Early Diagnosis Of Coronavirus Disease 2019 Research Articles

A Review of COVID-19 Diagnostic Methods

: The new coronavirus disease 2019 (COVID-19) has recently emerged as an acute respiratory syndrome. The virus has spread throughout the world since the primary outbreak of the disease reported in Wuhan, China. The pandemic has led to increased mortality as the most important threat of the disease in specific populations across the world. Furthermore, COVID-19 has caused significant economic problems in several countries. The early diagnosis of COVID-19 is currently an important concern for physicians and communities. The present study aimed to review the published articles regarding the diagnosis of COVID-19 until the end of February 2020. According to the results we show that deep learning and machine learning algorithms can be effectively used to the scope of the disease.

Interest of the cellular population data analysis as an aid in the early diagnosis of SARS-CoV-2 infection.

IntroductionCoronavirus disease 2019 (COVID‐19) is characterized by a high contagiousness requiring isolation measures. At this time, diagnosis is based on the positivity of specific RT‐PCR and/or chest computed tomography scan, which are time‐consuming and may delay diagnosis. Complete blood count (CBC) can potentially contribute to the diagnosis of COVID‐19. We studied whether the analysis of cellular population data (CPD), provided as part of CBC‐Diff analysis by the DxH 800 analyzers (Beckman Coulter), can help to identify SARS‐CoV‐2 infection.MethodsCellular population data of the different leukocyte subpopulations were analyzed in 137 controls, 322 patients with proven COVID‐19 (COVID+), and 285 patients for whom investigations were negative for SARS‐CoV‐2 infection (COVID−). When CPD of COVID+ were different from controls and COVID− patients, we used receiver operating characteristic analysis to test the discriminating capacity of the individual parameters. Using a random forest classifier, we developed the algorithm based on the combination of 4 monocyte CPD to discriminate COVID+ from COVID− patients. This algorithm was tested prospectively in a series of 222 patients referred to the emergency unit.ResultsAmong the 222 patients, 86 were diagnosed as COVID‐19 and 60.5% were correctly identified using the discriminating protocol. Among the 136 COVID− patients, 10.3% were misclassified (specificity 89.7%, sensitivity 60.5%). False negatives were observed mainly in patients with a low inflammatory state whereas false positives were mainly seen in patients with sepsis.ConclusionConsideration of CPD could constitute a first step and potentially aid in the early diagnosis of COVID‐19.

Eosinopenia and COVID-19.

Early diagnosis of coronavirus disease 2019 (COVID-19) and patient isolation are important for both individual patient care and disease containment. The diagnosis is confirmed by testing for the presence of nasopharyngeal viral RNA with a polymerase chain reaction assay, which has limited availability, variable turnaround time, and a high false-negative rate. The authors report that a rapid laboratory test, the eosinophil count, readily obtained from a routine complete blood cell count (CBC), may provide actionable clinical information to aid in the early recognition of COVID-19 in patients, as well as provide prognostic information. To investigate the diagnostic and prognostic value of eosinopenia in COVID-19-positive patients. The eosinophil results of routine CBC from the first 50 admitted COVID-19-positive patients were compared with the eosinophil results of 50 patients with confirmed influenza infection at the time of presentation to the emergency department at Coney Island Hospital in Brooklyn, New York. The number of patients with 0 eosinophils on the day of presentation was also compared between the 2 groups. Furthermore, the eosinophil counts in the 50 COVID-19 patients were reviewed for the first 5 days of their hospital stay and before discharge, along with the outcome (deceased vs discharged), and trends in eosinophil data were compared based on the outcome. On the day of presentation, 30 patients in the COVID-19 group (60%) and 8 patients in the influenza group (16%) had an eosinophil count of 0. An additional 14 patients in the COVID-19 group had 0 eosinophils during the following 2 days; the total number of patients in the COVID-19 group who had 0 eosinophils on admission or during the ensuing 2 days was 44 (88%). In addition, 18 of 21 deceased patients in the COVID-19 group (86%) who initially presented with eosinopenia remained eosinopenic compared with 13 of 26 survivors (50%). The absence of an eosinophil count in a CBC can aid in early diagnosis of COVID-19. It may be a useful tool in deciding whether to promptly isolate a patient and initiate specific therapies while waiting for confirmatory test results. Persistent eosinopenia after admission correlated with high disease severity and low rates of recovery.

