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新型冠状病毒肺炎的最佳诊断方法。

The optimal diagnostic methods for COVID-19.

作者信息

Harahwa Tinotenda A, Lai Yau Thomas Ho, Lim-Cooke Mae-Sing, Al-Haddi Salah, Zeinah Mohamed, Harky Amer

机构信息

St George's Medical school, University of London, London, UK.

Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

出版信息

Diagnosis (Berl). 2020 Nov 18;7(4):349-356. doi: 10.1515/dx-2020-0058.

Abstract

As the world continues to study and understand coronavirus disease (COVID-19), existing investigations and tests have been used to try and detect the virus to slow viral transmission and its global spread. A 'gold-standard' investigation has not yet been identified for detection and monitoring. Initially, computed tomography (CT) was the mainstay investigation as it shows the disease severity and recovery, and its images change at different stages of the disease. However, CT has been found to have limited sensitivity and negative predictive value in the early stages of the disease, and the value of its use has come under debate due to whether its images change the treatment plan, the risk of radiation, as well as its practicality with infection control. Therefore, there has been a shift to the use of other imaging modalities and tests, such as chest X-rays and ultrasound. Furthermore, the use of nucleic acid-based testing such as reverse-transcriptase polymerase chain reaction (RT-PCR) have proven useful with direct confirmation of COVID-19 infection. In this study, we aim to review and analyse current literature to compare RT-PCR, immunological biomarkers, chest radiographs, ultrasound and chest CT scanning as methods of diagnosing COVID-19.

摘要

随着全球持续研究和了解冠状病毒病(COVID-19),已采用现有调查和检测手段来尝试检测该病毒,以减缓病毒传播及其全球扩散。目前尚未确定用于检测和监测的“金标准”调查方法。最初,计算机断层扫描(CT)是主要的调查手段,因为它能显示疾病的严重程度和恢复情况,且其图像在疾病的不同阶段会发生变化。然而,人们发现CT在疾病早期的敏感性和阴性预测价值有限,并且由于其图像是否会改变治疗方案、辐射风险以及在感染控制方面的实用性,其使用价值一直存在争议。因此,已转向使用其他成像方式和检测方法,如胸部X光和超声。此外,基于核酸的检测方法,如逆转录聚合酶链反应(RT-PCR),已被证明对直接确诊COVID-19感染很有用。在本研究中,我们旨在回顾和分析当前文献,以比较RT-PCR、免疫生物标志物、胸部X光片、超声和胸部CT扫描作为诊断COVID-19的方法。

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