Hanania Noor, Najem Elie, Tamim Hani, Assaf Nada, Majari Ghaidaa, Younes Wael, Abbas Fatmeh, Berjawi Ghina, Mahfouz Rami
Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon.
Hum Gene (Amst). 2023 Feb;35:201150. doi: 10.1016/j.humgen.2023.201150. Epub 2023 Feb 2.
Chest Computerized Tomography has been widely used in COVID patients' assessment. Hence the question arises as to whether there is any correlation between the Ct value and findings on Chest CT scan or clinical presentation of the patient. We wanted to test the hypothesis of whether low Ct values (≤30) in RT-PCR were associated with a high mortality rate, CT scan findings, or with comorbidities such as immunosuppression and lung disease.
The radiographic records and RT-PCR Ct values of 371 COVID patents diagnosed at the American University of Beirut Medical Center were reviewed.
We found out that the sensitivity of chest CT scan compared to RT-PCR, the gold standard, turned out to be 74% (95% CI 69-79%). Specificity, on the other hand was 33% (95% CI 16-55%). The positive predictive value of CT was 94% (95% CI 91-97%) and the negative predictive value was 8% (95% CI 4-16%). low Ct values in RT-PCR were not associated with a higher mortality rate (-value = 0.416). There was no significant positive association between low Ct value and suspicious CT scan findings (typical and indeterminate for COVID-19), with a -value of 0.078. There was also no significant association between low Ct value and immunosuppression (-value = 0.511), or lung disease (p-value =0.06). CT scan findings whether suspicious or not for COVID-19 infection, were not shown to be significantly associated with respiratory symptoms of any kind.No association was found between a history of lung disease, immunosuppression and suspicious CT scan findings for COVID-19.
As long as this pandemic exists, nucleic acid testing was and remains the gold standard of COVID-19 diagnosis worldwide and in our community as it has a superior diagnostic accuracy to CT scan and higher sensitivity (94% vs 74%).
胸部计算机断层扫描已广泛用于新冠患者的评估。因此，问题在于新冠病毒核酸检测（Ct）值与胸部CT扫描结果或患者临床表现之间是否存在任何关联。我们想要检验以下假设：逆转录聚合酶链反应（RT-PCR）中低Ct值（≤30）是否与高死亡率、CT扫描结果或免疫抑制和肺部疾病等合并症相关。
回顾了在贝鲁特美国大学医学中心确诊的371例新冠患者的影像学记录和RT-PCR Ct值。
我们发现，与金标准RT-PCR相比，胸部CT扫描的敏感性为74%（95%置信区间69-79%）。另一方面，特异性为33%（95%置信区间16-55%）。CT的阳性预测值为94%（95%置信区间91-97%），阴性预测值为8%（95%置信区间4-16%）。RT-PCR中的低Ct值与较高死亡率无关（p值 = 0.416）。低Ct值与可疑的CT扫描结果（新冠典型和不明确表现）之间无显著正相关，p值为0.078。低Ct值与免疫抑制（p值 = 0.511）或肺部疾病（p值 = 0.06）之间也无显著关联。无论是否怀疑新冠病毒感染，CT扫描结果均未显示与任何类型的呼吸道症状有显著关联。未发现肺部疾病史、免疫抑制与可疑的新冠CT扫描结果之间存在关联。
只要这场大流行存在，核酸检测在全球范围内以及在我们社区一直是新冠病毒诊断的金标准，因为它比CT扫描具有更高的诊断准确性和更高的敏感性（94%对74%）。
