Comparing COVID-19 RT-PCR results, thorax computed tomography findings, and laboratory results of patients admitted to emergency medicine clinic with clinical symptoms of COVID-19 disease

Abstract

In December 2019, cases of pneumonia of unknown origin were detected in Wuhan, Hubei Province, China. It was later determined that the pathogen SARS-CoV, which causes these cases of pneumonia, has been identified as the new enveloped RNA Betacoronavirus 2, now called severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2). In Turkey, the first case was detected on March 10, 2020. This study aimed to evaluate the factors that will enable rapid diagnosis of the disease through comparison of COVID-19 RT PCR results, thorax computed tomography (CT) findings, and laboratory results of patients suspected with COVID-19 who visited Başkent University Ankara Hospital Emergency Medicine Clinic. In our sample of 515 patients (280 female and 235 male patients), infiltration was detected in 113 patients (21.9%) The ratio of females to males increased with age. When the sex distribution of the thoracic CT findings was examined, the incidence of infiltration was higher in male patients. Conversely, no statistically significant dependence was found between the two categories using the chi-squared test. Shortness of breath was observed in 32.7% of patients with positive thoracic CT findings. Other common complaints were chest pain, 12.4%; fever, 10.6%; and weakness, 9.7%, respectively. The other category, which covered unclassified arrival complaints, had the highest percentage in the entire sample. When the thoracic CT distribution of comorbidities was examined (hypertension, 29.2% and diabetes, 25.2%) were more common than the other comorbidities in terms of the presence of infiltration. Thoracic CT results with RT-PCR, which were analyzed using the chi-square test, showed a statistically significant dependence between them. Conversely, COVID-compatible thorax CT findings were detected in 80 of 260 patients who tested negative in the PCR test. No complaints of fever, cough, weakness, shortness of breath, or chest pain associated with COVID were found in 48.6% of patients who were thoracic CT positive. PCR showed a low sensitivity rate. Therefore, thoracic CT is a better choice than PCR for the detection of asymptomatic cases in emergency patients. Because its selectivity rate is high, using PCR as a diagnostic test is more significant.