Chest computed tomography for the diagnosis of patients with coronavirus disease 2019 (COVID-19): a rapid review and meta-analysis

Abstract

Background: The outbreak of the coronavirus disease 2019 (COVID-19) has had a massive impact on the whole world. Computed tomography (CT) has been widely used in the diagnosis of this novel pneumonia.This study aims to understand the role of CT for the diagnosis and the main imaging manifestations of patients with COVID-19.Methods: We conducted a rapid review and meta-analysis on studies about the use of chest CT for the diagnosis of COVID-19. We comprehensively searched databases and preprint servers on chest CT for patients with COVID-19 between 1 January 2020 and 31 March 2020. The primary outcome was the sensitivity of chest CT imaging. We also conducted subgroup analyses and evaluated the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.Results: A total of 103 studies with 5,673 patients were included. Using reverse transcription polymerase chain reaction (RT-PCR) results as reference, a meta-analysis based on 64 studies estimated the sensitivity of chest CT imaging in COVID-19 was 99% (95% CI, 0.97-1.00). If case reports were excluded, the sensitivity in case series was 96% (95% CI, 0.93-0.99). The sensitivity of CT scan in confirmed patients under 18 years old was only 66% (95% CI, 0.15-1.00). The most common imaging manifestation was ground-glass opacities (GGO) which was found in 75% (95% CI, 0.68-0.82) of the patients. The pooled probability of bilateral involvement was 84% (95% CI, 0.81-0.88). The most commonly involved lobes were the right lower lobe (84%, 95% CI, 0.78-0.90) and left lower lobe (81%, 95% CI, 0.74-0.87). The quality of evidence was low

Rapid advice guidelines for management of children with COVID-19

“…The pooled probability of bilateral involvement was 84% (95% CI: 81% to 88%). The role of a chest CT scan in diagnosis of children with COVID-19 is therefore likely to be limited (39). 18).…”

Exploration of CT manifestations of different clinical types of novel coronavirus pneumonia

“…(II) Bacterial pneumonia: Bacterial pneumonia usually has an acute onset, with increased peripheral white blood cell counts, and the lesions occur in the lung parenchyma. Most of them are bronchial pneumonia and lobar pneumonia, which are the consolidation of the distribution of lung lobes or lung segments (13). (III) Mycoplasma pneumonia is manifested as ground glass shadow, lung lobe or lung segment consolidation shadow, visible pleural thickening, pleural effusion and hilar lymph node enlargement are more common (14).…”

Corona virus disease (COVID-19): Epidemiology, Pathogenesis, Diagnosis, Therapeutics under trial and Prevention

“…On the other hand, several studies of He et al, (2020); Xu et al, (2020b) suggest that CT scan bears higher sensitivity than RT-PCR in COVID-19 diagnosis. Therefore, He et al, (2020); Lv et al, (2020) recently recommended that to overcome the false negative results of RT-PCR, the suspected patients with symptoms of COVID-19 should make chest CT scan. Accordingly, the use of both technologies is advised for confirming the COVID-19 infection.…”