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Review
. 2020 Nov 28;10(12):1023.
doi: 10.3390/diagnostics10121023.

Prevalence of COVID-19 Diagnostic Output with Chest Computed Tomography: A Systematic Review and Meta-Analysis

Temitope Emmanuel Komolafe  1   2 , John Agbo  3   4 , Ebenezer Obaloluwa Olaniyi  5   6 , Kayode Komolafe  7 , Xiaodong Yang  2   8
Affiliations
Review

Prevalence of COVID-19 Diagnostic Output with Chest Computed Tomography: A Systematic Review and Meta-Analysis

Temitope Emmanuel Komolafe et al. Diagnostics (Basel). .

Abstract

Background: The pooled prevalence of chest computed tomography (CT) abnormalities and other detailed analysis related to patients' biodata like gender and different age groups have not been previously described for patients with coronavirus disease 2019 (COVID-19), thus necessitating this study. Objectives: To perform a meta-analysis to evaluate the diagnostic performance of chest CT, common CT morphological abnormalities, disease prevalence, biodata information, and gender prevalence of patients.

Methods: Studies were identified by searching PubMed and Science Direct libraries from 1 January 2020 to 30 April 2020. Pooled CT positive rate of COVID-19 and RT-PCR, CT-imaging features, history of exposure, and biodata information were estimated using the quality effect (QE) model.

Results: Out of 36 studies included, the sensitivity was 89% (95% CI: 80-96%) and 98% (95% CI: 90-100%) for chest CT and reverse transcription-polymerase chain reaction (RT-PCR), respectively. The pooled prevalence across lesion distribution were 72% (95% CI: 62-80%), 92% (95% CI: 84-97%) for lung lobe, 88% (95% CI: 81-93%) for patients with history of exposure, and 91% (95% CI: 85-96%) for patients with all categories of symptoms. Seventy-six percent (95% CI: 67-83%) had age distribution across four age groups, while the pooled prevalence was higher in the male with 54% (95% CI: 50-57%) and 46% (95% CI: 43-50%) in the female.

Conclusions: The sensitivity of RT-PCR was higher than chest CT, and disease prevalence appears relatively higher in the elderly and males than children and females, respectively.

Keywords: COVID-19; age distribution; computed tomography; meta-analysis; prevalence.

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Conflict of interest statement

The authors declare no competing financial interest or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure A1
Figure A1
Forest plot of the pooled prevalence of male patients.
Figure A2
Figure A2
Forest plot of the pooled prevalence of female patients.
Figure A3
Figure A3
Funnel plots; the likelihood of publication bias was low for studies on (a) chest Computed tomography (CT) scans (b) Gender distribution (male and female).
Figure 1
Figure 1
Study of inclusion and exclusion flowcharts adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). n = number of literature and PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-analyses, CT = Computed tomography.
Figure 2
Figure 2
Forest plot of the pooled sensitivity of chest CT for detection of coronavirus disease 2019 (COVID-19) infection.
Figure 3
Figure 3
Forest plot of the pooled sensitivity studies for reverse transcriptase-polymerase chain reaction (RT-PCR).
Figure 4
Figure 4
Forest plot of the pooled prevalence of morphological abnormalities among 34 patients.
Figure 5
Figure 5
Forest plot of the studies for the pooled prevalence of exposure history for 28 included patients.
Figure 6
Figure 6
Forest plot of the pooled prevalence of grouped clinical symptoms (i.e., mild, moderate, and severe symptoms).
Figure 7
Figure 7
Forest plot of the prevalence of age distribution among patients, which include children, youth, adults, and elderly.
Figure 8
Figure 8
Stacked bar chart of QUADAS-2 domain versus the proportion of included studies for 36 studies (a) Risk of bias (b) Concerns regarding applicability. QUADAS-2 = Quality Assessment of Diagnostic Accuracy Studies 2.
See this image and copyright information in PMC

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