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Meta-Analysis
. 2021 Apr:72:75-82.
doi: 10.1016/j.clinimag.2020.11.021. Epub 2020 Nov 11.

Diagnostic accuracy of CT and radiographic findings for novel coronavirus 2019 pneumonia: Systematic review and meta-analysis

Mandeep Garg  1 , Pankaj Gupta  2 , Muniraju Maralakunte  1 , Praveen Kumar-M  3 , Anindita Sinha  1 , Mandeep Kang  1 , Ritesh Agarwal  4 , Manavjit Singh Sandhu  1
Affiliations
Meta-Analysis

Diagnostic accuracy of CT and radiographic findings for novel coronavirus 2019 pneumonia: Systematic review and meta-analysis

Mandeep Garg et al. Clin Imaging. 2021 Apr.

Abstract

Purpose: To evaluate pooled prevalence, sensitivity, and specificity of chest computed tomography (CT) and radiographic findings for novel coronavirus-2019 (COVID-19) pneumonia.

Methods: We performed systematic literature search in PubMed and Embase to identify articles reporting baseline imaging findings of COVID-19 pneumonia. The quality of the articles was assessed using NIH quality assessment tool for case series studies. The pooled prevalence, sensitivity, specificity, and diagnostic odds ratio of imaging findings were calculated.

Results: Fifty-six studies (6007 patients, age, 2.1-70 years, 2887 females, 5762 CT, 396 radiographs,) were included. The mean interval between onset of symptoms and CT acquisition was 1-8 days. On CT, the pooled prevalence of ground glass opacities (GGO), GGO plus consolidation, and consolidation only was 66.9% (95% CI 60.8-72.4%), 44.9% (38.7-51.3%), and 32.1 (23.6-41.9%) respectively. Pooled sensitivity and specificity of GGO on CT was 73% (71%-80%) and 61% (41%-78%), respectively. For GGO plus consolidation and consolidation only, the pooled sensitivities/ specificities were 58% (48%-68%)/ 58% (41%-73%) and 49% (20%-78%)/ 56% (30%-78%), respectively. The pooled prevalence of GGO and consolidation on chest radiograph was 38.7% (22.2%-58.3%) and 46.9% (29.7%-64.9%), respectively. The diagnostic accuracy of radiographic findings could not be assessed due to small number of studies.

Conclusion: GGO on CT has the highest diagnostic performance for COVID-19 pneumonia, followed by GGO plus consolidation and consolidation only. However, the moderate to low sensitivity and specificity suggest that CT should not be used as the primary tool for diagnosis. Chest radiographic abnormalities are seen in half of the patients.

Keywords: Covid-19; Imaging; Systematic review.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Flowchart of study inclusion.
Fig. 2
Fig. 2
Forest plots demonstrate the pooled prevalence of GGO, GGO plus consolidation and consolidation only on CT.
Fig. 3
Fig. 3
Forest plots demonstrate the pooled sensitivity, specificity, diagnostic odds ratio and hsROC of GGO on CT.
Fig. 4
Fig. 4
Forest plots demonstrate the pooled sensitivity, specificity, diagnostic odds ratio and hsROC of GGO plus consolidation on CT.
Fig. 5
Fig. 5
Forest plots demonstrate the pooled sensitivity, specificity, diagnostic odds ratio and hsROC of consolidation only on CT.
See this image and copyright information in PMC

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References

    1. World Health Organization Director-General's remarks at the media briefing on 2019-nCoV on 11 February 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at... (Accessed on February 12, 2020)
    1. Centers for Disease Control and Prevention Interim guidelines for collecting, handling, and testing clinical specimens from persons under investigation (PUIs) for coronavirus disease 2019 (COVID-19). February 14, 2020. https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specim...
    1. van Doremalen N., Bushmaker T., Morris D.H. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564–1567. - PMC - PubMed
    1. Chen N., Zhou M., Dong X. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–513. - PMC - PubMed
    1. Wang W., Xu Y., Gao R. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA. 2020;323(18):1843–1844. - PMC - PubMed