The significance of radiological and laboratory findings in the diagnosis of new COVID-19 disease

Abstract

Aim: The new coronavirus disease (COVID-19), which first appeared in Wuhan, China in December 2019 and spread rapidly throughout the country, has rapidly becoe a pandemic and a global threat within the first months of 2020. In this study, we aimed to compare the laboratory findings of the patients with negative and positive polymerase chain reaction (PCR) tests results due to COVID-19-like findings in chest computed tomography (CT). Material and Methods: The study included 49 patients admitted to the emergency department with the suspicion of COVID-19 due to the positive findings on chest CT. Nasopharyngeal swabs were taken from each patient. Whole blood count and biochemical parameters were examined, and as a result of swab investigations, the laboratory values of positive and negative results were compared in order to diagnose COVID-19 cases. Results: A total of 49 patients were included in the study. The swab specimensobtained from the nasopharynx were evaluated using the reverse transcription PCR (RT-PCR) test. While the RT-PCR positivity was observed in 13 patients (Group 1), the RT-PCR negativity was found in 36 (Group 2). The mean age of all participants was 55.7±17.3 years;in Group 1, however in Group 1, the values of leukocyte, lactate dehydrogenase and ferritin were observed to be higher and lymphocyte count was significantly lower, compared with thosein Group 2. Dicussion: Previous studies have shown that the diagnosis of new COVIDV-19 disease and its clinical features should be based on a comprehensive understanding of radiographic features and laboratory investigations. Patients with clinical suspicion and those with exposure, fever and a history of positive findings on chest CT should be rapidly diagnosed with molecular technology. The RT-PCR test was developed as a widely used method to detect viral RNA. Although the RT-PCR test is considered the gold standard diagnostic method, this method has some limitations. Clinical findings, history, physical examination and radiological findings were compatible with COVID 19 in our study, the RT-PCR test results were negative in some patients. The new COVID-19 disease is a very contagious condition leading to devastating consequences. Therefore, the clinical, radiological and laboratory findings should be taken into account as a holistic approach in the diagnosing process of new COVID-19 disease.