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1.
Cureus ; 14(3), 2022.
Article in English | EuropePMC | ID: covidwho-1801756

ABSTRACT

Purpose SARS-CoV-2 has been a diagnostic challenge for healthcare setups worldwide since 2019 due to its proximity to a myriad of pathological processes. Although reverse transcription - polymerase chain reaction (RT-PCR) and high-resolution computed tomography (HRCT) have helped in the diagnosis of the disease, they are not as widely available as chest X-rays. This study aims to investigate the diagnostic accuracy of right bronchial infiltration in chest X-ray in diagnosing COVID-19. Material and methods This was a validation study conducted in a single center in Riyadh, Saudi Arabia. A total of 114 patients were enrolled according to the selection criteria of the study. Consent was waived off on the condition of confidentiality maintenance as per the ethical review board. X-rays of suspected patients were viewed and analyzed by two blinded consultant radiologists. Patients were followed for their RT-PCR reports. Data were entered and analyzed in SPSS Statistics v.23.0 (IBM Corp., Armonk, USA). Results Among the 114 patients, the mean age was 46.2±17.3 years and 85 (74.6%) were males. The total number of COVID-19-positive patients were 82 (71.9%) while the patients presenting with right bronchial infiltration (RBI) were 94 (82.5%). RBI was significantly associated with the presence and absence of COVID-19 on PCR (p<0.001) and the presence of comorbidities (p<0.001). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the sign were 84.04%, 85.00%, 96.34%, 53.12%, and 84.21%, respectively. Conclusions RBI can be used as a diagnostic sign in X-rays for early identification of COVID-19 positive patients. This feature can be used in the triage of patients. This would decrease the spread of disease by providing early time to intervene to isolate patients.

2.
Cureus ; 14(3): e23351, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1791868

ABSTRACT

Purpose SARS-CoV-2 has been a diagnostic challenge for healthcare setups worldwide since 2019 due to its proximity to a myriad of pathological processes. Although reverse transcription - polymerase chain reaction (RT-PCR) and high-resolution computed tomography (HRCT) have helped in the diagnosis of the disease, they are not as widely available as chest X-rays. This study aims to investigate the diagnostic accuracy of right bronchial infiltration in chest X-ray in diagnosing COVID-19. Material and methods This was a validation study conducted in a single center in Riyadh, Saudi Arabia. A total of 114 patients were enrolled according to the selection criteria of the study. Consent was waived off on the condition of confidentiality maintenance as per the ethical review board. X-rays of suspected patients were viewed and analyzed by two blinded consultant radiologists. Patients were followed for their RT-PCR reports. Data were entered and analyzed in SPSS Statistics v.23.0 (IBM Corp., Armonk, USA). Results Among the 114 patients, the mean age was 46.2±17.3 years and 85 (74.6%) were males. The total number of COVID-19-positive patients were 82 (71.9%) while the patients presenting with right bronchial infiltration (RBI) were 94 (82.5%). RBI was significantly associated with the presence and absence of COVID-19 on PCR (p<0.001) and the presence of comorbidities (p<0.001). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the sign were 84.04%, 85.00%, 96.34%, 53.12%, and 84.21%, respectively. Conclusions RBI can be used as a diagnostic sign in X-rays for early identification of COVID-19 positive patients. This feature can be used in the triage of patients. This would decrease the spread of disease by providing early time to intervene to isolate patients.

3.
Cureus ; 14(1): e21724, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1732447

ABSTRACT

Background Clinically most apparent symptoms of COVID-19 include fever and cough, which in some patients show a worsening trend but are completely non-apparent in patients who present with an asymptomatic course of the disease. The aim of this study was to identify clinical and biochemical differences among polymerase chain reaction (PCR) positive patients who are either febrile or afebrile. Methods This study was conducted in Rawalpindi Medical University and Allied Hospitals between September and December 2020. All patients who tested positive for reverse transcription polymerase chain reaction (RT-PCR) COVID-19 were included in the study. After evaluation of 146 patients, 100 were selected, and with a response rate of 97%, a total of 97 patients were included in the final analysis. Depending on the presence of fever, the participants were divided into two groups. Both groups were then compared for baselines vitals and laboratory investigations. Data was entered and analyzed in SPSS v23.0 (IBM Inc., Armonk, New York). Results Among the 97 patients, 66 (68%) of the participants were male, and 31 (32%) were females. The mean age of the study participants was 45.23±18.08 years. Fever was present in 39 (40.2%) of the participants. When compared with patients with no fever, the patients with fever had greater severity of disease (p<0.001), higher heart rate (p<0.001), decreased oxygen saturation (p<0.001). Among the laboratory investigations, the fever group had a greater tendency of having deranged alanine aminotransferase (ALT) (70.82±29.23 vs. 32.83±16.22, p=0.010), Lymphocytes (1.56±0.54 vs. 2.12±0.94, p=0.003) and serum total bilirubin (1.06±0.36 vs. 0.55±0.21, p=0.009). Based on multiple regression analysis, the presence of fever is a predictor of derangement in ALT (OR=1.034, CI=1.001-1.068 p=0.025) and total bilirubin (OR=4.38, CI=2.14-6.78, p=0.021). Conclusion Fever may not be present among all patients presenting with COVID-19 infection, but those who have a fever have a greater risk of having deranged liver function tests. Hence, it is important to monitor liver function tests (LFTs) in COVID-19 patients presenting with fever.

4.
Cureus ; 13(6): e15849, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1296199

ABSTRACT

Background and objective The ambiguous nature and high infectivity of the coronavirus disease 2019 (COVID-19) have caused soaring morbidity and mortality worldwide. Real-time polymerase chain reaction (RT-PCR) is preferred for detecting COVID-19. However, its poor sensitivity and the emerging use of high-resolution CT (HRCT) scan for disease severity make the use of RT-PCR quite obsolete. In light of this, our study aimed to explore the beneficial role of HRCT and compare the HRCT findings across various patient demographics and parameters. Methods This cross-sectional study included 100 patients with clinical suspicion of COVID-19. All patients underwent a chest HRCT scan preceded by RT-PCR testing. We used the CT severity score (CTSS) of the chest to calculate disease severity. Demographical data and results of radiological findings were tabulated and compared across RT-PCR positivity, age, and gender. Independent samples t-test and chi-square test were used to analyze the data. Results Glass ground opacity was the most prevalent finding in 99% of the patients, followed by lymph node involvement, consolidation, and crazy-paving pattern. Pleural effusion was observed in only 10% of the patients while pericardial effusion and hiatal hernia were present in 5%. In RT-PCR-positive patients, the posterior basal segment of the lower lobe of the right and left lungs were found to be dominantly involved; however, the upper and middle lobes of the right lung were more commonly involved than the left lung. The mean CTSS was significantly higher in patients aged above 50 years (p<0.001). The mean CTSS of RT-PCR-negative patients was higher than that of RT-PCR-positive patients (15.18 vs. 14.31, p=0.537). Conclusion RT-PCR has a limited role in the diagnosis of COVID-19. The HRCT scan can detect typical COVID-19 findings even in patients with negative RT-PCR results. Moreover, the use of HRCT scan in determining the disease severity and extent of lung damage can lead to a better assessment of critically ill patients.

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