比较急诊就诊有COVID-19临床症状患者的COVID-19 RT-PCR结果、胸部ct和实验室结果

Murat Muratoglu, E. Bıyıklı, Idd Athumani, G. Koc, Beyza Kamisli, Furkan Kervancioglu, A. Karakose, Cem Canbeyli, Ejderhan Ulug, Utku Kildokum
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摘要

2019年12月,中国湖北省武汉市发现不明原因肺炎病例。后来确定,导致这些肺炎病例的病原体SARS-CoV已被确定为新型包膜RNA β -冠状病毒2,现在称为严重急性呼吸窘迫综合征冠状病毒2 (SARS-CoV-2)。在土耳其,第一例病例于2020年3月10日发现。本研究旨在通过比较前往ba肯特大学安卡拉医院急诊医学诊所就诊的疑似COVID-19患者的COVID-19 RT - PCR结果、胸部计算机断层扫描(CT)结果和实验室结果,评估能够快速诊断该疾病的因素。在515例患者中(女性280例,男性235例),有113例(21.9%)患者检出浸润。在检查胸部CT表现的性别分布时,男性患者浸润的发生率较高。相反,使用卡方检验,两类之间没有发现统计学上显著的依赖性。32.7%的胸部CT阳性患者出现呼吸短促。其他常见的抱怨是胸痛,占12.4%;发烧,10.6%;和疲软,分别为9.7%。另一类,包括未分类的抵达投诉,在整个样本中所占比例最高。在胸部CT检查时,合并症(高血压29.2%,糖尿病25.2%)在浸润方面比其他合并症更常见。胸部CT RT-PCR结果采用卡方检验进行分析,两者之间的相关性有统计学意义。相反,在PCR检测为阴性的260名患者中,有80名患者的胸部CT结果与新冠病毒相符。48.6%的胸部CT阳性患者未发现与COVID相关的发热、咳嗽、虚弱、呼吸急促或胸痛的主诉。PCR的敏感性较低。因此,对于急诊患者无症状病例的检测,胸部CT是比PCR更好的选择。由于其选择性高,因此采用PCR作为诊断手段更有意义。
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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
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.
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