Evaluating the Diagnostic Accuracy of High-Resolution Computed Tomography in Detecting COVID-19: A Comparative Study Using Polymerase Chain Reaction as the Gold Standard: Diagnostic Accuracy in Detecting COVID-19

Rida Saleem; Shandana Khan; . Nowsherwan; Syed Luqman Shuaib; Rabia Syed; Mamoona Sattar

doi:10.54393/pjhs.v6i1.2623

Authors

Rida Saleem Department of Diagnostic, Radiology Northwest General Hospital, Peshawar, Pakistan
Shandana Khan Department of Diagnostic, Radiology Northwest General Hospital, Peshawar, Pakistan
. Nowsherwan Department of Medicine, Pak International Medical College, Peshawar, Pakistan
Syed Luqman Shuaib Department of Pathology, Khyber Medical College, Peshawar, Pakistan
Rabia Syed Department of Anatomy, Northwest School of Medicine, Peshawar, Pakistan
Mamoona Sattar Department of Diagnostic, Radiology Northwest General Hospital, Peshawar, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i1.2623

Keywords:

High-Resolution Computed Tomography, COVID-19 Diagnosis, Polymerase Chain Reaction, Sensitivity and Specificity, Diagnostic Accuracy

Abstract

Pakistan has faced three waves of COVID-19, each intensifying the strain on diagnostic resources. Delayed diagnoses during these waves hindered timely treatment and contributed to disease transmission. Objective: To evaluate the diagnostic accuracy of High-Resolution Computed Tomography (HRCT) in detecting COVID-19, using Polymerase Chain Reaction (PCR) as the gold standard. Methods: A cross-sectional study was conducted from November 26, 2021, to May 26, 2022, at the Department of Radiology, Northwest General Hospital & Research Centre, Peshawar. The study included 234 clinically suspected COVID-19 patients, aged 20–60 years, of both genders. Chest CT scans were performed, and results were compared with PCR. Data were analyzed using SPSS version 20, with p<0.05 considered significant. Results: Of the 234 patients, 133 tested positive for COVID-19 via PCR, while 101 were negative. HRCT demonstrated an overall accuracy of 73.9%, sensitivity of 72.9%, specificity of 75.2%, positive predictive value of 79.5%, and negative predictive value of 67.8%. Chi-square analysis revealed significant correlations of HRCT accuracy with BMI (p=0.004) and illness duration (p=0.010) but not with age (p=0.956) or gender (p=0.113). Conclusions: HRCT shows reasonable sensitivity, specificity, and overall accuracy as a diagnostic tool for COVID-19. Its performance improves in women, those with higher BMI, and longer illness duration but should not replace PCR testing due to its modest negative predictive value.

References

Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: Emergence, transmission, and characteristics of human coronaviruses. Journal of advanced research. 2020 Jul; 24: 91-8. doi: 10.1016/j.jare.2020.03.005. DOI: https://doi.org/10.1016/j.jare.2020.03.005

Hanif N, Rubi G, Irshad N, Ameer S, Habib U, Zaidi SR. Comparison of HRCT chest and RT-PCR in diagnosis of COVID-19. Journal of College of Physicians and Surgeons Pakistan. 2021 Jan; 30(01): S1-6. doi: 10.29271/jcpsp.2021.Supp1.S1. DOI: https://doi.org/10.29271/jcpsp.2021.Supp1.S1

Ciotti M, Ciccozzi M, Terrinoni A, Jiang WC, Wang CB, Bernardini S. The COVID-19 pandemic. Critical reviews in clinical laboratory sciences. 2020 Aug; 57(6): 365-88. doi: 10.1080/10408363.2020.1783198. DOI: https://doi.org/10.1080/10408363.2020.1783198

Patel M, Chowdhury J, Zheng M, Abramian O, Verga S, Zhao H et al. High Resolution CHEST CT (HRCT) evaluation in patients hospitalized with COVID-19 Infection. Medrxiv. 2020 May: 2020-05. doi: 10.1101/2020.05.26.20114082. DOI: https://doi.org/10.1101/2020.05.26.20114082

Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020 Apr; 323(13): 1239-42. doi: 10.1001/jama.2020.2648. DOI: https://doi.org/10.1001/jama.2020.2648

Aziz U, Sohail A, Yaseen M, Alam M, Iqbal A. Assessing the Efficacy of Molecular, Serological, and Radiological Techniques for the Detection of SARS-CoV-2. National Journal of Life and Health Sciences. 2024 Apr; 3(1): 35-46. doi: 10.62746/njlhs.v3n1.39. DOI: https://doi.org/10.62746/njlhs.v3n1.39

Aragaw TA. Surgical face masks as a potential source for microplastic pollution in the COVID-19 scenario. Marine Pollution Bulletin. 2020 Oct; 159: 111517. doi: 10.1016/j.marpolbul.2020.111517. DOI: https://doi.org/10.1016/j.marpolbul.2020.111517

Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P et al. Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology. 2020 Aug; 296(2): E115-7. doi: 10.1148/radiol.2020200432. DOI: https://doi.org/10.1148/radiol.2020200432

Anwar S, Farooq F, Waheed A, Masood A, Khan TU, Baig FA. HRCT Pattern in COVID-19 Patients. Pakistan Journal of Medical & Health Sciences. 2022 May; 16(03): 1050-. doi: 10.53350/pjmhs221631050. DOI: https://doi.org/10.53350/pjmhs221631050

Hu L and Wang C. Radiological role in the detection, diagnosis and monitoring for the coronavirus disease 2019 (COVID-19). European Review for Medical & Pharmacological Sciences. 2020 Apr; 24(8). doi: 10.26355/eurrev_202004_21035.

Cozzi D, Cavigli E, Moroni C, Smorchkova O, Zantonelli G, Pradella S et al. Ground-glass opacity (GGO): a review of the differential diagnosis in the era of COVID-19. Japanese journal of radiology. 2021 Aug; 39(8): 721-32. doi: 10.1007/s11604-021-01120-w. DOI: https://doi.org/10.1007/s11604-021-01120-w

Noreen N, Dil S, Niazi SU, Naveed I, Khan NU, Khan FK et al. Coronavirus disease (COVID-19) pandemic and Pakistan; limitations and gaps. Global Biosecurity. 2020 Sep; 1(3): 1-1. doi: 10.31646/gbio.63. DOI: https://doi.org/10.31646/gbio.63

Shahzeb M, Khan A, Muhammad A. Detection of coronavirus disease (COVID-19) using radiological examinations. Journal of Pure and Applied Microbiology. 2020 May; 14(Suppl 1): 911-20. doi: 10.22207/JPAM.14.SPL1.28. DOI: https://doi.org/10.22207/JPAM.14.SPL1.28

van de Veerdonk FL, Netea MG, van Deuren M, van der Meer JW, de Mast Q, Brüggemann RJ, van der Hoeven H. Kallikrein-kinin blockade in patients with COVID-19 to prevent acute respiratory distress syndrome. Elife. 2020 Apr; 9: e57555. doi: 10.7554/eLife.57555. DOI: https://doi.org/10.7554/eLife.57555

Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Frontiers of Medicine. 2020 Apr; 14: 185-92. doi: 10.1007/s11684-020-0754-0. DOI: https://doi.org/10.1007/s11684-020-0754-0

Fosbøl EL, Butt JH, Østergaard L, Andersson C, Selmer C, Kragholm K et al. Association of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use with COVID-19 diagnosis and mortality. Journal of the American Medical Association. 2020 Jul; 324(2): 168-77. doi: 10.1001/jama.2020.11301. DOI: https://doi.org/10.1001/jama.2020.11301

Mancia G, Rea F, Ludergnani M, Apolone G, Corrao G. Renin-angiotensin-aldosterone system blockers and the risk of Covid-19. New England Journal of Medicine. 2020 Jun; 382(25): 2431-40. doi: 10.1056/NEJMoa2006923. DOI: https://doi.org/10.1056/NEJMoa2006923

Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet respiratory medicine. 2020 Apr; 8(4): 420-2. doi: 10.1016/S2213-2600(20)30076-X. DOI: https://doi.org/10.1016/S2213-2600(20)30076-X

Lu R, Zhao X, Li J, Niu P, Yang B, Wu H et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. The Lancet. 2020 Feb; 395(10224): 565-74. doi: 10.1016/S0140-6736(20)30251-8. DOI: https://doi.org/10.1016/S0140-6736(20)30251-8

Kashyape R and Jain R. The utility of HRCT in the initial diagnosis of COVID-19 pneumonia-An Indian perspective. Indian Journal of Radiology and Imaging. 2021 Jan; 31(S 01): S178-81. doi: 10.4103/ijri.IJRI_944_20. DOI: https://doi.org/10.4103/ijri.IJRI_944_20

Deng M, Sun W, Hu J, Mei L, Weng D, Liu B et al. Radiological features on HRCT and RT-PCR testing for the diagnosis of coronavirus disease 2019 (COVID-19) in China: a comparative study of 78 cases in pregnant women. 2020 Apr. doi: 10.21203/rs.3.rs-21005/v1. DOI: https://doi.org/10.21203/rs.3.rs-23565/v1

Ali A, Shaikh M AA, Sahito AA, Kumari S. Diagnostic Accuracy of HRCT Chest in Detection of Covid-19 Infection Taking PCR as Gold Standard. Pakistan Journal of Medical & Health Sciences. 2021 Jun: 1679-81. doi: 10.53350/pjmhs211561679. DOI: https://doi.org/10.53350/pjmhs211561679