ABSTRACT
Background: The simultaneous interpretation of computed tomography (CT) scans performed on patients with suspected clinical signs of coronavirus disease 2019 (COVID-19) or a history of contact may accelerate patient isolation, particularly during the peak of the pandemic. The use of an appropriate scoring system can lead to the conveyance of the findings in a more understandable way and the elimination of differences in interpretations. Objectives: This study aimed to evaluate the diagnostic performance of the coronavirus disease 2019 (COVID-19) imaging reporting and data system (CO-RADS) in admitted patients with suspected COVID-19 infection. Methods: This retrospective study included all patients admitted to our hospital with COVID-19 pneumonia suspicion within March 20-May 15, 2020, who were examined by both CT and real-time reverse transcription polymerase chain reaction (rRT-PCR) at initial presentation. Four radiologists, who were blinded to the rRT-PCR results and medical history, assessed all images independently and classified the CT findings according to the CO-RADS previously defined. Diagnostic value of the scoring system and interobserver agreement in rRT-PCR positive-negative groups and for CO-RADS 1-5 were evaluated. Results: In this study, 274 (153 men and 121 women;48.8 +/- 17.3 years) rRT-PCR positive and 437 (208 men and 229 women;49.0 +/- 19.5 years) rRT-PCR negative individuals were included. It was found that CO-RADS had a good diagnostic performance with area under the receiver operating characteristic roc curve of 0.857. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were obtained at 81.9%, 89.4%, 75.7%, 92.5%, and 84.8%, respectively. The interobserver agreement of four radiologists in CO-RADS 1 and 5 was substantial to almost perfect according to the kappa values. Other CO-RADS scores showed a fair to moderate agreement. The interrater agreement was slightly higher in the PCR (-) patient group than in the positive one. Conclusion: In conclusion, CO-RADS was a successful scoring system for distinguishing highly suspicious cases in terms of COVID-19 infection lung involvement, showing high interobserver agreement.
ABSTRACT
The most important factor in the transmission of the COVID-19 is asymptomatic carriers. We've tested all oncology patients , that receive anti-cancer therapy, for COVID-19. We aimed to determine the rate of asymptomatic carriers, and analyze the clinical and radiological findings of infected patients. Oncology patients who have indications of receiving anti-cancer treatment in the hospital were tested for COVID-19, two day prior to their treatment even if they were asymptomatic by collecting nasopharyngeal and oropharyngeal swab specimens for RT-PCR for viral RNA detection. Positive patients, underwent inspiratory phase of chest computed tomography examination. Infected patients were given the recommended treatment for COVID-19. PCR test was positive in 28 of 312 patients that we tested, and the positivity rate was 8.9%. Three patients (10.7%) had symptoms, 25 patients (89.3%) had no symptoms. Covid-19 testing before anti-cancer treatment may be recommended in order to continue their treatment without any problems and to prevent the risk of transmission due to the high rate of asymptomatics in infected patients.