CASE STUDY European Journal of Medical and Health Sciences www.ejmed.org DOI: http://dx.doi.org/10.24018/ejmed.2021.3.2.634 Vol 3 | Issue 2 | April 2021 38 Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2020(COVID-19) in Palestine: A Report of 200 Cases Sami Smerat, Murad Abu Samra, Maram Ghassan Sada, Azzam Alarab, Issa Al Hroush, Moath Al-Makhamreh, Osama Najjar, and Mohammed Hjouj ABSTRACT Purpose: Prove that Computed Tomography (CT) is a more effective diagnostic tool for diagnosing Coronavirus Disease 2019 (COVID-19) in comparison with Reverse Transcription Polymerase Chain Reaction (RT- PCR) due to its higher sensitivity. Methods and materials: A total of 200 cases that had records of chest CT scans and RT-PCR tests were collected from Palestinian governmental hospitals from September to November 2020. Results: CT indicated COVID-19 in 62.5% of sample population (125 of 200) whereas RT-PCR indicated COVID-19 in 37.5% (75 of 200) cases. A P-value of 0.028 signifies the existence of a relationship between gender and CT sensitivity. Conclusion: High resolution computed tomography (HRCT) of the chest is a more rapid, sensitive, and effective tool than the current gold standard (RT-PCR); therefore, should be considered a primary diagnostic method for COVID-19. Keywords: COVID-19, CT, RT-PCR, Sensitivity. Submitted : December 28, 2020 Published : April 23, 2021 ISSN: 2593-8339 DOI: 10.24018/ejmed.2021.3.2.634 Mohammed Hjouj* Al-Quds University, Palestine. (e-mail: mhjouj staff.alquds.edu) Sami Smerat Istishari Arab Hospital, Palestine. (e-mail: ssmerat paluniv.edu.ps) Murad Abu Samra Icahn School of Medicine at Mount Sinai, NY, USA. (e-mail: muradabusamra gmail.com) Maram Ghassan Sada Al-Quds University, Palestine. (e-mail: maram.sada students.alquds.edu) Azzam Alarab Palestine Ahliya University, Palestine. Issa Sameeh Al Hroush Istishari Arab Hospital, Palestine. Moath Al-Makhamreh Yatta Public Hospital, Palestine. Osama Najjar Palestinian Ministry of Health, Palestine. *Corresponding Author I. INTRODUCTION The first cases infected with severe acute respiratory syndrome coronavirus 2 virus (SARS-CoV-19) appeared in Wuhan, Hubei Province, China in December of 2019. Weeks later, the virus spread rapidly across China and the rest of the world [1]. The rising numbers of confirmed cases necessitated international measures to help contain the spread. These measures included but were not limited to diagnostic testing, management of confirmed cases, and community Infection Prevention and Control (IPC) [1]. Considering that the identification of infected people is the first and most crucial step to containing the spread, a diagnostic tool that is available, rapid, sensitive, and affordable is essential [2]. The current diagnostic test for Coronavirus Disease 2019 (COVID-19) is Reverse transcription polymerase chain reaction (RT-PCR) assay [3]. Through oropharyngeal (OP) or nasopharyngeal (NP) swabs, specimens are obtained to detect the presence of SARS-CoV- 2 [4]. As previously mentioned, early detection of COVID- 19 is essential to prevent and control infectious transmission; however, many issues are presented with the use of RT-PCR as the gold standard of testing [5]. The waiting time, limited availability, and costly nature renders the RT-PCR as an ineffective diagnostic tool [4]. The most concerning issue of using RT-PCR is its inability to detect the viral genome of symptomatic or asymptomatic people (5). Specifically, the sensitivity of RT-PCR is very limited (60%-71%) [5]. The first factor that limits the sensitivity of RT-PCR assays as a diagnostic tool is the inherent susceptibility to errors due to specimen collection [4]. There are many methods to collect specimens, but the most rapid and common are NP and/ or OP swabs, and improper sample collection, transportation, and/or handling can result in inconsistencies [5]. Moreover, RT-PCR is vulnerable to inter-operator variability that can affect the quality of the collected sample [5]. Finally, the limited sensitivity of RT-PCR is also due to its dependence upon viral load, sampling timing, and period of the disease development [5]. A diagnostic tool that is considered to be effective due to its availability, high sensitivity, and rapidity @ @ @ @