Improving the early diagnosis of suspected patients with COVID-19: a retrospective study of 106 patients.

An outbreak of coronavirus disease 2019 (COVID-19) occurred in Wuhan, Hubei Province, China. This study aimed to analyze the clinical and epidemiologic characteristics of patients with COVID-19 to better differentiate the suspected patients in Beijing, China. This was a retrospective, single-center study. Clinical and epidemiologic data were collected from suspected patients with COVID-19 admitted to Beijing Ditan Hospital from January 29 to February 21, 2020. One hundred and six patients (60 males and 46 females, median age 36 years) were enrolled. Thirty-six patients were ultimately laboratory confirmed. Fifty-three were excluded from the diagnosis of COVID-19. The remaining 17 patients were highly suspected, although their nucleic acid tests were repeatedly negative. The confirmed patients and highly suspected patients had a significantly higher proportion of epidemiologic history than the excluded patients (P < 0.001). There was no significant difference in clinical symptoms or the underlying diseases among the three groups. The confirmed patients had a higher frequency of lymphopenia and eosinopenia than the highly suspected and excluded patients. Chest computed tomography scans showed bilateral lung involvement, and ground-glass opacity was more likely observed in the confirmed patients. The clinical features of the confirmed patients with COVID-19 were insufficient for early diagnosis of COVID-19. The epidemiologic history was of great significance in the early diagnosis of COVID-19. More sensitive diagnostic methods are needed to aid the differential diagnosis of suspected patients with COVID-19.

Chest CT features of coronavirus disease 2019 (COVID-19) pneumonia: key points for radiologists

COVID-19 is an emerging infection caused by a novel coronavirus that is moving so rapidly that on 30 January 2020 the World Health Organization declared the outbreak a Public Health Emergency of International Concern and on 11 March 2020 as a pandemic. An early diagnosis of COVID-19 is crucial for disease treatment and control of the disease spread. Real-time reverse-transcription polymerase chain reaction (RT-PCR) demonstrated a low sensibility; therefore chest computed tomography (CT) plays a pivotal role not only in the early detection and diagnosis, especially for false negative RT-PCR tests, but also in monitoring the clinical course and in evaluating the disease severity. This paper reports the CT findings with some hints on the temporal changes over the course of the disease: the CT hallmarks of COVID-19 are bilateral distribution of ground glass opacities with or without consolidation in the posterior and peripheral lung, but the predominant findings in later phases include consolidations, linear opacities, “crazy-paving” pattern, “reversed halo” sign and vascular enlargement. The CT findings of COVID-19 overlap with the CT findings of other diseases, in particular the viral pneumonia including influenza viruses, parainfluenza virus, adenovirus, respiratory syncytial virus, rhinovirus, human metapneumovirus, etc. There are differences as well as similarities in the CT features of COVID-19 compared with those of the severe acute respiratory syndrome. The aim of this article is to review the typical and atypical CT findings in COVID-19 patients in order to help radiologists and clinicians to become more familiar with the disease.

Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Is Comparable in Clinical Samples Preserved in Saline or Viral Transport Medium

As the coronavirus disease 2019 (COVID-19) pandemic sweeps across the world, the availability of viral transport medium (VTM) has become severely limited, contributing to delays in diagnosis and rationing of diagnostic testing. Given that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral RNA has demonstrated stability, we posited that phosphate-buffered saline (PBS) may be a viable transport medium, as an alternative to VTM, for clinical real-time quantitative PCR (qPCR) testing. The intra-individual reliability and interindividual reliability of SARS-CoV-2 qPCR were assessed in clinical endotracheal secretion samples transported in VTM or PBS to evaluate the stability of the qPCR signal for three viral targets (N gene, ORF1ab, and S gene) when samples were stored in these media at room temperature for up to 18 hours. We report that the use of PBS as a transport medium allows high intra-individual and interindividual reliability, maintains viral stability, and compares with VTM in the detection of the three SARS-CoV-2 genes through 18 hours of storage. This study establishes PBS as a clinically useful medium that can be readily deployed for transporting and short-term preservation of specimens containing SARS-CoV-2. Use of PBS as a transport medium has the potential to increase testing capacity for SARS-CoV-2, aiding more widespread screening and early diagnosis of COVID-19.

Typical radiological progression and clinical features of patients with coronavirus disease 2019.

