as chest HRCT to improve the diagnostic accuracy andassess the severity of the infection. Objectives: The study aimed to compare the chest HRCT severity scores in RT-PCR positive and negative cases of COVID-19. Methods: This cross-sectional study included 50 clinically suspected COVID-19 patients. Chest HRCT and PCR testing of all 50 patients were done and the chest HRCT severity scores for each lung and bronchopulmonary segments were compared in patients with positive and negative PCR results. Chi-square and Mann Whitney U test were used to assess differences among study variables. Results: Chest HRCT severity score was more in PCR negative patients than in those with PCR positive results . However, the difference was not significant (p=0.11). There was a significant association in severity scores of the anterior basal segment of the left lung (p=0.022) and posterior segment upper lobe of right lung (p=0.035) with PCR results. This association was insignificantfor other bronchopulmonary segments (p>0.05). Conclusion: CR negativity does not rule out infection in clinically suspected COVID-19 patients. The use of chest HRCT helps to determine the extent of lung damage in clinically suspected patients irrespective of PCR results. Guidelines that consider clinical symptoms, chest HRCT severity score and PCR results for a confirmed diagnosis of COVID-19 in suspected patientsare needed. Keywords: Chest High resolution computed tomography (HRCT); COVID-19; Polymerase Chain Reaction (PCR).

scholarly journals Perspective of Arguments in Public Health

2021 ◽  
Vol 9 (1) ◽  
pp. 44-45
Author(s):  
Dinesh Kumar
Keyword(s):  
Polymerase Chain Reaction ◽  
Real Time ◽  
Respiratory Symptoms ◽  
False Negative ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Negative Report ◽  
Polymerase Chain ◽  
Time Of Admission ◽  
Pcr Test

Recently, an argument was put forth because a symptomatic and positive patient for CoVID-19 turned tested negative after 7 days, so discharged from the hospital. Both at the time of admission and discharge real-time reverse transcriptase Polymerase Chain Reaction (RT-PCR) was done for testing of CoVID-19. Immediately, patient again developed respiratory symptoms and was admitted to hospital again. Amidst of current CoVID-19 pandemic, a question was asked “What is the specificity of the Real Time-Polymerase Chain Reaction (RT-PCR) test for COVID-19?” with an assumption that what if at the time of discharge the disease is present in patient but test turned out to be negative? In response to that a counter statement was posed that “It is the sensitivity that should be asked rather than specificity”. It was based on the implication of primary question that was implying false negative report of the RT-PCR. It means, since patient was discharged with negative result that could be false negative.

scholarly journals Reducing False Negative PCR Test for COVID-19

2020 ◽  
Vol 9 (3) ◽  
pp. 408-410
Author(s):  
Fatemeh Bahreini ◽  
Rezvan Najafi ◽  
Razieh Amini ◽  
Salman Khazaei ◽  
Saeid Bashirian
Keyword(s):  
Polymerase Chain Reaction ◽  
Real Time ◽  
False Negative ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Creative Commons ◽  
Negative Results ◽  
False Negative Results ◽  
Polymerase Chain ◽  
Pcr Test

As the SARS-CoV-2 (COVID-19) pandemic spreads rapidly, there is need for a diagnostic test with high accuracy to detect infected individuals especially those without symptoms. Real-time polymerase chain reaction (RT-PCR) is a common molecular test for diagnosing SARS-CoV-2. If some factors are not taken into consideration when performing this test, it can have a relatively large number of false negative results. In this article, we discuss important considerations that could lead to false negative test reduction. Key words: • SARS-CoV-2 • COVID-19 • Real time polymerase chain reaction • RT-PCR test • Diagnosis • False negatives • Genetics • Emerging disease   Copyright © 2020 Bahreini et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0)which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

scholarly journals Real-Time Polymerase chain reaction trends in COVID-19 patients

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Dr Sana Abbas ◽  
Aisha Rafique ◽  
Dr Beenish Abbas ◽  
Dr Rashid Iqbal
Keyword(s):  
Polymerase Chain Reaction ◽  
Real Time ◽  
Tertiary Care ◽  
False Negative ◽  
Polymerase Chain Reaction Test ◽  
Upper Respiratory Tract ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Asymptomatic Patients ◽  
Polymerase Chain

