Chest CT for Typical 2019-nCoV Pneumonia: Relationship to Negative RT-PCR Testing(2020/02/12)

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

 

Summary

In patients at high risk for 2019-nCoV infection, chest CT evidence of viral pneumonia may precede positive negative RT-PCR test results.

 

Introduction

In December 2019, an outbreak of 2019-nCoV pneumonia began in Wuhan (Hubei, China) and spread rapidly [1]. Without a therapeutic vaccine or specific antiviral drugs, early detection and isolation becomes essential against novel coronavirus. The use of chest computed tomography (CT) as a screening tool for patients with suspected 2019-nCoV not well understood. In our experience, some patients with likely 2019-nCoV infection may have initial negative reverse transcriptase (RT) polymerase chain reaction (PCR) results. Reasons for false negative RT-PCR may include insufficient cellular material for detection and improper extraction of nucleic acid from clinical materials.

The purpose of the study was to describe CT imaging features of five patients with initial negative or weakly positive RT-PCR results but high suspicion of 2019-nCoV infection.

Author:Xingzhi Xie, Zheng Zhong, Wei Zhao, et al.

Link:https://pubs.rsna.org/doi/10.1148/radiol.2020200343