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   Table of Contents      
CORRESPONDENCE
Year : 2020  |  Volume : 152  |  Issue : 1  |  Page : 135-136

Authors’ response


1 Translational Global Health Policy Research Cell, New Delhi, India
2 Multidisciplinary Research Unit/Model Rural Health Research Unit, New Delhi, India
3 ICMR-National Institute of Medical Statistics, New Delhi, India
4 Division of Reproductive Biology, Maternal Health & Child Health, New Delhi, India
5 Division of Non-Communicable Diseases, Indian Council of Medical Research, New Delhi, India
6 Division of Clinical Medicine, ICMR-National Institute of Cholera & Enteric Diseases, Kolkata, West Bengal, India
7 Informatics, Systems & Research Management Cell, Indian Council of Medical Research, New Delhi, India
8 Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
9 Department of Health Research, Ministry of Health & Family Welfare; Indian Council of Medical Research, New Delhi, India
10 ICMR-National AIDS Research Institute, Pune, Maharashtra, India

Date of Web Publication03-Aug-2020

Correspondence Address:
Samiran Panda
ICMR-National AIDS Research Institute, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


Read associated with this article

DOI: 10.4103/0971-5916.291340

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How to cite this article:
Chatterjee P, Anand T, Singh KJ, Rasaily R, Singh R, Das S, Singh H, Praharaj I, Gangakhedkar RR, Bhargava B, Panda S. Authors’ response. Indian J Med Res 2020;152:135-6

How to cite this URL:
Chatterjee P, Anand T, Singh KJ, Rasaily R, Singh R, Das S, Singh H, Praharaj I, Gangakhedkar RR, Bhargava B, Panda S. Authors’ response. Indian J Med Res [serial online] 2020 [cited 2021 Apr 19];152:135-6. Available from: https://www.ijmr.org.in/text.asp?2020/152/1/135/291340

We appreciate Gouda and Goudra[1] for critical reading of our article[2] and thank them for raising the issue of COVID-19 diagnosis. It has been correctly pointed out that the RT-PCR cannot diagnose all cases of SARS-CoV-2 infection. As a chest computed tomography (CT) may detect changes before PCR positivity in some cases and therefore, has the potential to serve as a valuable adjunct diagnostic tool, the non-specific nature of such changes in a low prevalence setting is destined to have a low positive predictive value. Investigation of the passengers on cruise ship Diamond Princess (cruise number M003 with cases of pneumonia-like illness) is worth considering in this context, where it was observed that 61 per cent of the cases had lung opacities and 20 per cent of symptomatic patients had negative CT scans[3]. In brief, chest CT may supplement, but does not substitute RT-PCR for the diagnosis of COVID-19[4].

In unknown disease outbreak situation or newly recognized clusters of symptomatic cases, different case definitions are used for different purposes, such as disease surveillance, clinical management or drug trials. Likewise, for COVID-19, case definitions have included suspected cases, probable cases and confirmed cases. Moreover, case definitions may vary between countries and may even change from time to time in the same country. The database we used for our study was originally developed to track laboratory-confirmed COVID-19 cases out of the symptomatic healthcare workers. As per the case definition of COVID-19, a confirmed case is 'any person meeting the laboratory criteria'[5],[6] and India follows the same[7]. This definition does not hinge upon other investigation results and conforming to the same, our investigation was at par with internationally acceptable standard practices. Adhering to this definition further allowed us to keep uniformity across the study population (cases and controls) and minimize selection biases.

 
   References Top

1.
Gouda D, Goudra B. Effect of quantitative real-time RT-PCR reaction sensitivity in determining the efficacy of HCQ prophylaxis for COVID-19. Indian J Med Res 2020; 152 : 134.  Back to cited text no. 1
    
2.
Chatterjee P, Anand T, Singh KJ, Rasaily R, Singh R, Das S, et al. Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19. Indian J Med Res 2020; 151 : 459-67.  Back to cited text no. 2
    
3.
Inui S, Fujikawa A, Jitsu M, Kunishima N, Watanabe S, Suzuki Y, et al. Chest CT findings in cases from the cruise ship “Diamond Princess” with coronavirus disease 2019 (COVID-19). Radiol Cardiothorac Imaging 2020; 2 : e200110.  Back to cited text no. 3
    
4.
Hope MD, Raptis CA, Shah A, Hammer MM, Henry TS, six signatories. A role for CT in COVID-19? What data really tell us so far. Lancet 2020; 395 : 1189-90.  Back to cited text no. 4
    
5.
European Centre for Disease Prevention and Control. Case Definition for Coronavirus Disease 2019 (COVID-19), as of 29 May 2020. Available from: https://www.ecdc.europa.eu/en/covid-19/surveillance/case-definition, accessed on June 13, 2020.  Back to cited text no. 5
    
6.
Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19): 2020 Interim Case Definition, Approved April 5, 2020. Atlanta: CDC; 2020.   Back to cited text no. 6
    
7.
Ministry of Health & Family Welfare, Government of India. Guidelines for notifying COVID-19 affected persons by Private Institutions. Available from: https://www.mohfw.gov.in/pdf/GuidelinesfornotifyingCOVID-19affectedpersonsbyPrivateInstitutions.pdf, accessed on June 13, 2020.  Back to cited text no. 7
    




 

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