We aimed to describe typical radiological features and progression of Coronavirus disease 2019 (COVID-19) patients. We reviewed the chest CT scans, laboratory findings, and clinical records of 66 COVID-19 patients who were admitted to affiliated hospitals of Nanchang university, Nanchang, China, from Jan 21 to Feb 2, 2020. CT was used to evaluate the radiological characteristics of COVID-19 patients. Only 4 patients (4/66, 6%) claimed their exposure to COVID-19 pneumonia patients. The major symptoms were fever (60/66, 91%) and cough (37/66, 56%). The predominant features of lesion were scattered (43/66, 65%), bilateral (50/66, 76%), ground-glass opacity (64/66, 97%), and air bronchogram sign (47/66, 71%). Forty-eight patients (48/66, 73%) had more than two lobes involved. Right lower lobe (58/66, 88%) and left lower lobe (49/66, 74%) were most likely invaded. Twelve patients (12/66, 18%) had at least one comorbid condition. Pleural traction (29/66, 44%), crazy paving (15/66, 23%), interlobular septal thickening (11/66, 17%), and consolidation (7/66, 11%) were also observed. The typical radiology features of COVID-19 patients are scattered ground-glass opacity in the bilateral lobes. Fever and cough are the major symptoms. Evaluating chest CT, clinical symptoms, and laboratory results could facilitate the early diagnosis of COVID-19, and judge disease progression.

Longitudinal Change of Severe Acute Respiratory Syndrome Coronavirus 2 Antibodies in Patients with Coronavirus Disease 2019.

BackgroundA novel coronavirus, SARS-CoV-2, has recently emerged and caused the rapid spread of COVID-19 worldwide.MethodsWe did a retrospective study and included COVID-19 patients admitted to Renmin Hospital of Wuhan University between February 1 and February 29, 2020. Antibody assay was conducted to detect COVID-19 envelope protein E and nucleocapsid protein N antigen.Results112 patients were recruited with symptoms of fever, cough, fatigue, myalgia, and diarrhoea. All patients underwent antibody tests. Fifty-eight (51.79%) were positive for both IgM and IgG, 7 (6.25%) were negative for both antibodies, 1 (0.89%) was positive for only IgM, and 46 (41.07%) were positive for only IgG. IgM antibody appeared within a week post disease onset, and lasted for one month and gradually decreased, while IgG antibody was produced 10 days after infection, and lasted for a longer time. However, no significant difference in level of IgM and IgG antibody between positive and negative patients of nucleic acid test after treatment was found.ConclusionsOur results indicate that serological tests could be powerful approach for the early diagnosis of COVID-19.

Coronavirus Disease 2019 (COVID-19)

The ongoing outbreak of Coronavirus Disease 2019 (COVID-19) has spread rapidly throughout China and other countries, and has been characterized as a pandemic. With the strict prevention and control measures implemented by the Chinese government, the spread of the epidemic in China has come under preliminary control by the end of February, 2020, whereas the situation of some countries outside China is not optimistic and raises great public concern. In fighting COVID-19, radiologic examinations played a critical role in the early diagnosis of COVID-19, and could also help assess disease course and severity. There is an urgent need to share useful experience and effective measures internationally. This article outlines the collaborative actions and efforts by the Chinese radiology field and the situation of front-line health care workers in radiology departments to present the world with experiences and examples of Chinese radiology during the COVID-19 outbreak.

Correlation between clinical classification of COVID-19 and imaging characteristics of MSCT volume scanning of the lungs