Objective: To assess trends of real-time Polymerase Chain Reaction test in Coronavirus infected Patients. Methods: This cross-sectional analytical study was conducted at Tertiary Care Institute, Rawalpindi from March 2020 to June 2020. All patients confirmed COVID positive by real-time Polymerase Chain Reaction (PCR) with recent travel history, close contact with known diagnosed patients and had symptoms of fever or upper respiratory tract with body aches. Nasopharyngeal swabs were taken and results generated within 48 hours. Positive PCR was admission criteria follow up was carried out at 7th and 8th day, with negative PCR were discharged. However, those who had persistent positive PCR on the 8th day were tested again on 11th and 12th day. Those with persistent positive results beyond 12th day were shifted to specialized quarantine centres. Results: A total of three hundred and ninety-two patients with mild to moderate illness, PCR positive for COVID 19 were included study with age range 9 - 45 and mean 33.22±7.98 years. A total of 8 (2%) patients were females and 384(98%) males. The duration of the negative test result was Mean ± Std. Deviation 9.05±2.00 with 7 – 8 days 152(38.8%)in and 11 – 12 days in 160(40.8%). PCR results on Day 7 and 8 were negative in 144(36.7%) patients whereas positive in 248(63.3%). PCR results on Day 11 and 12 were negative in 312(79.6%) patients whereas positive in 80 (20.4%). Conclusion: To conclude Real-Time Polymerase Chain Reaction (rT-PCR) inclines to give false negative results additionally can stay positive in asymptomatic patients for moderately longer-term. Hence decision to discharge ought to be intricately adjusted between RT-PCR, clinical judgement, radiological examinations, and biochemical assays. doi: https://doi.org/10.12669/pjms.37.1.3000 How to cite this:Abbas S, Rafique A, Abbas B, Iqbal R. Real-Time Polymerase chain reaction trends in COVID-19 patients. Pak J Med Sci. 2021;37(1):180-184. doi: https://doi.org/10.12669/pjms.37.1.3000 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

High False-Negative Rate of HER2 Quantitative Reverse Transcription Polymerase Chain Reaction of the Oncotype DX Test: An Independent Quality Assurance Study

2011 ◽  
Vol 29 (32) ◽  
pp. 4279-4285 ◽  
Author(s):  
David J. Dabbs ◽  
Molly E. Klein ◽  
Syed K. Mohsin ◽  
Raymond R. Tubbs ◽  
Yongli Shuai ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Quality Assurance ◽  
Reverse Transcription ◽  
False Negative ◽  
False Negative Rate ◽  
Oncotype Dx ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Negative Rate ◽  
Polymerase Chain

Purpose HER2 (ERBB2) status is an important prognostic and predictive marker in breast carcinoma. In recent years, Genomic Health (GHI), purveyors of the Oncotype DX test, has been separately reporting HER2 by reverse transcription polymerase chain reaction (RT-PCR) to oncologists. Because of the lack of independent evaluation, this quality assurance study was undertaken to define the concordance rate between immunohistochemistry (IHC)/fluorescent in situ hybridization (FISH) and GHI RT-PCR HER2 assay. Methods All patients at three participating laboratories (Magee-Womens Hospital [Pittsburgh, PA], Cleveland Clinic [Cleveland, OH], and Riverside Methodist Hospital [Columbus, OH]) with available HER2 RT-PCR results from GHI were included in this study. All IHC-positive and equivocal patient cases were further evaluated and classified by FISH at respective laboratories. Results Of the total 843 patient cases, 784 (93%) were classified as negative, 36 (4%) as positive, and 23 (3%) as equivocal at the three institutions using IHC/FISH. Of the 784 negative patient cases, 779 (99%) were also classified as negative by GHI RT-PCR assay. However, all 23 equivocal patient cases were reported as negative by GHI. Of the 36 positive cases, only 10 (28%; 95% CI, 14% to 45%) were reported as positive, 12 (33%) as equivocal, and 14 (39%) as negative. Conclusion There was an unacceptable false-negative rate for HER2 status with GHI HER2 assay in this independent study. This could create confusion in the decision-making process for targeted treatment and potentially lead to mismanagement of patients with breast cancer if only GHI HER2 information is used.

