1.The predictive value of chest x-ray and plain chest CT scan as adjunct screening tools for COVID-19 patients in a national tertiary infectious disease hospital from March 1 to November 30, 2020
Marvin Robert L. Ocampo ; Ferdinand S. De Guzman
The Filipino Family Physician 2022;60(1):126-131
Background:
COVID-19 is diagnosed via Real Time Reverse Transcription Polymerase Chain Reaction (RT-PCR), with plain chest CT and chest x-ray as adjuncts. In the Philippines, chest x-ray is used as initial screening in assessing potential COVID-19 cases, with plain chest CT scan not routinely used due to higher cost and decreased availability.
Objective:
This study determined the validity of chest x-ray and plain chest CT as initial screening tools for admitted COVID-19 patients from March 1 to November 30, 2020, at San Lazaro Hospital, comparing these with RT-PCR testing for COVID-19 as initial basis for considering a patient as a possible case of COVID-19.
Methods:
This was a cross-sectional study of radiographic literature of admitted COVID-19 patients from March 1 to November 30, 2020, at San Lazaro Hospital, all with confirmatory RT-PCR, chest X-rays, and plain chest CTs. Baseline chest x-rays, with initial plain chest CT results, were compared with RT-PCR results. A tally was made, noting radiographic findings on both Chest X-ray and Plain Chest CT most frequently seen among patients with corresponding positive real time RT-PCR results.
Results:
Chest X-rays done < 2 days from admission revealed involvement of both lungs, with infiltrates located centrally and peripherally, with major predilection for both lower lobes. Plain chest CT was similar, with ground glass opacities as the most common finding, consolidation second. Chest x-ray had a sensitivity of 88.11%, plain chest CT 94.71%. Sensitivity of combined chest x-ray and plain chest CT was 86.78%. Specificity and predictive value were not computed due to non-inclusion of admitted patients with COVID negative RT-PCR swab.
Conclusion
Chest X-ray and plain chest CT are useful modalities with high sensitivity in screening patients with fever, cough, and colds on admission. However, initial chest x-ray and plain chest CT scan results do not translate into a prognosis without context of initial diagnostics and management done during confinement.
COVID-19
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X-Rays
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COVID-19 Testing
2.Evolution of the newest diagnostic methods for COVID-19: a Chinese perspective.
Mingtao LIU ; Jiali LYU ; Xianhui ZHENG ; Zhiman LIANG ; Baoying LEI ; Huihuang CHEN ; Yiyin MAI ; Huimin HUANG ; Baoqing SUN
Journal of Zhejiang University. Science. B 2023;24(6):463-484
Coronavirus disease 2019 (COVID-19) has continued to spread globally since late 2019, representing a formidable challenge to the world's healthcare systems, wreaking havoc, and spreading rapidly through human contact. With fever, fatigue, and a persistent dry cough being the hallmark symptoms, this disease threatened to destabilize the delicate balance of our global community. Rapid and accurate diagnosis of COVID-19 is a prerequisite for understanding the number of confirmed cases in the world or a region, and an important factor in epidemic assessment and the development of control measures. It also plays a crucial role in ensuring that patients receive the appropriate medical treatment, leading to optimal patient care. Reverse transcription-polymerase chain reaction (RT-PCR) technology is currently the most mature method for detecting viral nucleic acids, but it has many drawbacks. Meanwhile, a variety of COVID-19 detection methods, including molecular biological diagnostic, immunodiagnostic, imaging, and artificial intelligence methods have been developed and applied in clinical practice to meet diverse scenarios and needs. These methods can help clinicians diagnose and treat COVID-19 patients. This review describes the variety of such methods used in China, providing an important reference in the field of the clinical diagnosis of COVID-19.
Humans
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Artificial Intelligence
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China
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COVID-19/diagnosis*
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COVID-19 Testing
3.Strengthening the treatment of SARS-CoV-2 infection in children with underlying diseases.
Hong Bao LIU ; Xiao Bo ZHANG ; Lin YUAN ; Xiao Wen ZHAI ; Wen Hao ZHOU ; Mei ZENG ; Guo Ying HUANG
Chinese Journal of Pediatrics 2022;60(11):1100-1102
Child
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Humans
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COVID-19
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SARS-CoV-2
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COVID-19 Testing
4.Key Points for Quality Control of 2019 Novel Coronavirus Testing Kits.
