Diagnostic Precision of Molecular Testing for Severe Acute Respiratory Syndrome Coronavirus 2 versus Chest Computer Tomography

Abstract

Background: Molecular detection is considered benchmark criteria for SARS-CoV-2 diagnosis. Both computer tomography (CT) chest imaging and reverse transcriptase polymerase chain reaction (RTPCR) can give false-negative test results in the initial state of coronavirus infection. This study aimed to assess the precision of computer tomography (CT) chest imaging and RTPCR assay and to compare the role of CT chest imaging and molecular testing (RTPCR) in the early detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods: Retrospective analysis of 588 clinically suspected coronavirus disease cases was performed over from April 2021 to June 2021. RTPCR test result was compared with chest computer tomography and diagnostic precision of computer tomography (CT) scan was determined using RTPCR as reference standard. Categorical variables were statistically analyzed as frequencies and percentages. Results: Out of 465 patients who tested positive by chest computer tomography (CT) scan findings, 132 (28.39%) tested RTPCR positive and 333 (71.61%) tested RTPCR negative. 306/465 (65.81%) cases showed moderate-to-severe infection and 159/465 (34.19%) had mild infection. Diagnostic precision of imaging chest computer tomography (CT) scan was observed to be 38.44%. Low sensitivity of RTPCR detection method in the early identification of coronavirus disease was observed. Conclusion: The use of computer tomography (CT) scan in the early detection of coronavirus disease is supplemental to RTPCR assay and is limited to the detection of laboratory-confirmed coronavirus disease cases as imaging characteristics of SARS-CoV-2 pneumonia superimposed with other types of pneumonia.

Keywords

• assay sensitivity
• chest computer tomography
• molecular detection
• severe acute respiratory syndrome coronavirus 2 infection
• specificity