Chest CT for Typical Coronavirus Disease 2019 (COVID-19) Pneumonia: Relationship to Negative RT-PCR Testing

Abstract

Some patients with positive chest CT findings may present with negative results of real time reverse-transcription-polymerase chain-reaction (RT-PCR) for 2019 novel coronavirus (2019-nCoV). In this report, we present chest CT findings from five patients with 2019-nCoV infection who had initial negative RT-PCR results. All five patients had typical imaging findings, including ground-glass opacity (GGO) (5 patients) and/or mixed GGO and mixed consolidation (2 patients). After isolation for presumed 2019-nCoV pneumonia, all patients were eventually confirmed with 2019-nCoV infection by repeated swab tests. A combination of repeated swab tests and CT scanning may be helpful when for individuals with high clinical suspicion of nCoV infection but negative RT-PCR screening Abbreviations PT-PCR=reverse-transcription-polymerase chain-reaction GGO=ground glass opacity

Molecular immune pathogenesis and diagnosis of COVID-19

“…RT-qPCR detection also showed high sensitivity and specificity for SARS-CoV and MERS-CoV infection [48]. However, five patients with negative results of RT-qPCR for SARS-CoV-2 may present with positive chest CT findings, and repeated swab tests (RT-qPCR) eventually confirmed that all patients were infected by SARS-CoV-2 [49]. The detection of SARS-CoV using RT-qPCR can only achieve a sensitivity of 50% to 79%, depending on the protocol used the sample type and number of clinical specimens collected [50].…”

Diagnosis of SARS-CoV-2 infection based on CT scan vs RT-PCR: reflecting on experience from MERS-CoV

“…In another study of 167 patients, concordant CT scan and PCR test results were observed in 93% of patients, and a discordant results were observed in 4% (positive PCR but negative CT scan) and in 3% (negative initial PCR and positive CT scan) [7]. In a larger study of 1014 SARS-CoV-2 patients, 59% had positive RT-PCR and 88% had positive CT scan; using RT-PCR as a reference, the sensitivity of chest CT imaging was 97% [8].…”

WITHDRAWN: Clinical and CT imaging features of 2019 novel coronavirus disease (COVID-19)

“…In the early stage of the disease, the lesion can manifest as round nodular-like GGO in the central area of the lung lobe, which is different from the common imaging manifestations that are patchy-like lesion in subpleural region [4][5][6]…”