Chinese Journal of Medical Instrumentation 2021;45(3):321-325
Since the outbreak of COVID-19, the accurate and rapid clinical diagnosis technology of SARS-CoV-2 has played a crucial role in the prevention and control of epidemic situation. This study aims to analyze and discuss the key points for quality control of 2019 novel coronavirus testing kits, while incorporating the actual testing process, the distribution of testing kits and interpretation of relevant policies and regulations.
COVID-19
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COVID-19 Testing
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Humans
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Quality Control
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SARS-CoV-2
5.Evaluation of COVID-19 Antigen Test Kit Assay Analytical and Clinical Performance.
Xiaolu JIANG ; Mingqiu DU ; Lancui YANG ; Chenxia FAN ; Ming ZHENG
Chinese Journal of Medical Instrumentation 2023;47(1):99-105
Objective To rapidly screen patients with novel coronavirus pneumonia (COVID-19) infection including asymptomatic ones. Method Established a rapid detection test kit, and evaluated analytical and clinical performance of it. Result The minimum limit of detection of the reagent was 9.75×102 TCID50/mL; there was no cross-reaction and interference in the high-concentration samples of 29 common respiratory pathogens tested. The diagnostic sensitivity of clinical samples was 98.56%, specificity was 99.00%, and the total coincidence rate was 98.85%; the consistency test Kappa value is 0.974 5. The stratified analysis of positive samples with different Ct values showed that the coincidence rate within each stratum was greater than 95%. Conclusion This COVID-19 antigen test kit with excellent detection performance, fast detection speed, and portable operation. It can be used as a supplementary method for existing nucleic acid detection methods for early screening of new coronavirus.
Humans
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COVID-19
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COVID-19 Testing
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Sensitivity and Specificity
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SARS-CoV-2
6.Diagnosis and treatment of adult tumor patients with COVID-19.
Chinese Journal of Oncology 2023;45(3):191-202
After the first outbreak of corona virus disease 2019 (COVID-19) at the end of 2019, it has caused multiple rounds of transmission in many countries around the world. Cancer patients are mainly elderly people, and the immunosuppression state caused by the tumor itself and anti-tumor treatment, more accompanying underlying diseases, and more hospital environmental exposure leading to a higher incidence of COVID-19 infection. The proportion of severe cases after infection is high, and the mortality is high. Therefore, based on the domestic and foreign research and clinical practice, the Expert Committee of Geriatric Cancer Prevention and Treatment of Chinese Society of Clinical Oncology launched a discussion based on the characteristics of cancer patients, including the epidemiology, clinical manifestations, differential diagnosis, definition and risk factors of severe cases, diagnosis and treatment recommendations, recovery of anti-tumor treatment and vaccination recommendations. To provide the corresponding suggestions for the clinical diagnosis and treatment of such patients.
Humans
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Adult
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Aged
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COVID-19/diagnosis*
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Neoplasms/epidemiology*
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Incidence
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Disease Outbreaks
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Diagnosis, Differential
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COVID-19 Testing
7.Expert consensus on diagnosis and treatment of COVID-19 infection related cough in children.
Chinese Journal of Preventive Medicine 2023;57(3):309-317
An epidemic outbreak of the corona virus disease 2019(COVID-19) Omicron variant occurred in most regions of China. Children are susceptible to COVID-19 and the vast majority of them suffer from upper respiratory tract infection. Cough is one of the most common symptoms. COVID-19 infection related cough includes acute cough, persistent cough and chronic cough, and children with original chronic cough or chronic lung disease can also induce or aggravate symptom of cough after infection, which has a great impact on children's physical and mental health. The treatment for COVID-19 infection related cough vary with the etiology. Improper treatment would delay the patient's condition and increase adverse drug reaction. Currently, there is no guideline or consensus on the diagnosis and treatment of COVID-19 infection related cough in children in China, therefore this consensus is drafted. Referring to the latest international research and the diagnostic and therapeutic strategy for COVID-19 infection (Tenth Edition For Trial Implementation), and combining with clinical diagnosis and treatment experience,the consensus elaborates the pathogenesis and etiology of COVID-19 infection related cough, the use of cough relievers and expectorants, as well as the key points of diagnosis and treatment of different etiological factors. It is expected to provide specific and feasible guidance scheme for pediatricians, general practitioners and clinical pharmacists.
