Xiaogan Hospital Affiliated to Wuhan University of Science and Technology, No. 6, Square Street, Xiaonan District, Xiaogan City, Hubei Province, China.
J Clin Virol. 2020 Jun;127:104359. doi: 10.1016/j.jcv.2020.104359. Epub 2020 Apr 10.
COVID-19, the latest outbreak of infectious disease, has caused huge medical challenges to China and the entire globe. No unified diagnostic standard has been formulated. The initial diagnosis remains based on the positive of nucleic acid tests. However, early nucleic acid tests were identified to be negative in some patients, whereas the patients exhibited characteristic CT changes of lung, and positive test results appeared after repeated nucleic acid tests, having caused the failure to diagnose these patients early. The study aimed to delve into the relationships between initial nucleic acid testing and early lung CT changes in patients with COVID-19.
In accordance with the latest COVID-19 diagnostic criteria, 69 patients diagnosed with COVID-19 treated in the infected V ward of Xiaogan Central Hospital from 2020/1/25 to 2020/2/6 were retrospectively analyzed. The consistency between the first COVID-19 nucleic acid test positive and lung CT changes was studied. In addition, the sensitivity and specificity of CT and initial nucleic acid were studied.
The Kappa coefficient of initial nucleic acid positive changes and lung CT changes was -1.52. With a positive nucleic acid test as the gold standard, the sensitivity of lung CT was 12.00 %, 95 % CI: 4.6-24.3; with the changes of CT as the gold standard, the sensitivity of nucleic acid positive was 30.16 %, 95 % CI: 19.2-43.0.
The consistency between the initial positive nucleic acid test and the CT changes in the lungs is poor; low sensitivity was achieved for initial nucleic acid detection and CT changes.
COVID-19 是最新爆发的传染病，给中国乃至全球带来了巨大的医疗挑战。目前尚未制定统一的诊断标准，初始诊断仍基于核酸检测阳性。然而，一些患者的早期核酸检测结果呈阴性，但肺部 CT 呈现出典型的改变，且经过多次核酸检测后才呈阳性，导致这些患者未能得到早期诊断。本研究旨在探讨 COVID-19 患者初始核酸检测与早期肺部 CT 改变之间的关系。
根据最新的 COVID-19 诊断标准，回顾性分析了 2020 年 1 月 25 日至 2 月 6 日在孝感市中心医院感染科 V 区治疗的 69 例 COVID-19 患者。研究了首次 COVID-19 核酸检测阳性与肺部 CT 改变之间的一致性。此外，还研究了 CT 和初始核酸的灵敏度和特异性。
初始核酸阳性变化与肺部 CT 变化的 Kappa 系数为-1.52。以核酸检测阳性为金标准，肺部 CT 的灵敏度为 12.00%，95%CI：4.6-24.3；以 CT 改变为金标准，核酸阳性的灵敏度为 30.16%，95%CI：19.2-43.0。
初始核酸检测阳性与肺部 CT 改变之间的一致性较差；初始核酸检测和 CT 改变的灵敏度均较低。
