Role of Chest Computed Tomography versus Real Time Reverse Transcription Polymerase Chain Reaction for Diagnosis of COVID-19: A Systematic Review and Meta-Analysis

Abstract

Background. The current global pandemic of COVID-19 is considered a public health emergency. The diagnosis of COVID-19 depends on detection of the viral nucleic acid by real time reverse transcription polymerase chain reaction (RT-PCR). However, false-negative RT-PCR tests are reported and could hinder the control of the pandemic. Chest computed tomography could achieve a more reliable diagnosis and represent a complementary diagnostic tool. Aim. To perform a meta-analysis and systematic review to find out the role of chest computed tomography versus RT-PCR for precise diagnosis of COVID-19 infection. Methods. We searched three electronic databases (PubMed, ScienceDirect, and Scopus) from April 1 to April 20, 2020, to find out articles including the accuracy of chest computed tomography scan versus RT-PCR for diagnosis of SARS-CoV-2 infection. Observational studies, case series, and case reports were included. Results. A total of 238 articles were retrieved from the search strategy. Following screening, 39 articles were chosen for full text assessment and finally 35 articles were included for qualitative and quantitative analysis. Chest computed tomography showed a wide range of sensitivity varied from 12%–100%. Conclusion. Chest computed tomography is playing a key role for diagnosis and detection of COVID-19 infection. Computed tomography image findings may precede the initially positive RT-PCR assay.

The incidence of moderate and severe COVID-19 at Zagazig University Hospitals: A single center experience in Egypt

“…(1) The cases were diagnosed based on clinical symptoms, laboratory investigations, and chest CT scans (2) SARS-CoV-2 RT-PCR or antigen testing was not accessible at E&A or outpatient departments (3) The cases were not followed up after being transferred from the E&A or outpatient departments (4) The factors affecting the occurrence of the disease were not evaluated in this study (5) Being a hospital-based study, the data still may not reflect all cases in the community who sought medical advice at other public or private facilities.…”

“…Multiple false negative findings have been documented in individuals with typical COVID-19 clinical and radiological evidence. Therefore; the role of chest CT for the diagnosis of COVID-19 was evolved [5]. The 7 th Chinese Novel Coronavirus Pneumonia Diagnosis and Treatment Plan incorporated chest CT imaging into the criteria that clinically define COVID-19 [6].…”

Incorporating Feature Selection Methods into Machine Learning-Based Covid-19 Diagnosis

“…In line with these symptoms that occur in the patient, many active methods are used for the diagnosis of the disease. The diagnosis of Covid-19 is based on some ancillary tests such as the patient's clinical symptoms, contact history and determination of viral nucleic acids, detection of lung findings by computed tomography, demonstration of seroconversion [2]. Radiological methods alone are not sufficient in the diagnosis stage and require additional laboratory tests.…”