Child
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Humans
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Cough/therapy*
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COVID-19/therapy*
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SARS-CoV-2
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Consensus
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COVID-19 Testing
9.Saliva as an alternative to Nasopharyngeal swab specimen for reverse-transcription Polymerase Chain Reaction (RT-PCR) diagnosis of SARS-CoV-2 infection: A systematic review and meta-analysis
Acta Medica Philippina 2020;54(Rapid Reviews on COVID19):1-10
Objectives
To assess the accuracy of reverse-transcription polymerase chain reaction (RT-PCR) of saliva specimens compared to RT-PCR of nasopharyngeal swabs (NPS) in the diagnosis of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection.
COVID-19
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SARS-CoV-2
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COVID-19 Nucleic Acid Testing
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Saliva
10.Diagnostic value of rapid antigen testing for the detection of SARS-CoV-2 infection.
Jing Jing LI ; Mei ZENG ; Jin XU ; Yan Ling GE ; He TIAN ; Zhong Lin WANG ; Gong Bao LIU ; Xiao Wen ZHAI ; Xiao Bo ZHANG ; Qi Rong ZHU ; Hai Ling CHANG
Chinese Journal of Pediatrics 2022;60(11):1153-1157
Objective: To investigate the diagnostic value of rapid antigen test based on colloidal gold immunochromatographic assay for the detection of SARS-CoV-2 infection in symptomatic patients. Methods: From May 20 to June 5 2022, 76 hospitalized children and their 55 accompanying family members with confirmed SARS-CoV-2 infection in the COVID-19 isolation unit of the Children's Hospital of Fudan University (designated referral hospital for SARS-CoV-2 infection in Shanghai) enrolled. Their nasopharyngeal swab specimens were consecutively collected. The samples were tested for SARS-CoV-2 nucleic acid by real-time quantitative. SARS-CoV-2 antigen was tested by immunochromatography. The correlation between the antigen detection results and the change of the cycle threshold (Ct) values were evaluated, as well as the sensitivity and specificity of SARS-CoV-2 antigen detection at different periods after the onset of the disease. Kappa consistency test was conducted to investigate the consistency between the 2 diagnostic methods. Results: Of the enrolled SARS-CoV-2 symptomatic infections, 76 were children, including 41 males and 35 females, with an age of 5 (2, 9) years; 55 were accompanying families, including 8 males and 47 females, with an age of 38 (32, 41) years. All 478 samples were simultaneously tested for SARS-CoV-2 antigen and nucleic acid. In any period from disease onset to negative conversion of viral nucleic acid, the overall sensitivity of the rapid antigen test was 48.2% (119/247), the specificity was 98.3% (227/231), and antigen test and nucleic acid test showed moderate consistency (κ=0.46, P<0.05). The sensitivity of antigen test was 100% (82/82) when the Ct value was ≤25. And the sensitivity of antigen test was 8/10, 4/15 and 8.3% (3/36) when the Ct value was 26, 30 and 35, respectively. All antigen tests were negative when Ct value was >35. During the period of 1-2 days, 3-5 days, 6-7 days, 8-10 days and >10 days after onset, the sensitivity and specificity of SARS-CoV-2 antigen test were 5/8 and 5/5, 90.2% (37/41) and 5/5, 88.9% (24/27) and 2/5, 45.0% (36/80) and 94.1% (32/34), 18.7% (17/91) and 98.9% (183/185) respectively. The Ct values of nasopharyngeal swabs were<26 during 2 to 7 days after onset, 28.7±5.0 on day 8, 34.5±2.9 on day 13 and > 35 after 14 days, respectively . Conclusion: SARS-CoV-2 antigen test in the patients with SARS-CoV-2 infection shows acceptable sensitivity and specificity within 7 days after onset of disease, and the sensitivity was positively correlated with viral load and negatively correlated with onset time.
Male
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Child
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Female
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Humans
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COVID-19
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SARS-CoV-2
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China
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COVID-19 Testing
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Nucleic Acids