scholarly journals Chest CT versus RT-PCR for the Detection of COVID-19: Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Mohammad Karam ◽  
Sulaiman Althuwaikh ◽  
Mohammad Alazemi ◽  
Ahmad Abul ◽  
Amrit Hayre ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Polymerase Chain Reaction ◽  
Meta Analysis ◽  
False Negative ◽  
Chest Ct ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Chest Computed Tomography ◽  
Polymerase Chain

AbstractPurposeTo compare the performance of chest computed tomography (CT) scan versus reverse transcription polymerase chain reaction (RT-PCR) in the initial diagnostic assessment of coronavirus disease 2019 (COVID-19) patients.MethodsA systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A search of electronic information was conducted to identify all relevant studies comparing the diagnostic performance of chest CT scan versus RT-PCR in COVID-19 suspected cases. Sensitivity, specificity and accuracy were primary outcome measures. Secondary outcome measures included other test performance characteristics, discrepant findings between both investigations and main chest CT findings. Random effects modelling was used for the analyses.ResultsEight non-randomised retrospective studies enrolling 1910 patients were identified. Chest CT was more sensitive but less specific than RT-PCR. Accuracy was not statistically significantly different between chest CT and RT-PCR for the identification and exclusion of COVID-19 cases (Odds Ratio [OR] = 0.40, P = 0.15) in the context of hospitalised patients in a pandemic. Chest CT was shown to detect patients with false-negative RT-PCR results and true positives. Ground-glass opacities and consolidations were the most common chest CT manifestations.ConclusionsChest CT is not superior to RT-PCR for the initial detection of COVID-19 and has more false positives. It is likely to be useful in confirming COVID-19 in patients with a suspicious clinical presentation, but who have a false-negative SARS-CoV-2 RT-PCR test.Key Points‐Chest computed tomography (CT) is more sensitive but less specific in detecting and excluding coronavirus disease 2019 (COVID-19) when compared to reverse transcription polymerase chain reaction (RT-PCR).‐Accuracy of chest CT is not significantly different from RT-PCR for COVID-19 cases.‐Chest CT can detect false-negative and true-positive RT-PCR cases.

scholarly journals Serum antibody response in COVID-19-recovered patients who retested positive

2021 ◽  
Vol 47 (04) ◽  
pp. 195-201
Author(s):  
Nicole Atchessi ◽  
Megan Striha ◽  
Rojiemiahd Edjoc ◽  
Christine Abalos ◽  
Amanda Lien ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Antibody Response ◽  
Reverse Transcription ◽  
False Negative ◽  
Serum Antibody ◽  
Immunoglobulin M ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Antibody Levels

Background: Research studies comparing antibody response from coronavirus disease 2019 (COVID-19) cases that retested positive (RP) using reverse transcription polymerase chain reaction (RT-PCR) and those who did not retest positive (NRP) were used to investigate a possible relationship between antibody response and retesting status. Methods: Seven data bases were searched. Research criteria included cohort and case-control studies, carried out worldwide and published before September 9, 2020, that compared the serum antibody levels of hospitalized COVID-19 cases that RP after discharge to those that did NRP. Results: There is some evidence that immunoglobulin G (IgG) and immunoglobulin M (IgM) antibody levels in RP cases were lower compared with NRP cases. The hypothesis of incomplete clearance aligns with these findings. The possibility of false negative reverse transcription polymerase chain reaction (RT-PCR) test results during viral clearance is also plausible, as concentration of the viral ribonucleic acid (RNA) in nasopharyngeal and fecal swabs fluctuate below the limits of RT-PCR detection during virus clearance. The probability of reinfection was less likely to be the cause of retesting positive because of the low risk of exposure where cases observed a 14 day-quarantine after discharge. Conclusion: More studies are needed to better explain the immune response of recovered COVID-19 cases retesting positive after discharge.