To investigate the correlation between the clinical classification of coronavirus disease 2019 (COVID-19) and the imaging characteristics of multislice spiral computed tomography (MSCT) volume scanning of the lungs. The clinical data and thoracic MSCT volume scanning data were analyzed retrospectively for 102 patients with COVID-19 diagnosed and hospitalized in the First Affiliated Hospital of Bengbu Medical College between January 18 and February 26, 2020. According to the Fifth Edition of the Diagnosis and Treatment Guidelines by the National Health Commission, the patients were divided into common type, severe type and critical type. The imaging characteristics including the lung sides of the lesions, lung segment involved, lesion distribution, and lesion number and density were compared among the patients with different clinical types of COVID-19. Seventy-seven of the patients had common type, 18 had severe type and 7 had critical type of COVID-19. The main clinical manifestations included fever, cough and fatigue. Severe and critical types were more frequently seen in elderly patients, who were more prone to show such symptoms as asthenia, breathing difficulty and dyspnea. Two patients presented with no obvious abnormality in the first CT examinations; in the remaining 100 patients, 89.0% had bilateral lung lesions, 16.0% had diffuse lesions, involving a mean of 6.56±4.22 lung segments. Compared with the patients with the common type, the severe and critical patients had a significantly greater number of lung segments involved (P < 0.05), and were also more likely to show diffuse lesions (P < 0.05). The lesion side, lesion number or lesion density did not differ significantly among the patients with different clinical types of COVID-19 (P > 0.05). MSCT volume scanning not only allows early diagnosis of COVID-19 but also provides evidence for evaluating the severity of COVID-19 to assist in the clinical treatment of the patients.

Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study

SummaryBackgroundA cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were successively reported in Wuhan, China. We aimed to describe the CT findings across different timepoints throughout the disease course.MethodsPatients with COVID-19 pneumonia (confirmed by next-generation sequencing or RT-PCR) who were admitted to one of two hospitals in Wuhan and who underwent serial chest CT scans were retrospectively enrolled. Patients were grouped on the basis of the interval between symptom onset and the first CT scan: group 1 (subclinical patients; scans done before symptom onset), group 2 (scans done ≤1 week after symptom onset), group 3 (>1 week to 2 weeks), and group 4 (>2 weeks to 3 weeks). Imaging features and their distribution were analysed and compared across the four groups.Findings81 patients admitted to hospital between Dec 20, 2019, and Jan 23, 2020, were retrospectively enrolled. The cohort included 42 (52%) men and 39 (48%) women, and the mean age was 49·5 years (SD 11·0). The mean number of involved lung segments was 10·5 (SD 6·4) overall, 2·8 (3·3) in group 1, 11·1 (5·4) in group 2, 13·0 (5·7) in group 3, and 12·1 (5·9) in group 4. The predominant pattern of abnormality observed was bilateral (64 [79%] patients), peripheral (44 [54%]), ill-defined (66 [81%]), and ground-glass opacification (53 [65%]), mainly involving the right lower lobes (225 [27%] of 849 affected segments). In group 1 (n=15), the predominant pattern was unilateral (nine [60%]) and multifocal (eight [53%]) ground-glass opacities (14 [93%]). Lesions quickly evolved to bilateral (19 [90%]), diffuse (11 [52%]) ground-glass opacity predominance (17 [81%]) in group 2 (n=21). Thereafter, the prevalence of ground-glass opacities continued to decrease (17 [57%] of 30 patients in group 3, and five [33%] of 15 in group 4), and consolidation and mixed patterns became more frequent (12 [40%] in group 3, eight [53%] in group 4).InterpretationCOVID-19 pneumonia manifests with chest CT imaging abnormalities, even in asymptomatic patients, with rapid evolution from focal unilateral to diffuse bilateral ground-glass opacities that progressed to or co-existed with consolidations within 1–3 weeks. Combining assessment of imaging features with clinical and laboratory findings could facilitate early diagnosis of COVID-19 pneumonia.FundingNone.

Новая коронавирусная инфекция в практике врача-оториноларинголога

Coronavirus disease 2019 (COVID-19) is a global pandemic that affects millions of people and kills hundreds of thousands of people. Chinese researchers found that the most common clinical manifestations of the disease were: fever, dry cough, shortness of breath, muscle weakness, muscle pain and various degrees of respiratory disorders. But despite this, a more in-depth understanding of COVID-19 revealed many other clinical manifestations. Cough, shortness of breath, sore throat, rhinorrhea, nasal congestion, acute tonsillitis, enlarged cervical lymph nodes, or dizziness are symptoms that an otolaryngologist may encounter when examining patients with COVID-19. And olfactory dysfunction has recently been recognized as an important symptom of COVID-19 and is increasingly being used as a tool to identify patients with COVID-19, particularly in cases of asymptomatic carriers who may unknowingly be the main cause of the spread of the disease. The analysis of detected cases of coronavirus infection and the diagnosis of upper respiratory pathologies in these patients, including olfactory dysfunction, allowed us to understand the frequency of their occurrence in the Moscow region, to compare with world data, and to evaluate their role, in the aspect of early diagnosis of COVID-19.