Article type
Year
Abstract
Background: The outbreak of the coronavirus disease 2019 (COVID-19) has had a massive impact on the whole world. As computed tomography (CT) has been widely used in the diagnosis of this novel pneumonia, it is essential to understand the role of CT for the diagnosis and the main imaging manifestations of patients with COVID-19.
Objectives: To estimate the probability of positive findings in the initial CT examination and to investigate the main imaging manifestation in patients with COVID-19.
Methods: We conducted a systematic 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 29 February 2020. The primary outcome is the initial sensitivity CT examination. We also conducted subgroup analyses and evaluated the quality of evidence using the GRADE approach.
Results: A total of 56 studies with 3380 patients were included. A meta-analysis of 37 studies estimated the probability of positive results in the initial CT examination to be 98% (95%CI, 0.94-1.00). This probability was slightly higher in Hubei (99%, 95%CI, 0.97-1.00) than outside of Hubei (95%, 95%CI, 0.89-0.99). If case reports were excluded, the probability was 94% (95%CI, 0.90-0.98). The positive rate of initial CT examination in children was only 50% (5%CI, 0.07-0.94). The most common imaging manifestation was GGO which was found in 63% (95%CI, 0.53-0.73) of the patients. The pooled probability of bilateral involvement was 84% (95%CI, 0.78-0.88). The quality of evidence was low across all outcomes.
Conclusions: In conclusion, this meta-analysis indicated that almost all patients with COVID-19 presented abnormal findings in their initial CT scan. Therefore, CT can potentially be used to assist in the diagnosis of COVID-19. However, considering low sensitivity of CT scan in children with COVID-19 and the risk it may pose, we do not recommend it as a routine diagnostic tool for pediatric patients.
Patient or healthcare consumer involvement: none
Objectives: To estimate the probability of positive findings in the initial CT examination and to investigate the main imaging manifestation in patients with COVID-19.
Methods: We conducted a systematic 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 29 February 2020. The primary outcome is the initial sensitivity CT examination. We also conducted subgroup analyses and evaluated the quality of evidence using the GRADE approach.
Results: A total of 56 studies with 3380 patients were included. A meta-analysis of 37 studies estimated the probability of positive results in the initial CT examination to be 98% (95%CI, 0.94-1.00). This probability was slightly higher in Hubei (99%, 95%CI, 0.97-1.00) than outside of Hubei (95%, 95%CI, 0.89-0.99). If case reports were excluded, the probability was 94% (95%CI, 0.90-0.98). The positive rate of initial CT examination in children was only 50% (5%CI, 0.07-0.94). The most common imaging manifestation was GGO which was found in 63% (95%CI, 0.53-0.73) of the patients. The pooled probability of bilateral involvement was 84% (95%CI, 0.78-0.88). The quality of evidence was low across all outcomes.
Conclusions: In conclusion, this meta-analysis indicated that almost all patients with COVID-19 presented abnormal findings in their initial CT scan. Therefore, CT can potentially be used to assist in the diagnosis of COVID-19. However, considering low sensitivity of CT scan in children with COVID-19 and the risk it may pose, we do not recommend it as a routine diagnostic tool for pediatric patients.
Patient or healthcare consumer involvement: none