scholarly journals Development of a reverse transcription polymerase chain reaction for the detection of severe fever with thrombocytopenia syndrome virus from suspected infected animals

2020 ◽  
Author(s):  
Eun-sil Park ◽  
Osamu Fujita ◽  
Masanobu Kimura ◽  
Akitoyo Hotta ◽  
Koichi Imaoka ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Reverse Transcription ◽  
Neutralizing Antibodies ◽  
Clinical Symptoms ◽  
Enzyme Linked Immunosorbent Assay ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Primer Sets ◽  
Severe Fever

AbstractBackgroundSevere fever with thrombocytopenia syndrome virus (SFTSV) causes severe hemorrhagic fever in humans and cats. Clinical symptoms of SFTS-infected cats resemble to those of SFTS patients and SFTS-contracted cats shows high levels of viral RNA loads in the serum and body fluids. Due to the risk of direct infection from SFTS-infected cats to human, it is important to diagnose SFTS-suspected animals.Methodology/Principle findingsFour primer sets were newly designed from consensus sequences constructed by 108 strains of SFTSV. A reverse transcription polymerase chain reaction (RT-PCR) with these four primer sets were successfully and specifically detected several clades of SFTSV. Their limits of detection are 1-10 copies/reaction. By this RT-PCR, 5 cat cases among 56 SFTS-suspected animal cases were diagnosed as SFTS. From these cats, IgM or IgG against SFTSV were detected by enzyme-linked immunosorbent assay (ELISA), but not neutralizing antibodies by plaque reduction neutralization titer (PRNT) test. This phenomenon is similar to those of fatal SFTS patients.Conclusion/SignificanceThis newly developed RT-PCR could detect SFTSV RNA of several clades from SFTS-suspected animals. In addition to ELISA and PRNT test, the useful laboratory diagnosis systems of SFTS-suspected animals has been made in this study.Author summaryThis study developed RT-PCR to detect SFTS animal cases. This assay could detect SFTSV RNA belonging to different clades. Cats diagnosed as SFTS had IgM or IgG, but not neutralizing antibodies. SFTS cat cases were distributed in the area where SFTS patients have been reported highly, indicating the establishment of the circulation of SFTSV in the environment. These diagnostic assays could be helpful tools to detect and not to miss SFTS animal cases.

scholarly journals Investigation of revers-transcriptase polymerase chain reaction values of patients with COVID-19 findings in lung computed tomography results

2020 ◽  
Vol 9 (1) ◽  
pp. 41-48
Author(s):  
Ozüdogru Osman ◽  
Gunes Bolatli ◽  
Fatih Tas
Keyword(s):  
Polymerase Chain Reaction ◽  
Clinical Symptoms ◽  
Chest Ct ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Alternative Approach ◽  
Polymerase Chain ◽  
Bilateral Lung ◽  
Patient’S History ◽  
Positive Results

It turned out that the cause of pneumonia cases that occurred in China was due to SARS-CoV-2. The aim is to compare chest computer tomography and Revers-Transcriptase Polymerase Chain Reaction methods used in the diagnosis of COVID-19 disease with each other and to evaluate this disease with risk factors. The study was carried out on 66 patients. Epidemiological history, clinical symptoms, chest CT and RT-PCR results of the cases were examined. RT-PCR results of 1, 4, and 7 days were evaluated for each case with positive chest CT results. Thirty-seven of them were found to be positive on day 1, 5 of them were found to be positive on day 4, and 2 of them were found to be positive on day seven from 52 patients whose RT-PCR results were examined. In the remaining 8 cases, no positive findings were found. The most common findings are; cough (78.8%), fever (55.8%), and shortness of breath (28.8%). It was observed that 51.9% of the cases had chronic disease history and 50% of the patients using cigarettes had bilateral lung involvement in their CT results. Seven cases received intensive care support, 3 cases were intubated. Two of the intubated cases were exitus (3,8%). The positive results of RT-PCR were found to be negative in most of the cases which have positive chest CT; suggests that chest CT is more reliable in making a diagnosis.  Therefore, evaluating chest CT results with RT-PCR can be an appropriate alternative approach in the diagnosis and treatment of disease. However, in order to be fully diagnosed, the patient's history, chronic diseases, age, symptoms, imaging, blood, and test findings must all be considered as a whole.

scholarly journals Peran pemeriksaan radiologis pada diagnosis Coronavirus disease 2019

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Budi Yanti ◽  
Ulfa Hayatun
Keyword(s):  
Polymerase Chain Reaction ◽  
Ct Scan ◽  
Real Time ◽  
False Negative ◽  
Ground Glass Opacity ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Lung Abnormalities ◽  
Polymerase Chain ◽  
Radiological Examinations

Abstrak. Coronavirus Disease 19 (COVID-19) telah menjadi pandemi di seluruh dunia dengan angka kejadian yang terus meningkat di beberapa negara. Kecepatan dan ketepatan diagnosis diperlukan untuk mencegah perburukan kondisi pasien. Real-Time Transcription Polymerase Chain Reaction (RT-PCR) sampai saat ini masih menjadi baku emas untuk menegakkan diagnosis COVID-19, namun uji diagnostik ini dilaporkan banyak menunjukkan hasil negatif palsu. Pemeriksaan radiologi berupa foto toraks dan CT-Scan dada banyak dilakukan untuk  menunjang diagnosis COVID-19. Gambaran foto toraks yang paling sering ditemukan adalah konsolidasi, ground-glass opacity (GGO), distribusi bilateral, perifer dan di lobus bawah paru-paru, namun pemeriksaan ini dianggap tidak sensitif untuk menemukan kelainan paru pada tahap awal penyakit. Meskipun demikian, foto toraks dapat digunakan untuk memantau perkembangan kelainan paru akibat COVID-19, salah satunya dengan metode Brixia Score. Pada sisi lain,CT-scan dada dinilai lebih sensitif daripada foto toraks serta mampu menunjukkan kelainan paru tahap awal pada pasien dengan hasil RT-PCR yang negatif. Gambaran pada CT-scan dada umumnya menunjukkan GGO, konsolidasi, crazy-paving stone, dan air bronchogram.  CT-scan dapat mengurangi angka negatif palsu pada RT-PCR dan sebagai alat skrining pada pasien yang dicurigai COVID-19 di lokasi epidemis saat hasil RT-PCR tidak tersedia. Penggunaan pemeriksaan radiologi dan RT-PCR dapat menghemat waktu serta membantu diagnosis dan manajemen COVID-19. Kata Kunci: Pencitraan COVID-19, Radiologi SARS-CoV-2Abstract. Coronavirus Disease 19 (COVID-19) has become a worldwide pandemic with an increasing incidence in several countries. Speed and accuracy of diagnosis are needed to prevent worsening of patient's condition. Real-Time Transcription Polymerase Chain Reaction (RT-PCR) is still a gold standard of COVID-19 diagnosis, however, this test shown false negative results in several case. Radiological examinations, chest X-Ray (CXR) and CT scan, are used to support the diagnosis. The most commonly found in CXR are consolidation, ground-glass opacity (GGO), bilateral distribution, peripheral and in the lower lobe, but this examination is insensitive to find lung abnormalities in early stages of disease. However, CXR can be used to monitor the development of lung abnormalities due to COVID-19, such as the Brixia Score method. On the other hand, CT-Scan is more sensitive than CXR and able to show early lung abnormalities in negative RT-PCR results. CT scan show the presence of GGO, consolidation, crazy-paving stone, and air bronchogram. CT-scanning can reduce the false-negative rate on RT-PCR and become a screening tool in suspected COVID-19 patients at epidemic area where RT-PCR is not available. The use of radiological examinations and RT-PCR can save the time and help in the diagnosis and management of COVID-19.Keywords: COVID-19’s Radiology, Imaging of SARS-CoV-2

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