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Meta-Analysis
. 2020 Dec 28;10(1):22402.
doi: 10.1038/s41598-020-80061-2.

A meta-analysis of accuracy and sensitivity of chest CT and RT-PCR in COVID-19 diagnosis

Fatemeh Khatami  1 , Mohammad Saatchi  2 , Seyed Saeed Tamehri Zadeh  1 , Zahra Sadat Aghamir  3 , Alireza Namazi Shabestari  4 , Leonardo Oliveira Reis  5 , Seyed Mohammad Kazem Aghamir  6
Affiliations
Meta-Analysis

A meta-analysis of accuracy and sensitivity of chest CT and RT-PCR in COVID-19 diagnosis

Fatemeh Khatami et al. Sci Rep. .

Abstract

Nowadays there is an ongoing acute respiratory outbreak caused by the novel highly contagious coronavirus (COVID-19). The diagnostic protocol is based on quantitative reverse-transcription polymerase chain reaction (RT-PCR) and chests CT scan, with uncertain accuracy. This meta-analysis study determines the diagnostic value of an initial chest CT scan in patients with COVID-19 infection in comparison with RT-PCR. Three main databases; PubMed (MEDLINE), Scopus, and EMBASE were systematically searched for all published literature from January 1st, 2019, to the 21st May 2020 with the keywords "COVID19 virus", "2019 novel coronavirus", "Wuhan coronavirus", "2019-nCoV", "X-Ray Computed Tomography", "Polymerase Chain Reaction", "Reverse Transcriptase PCR", and "PCR Reverse Transcriptase". All relevant case-series, cross-sectional, and cohort studies were selected. Data extraction and analysis were performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5. Among 1022 articles, 60 studies were eligible for totalizing 5744 patients. The overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan compared to RT-PCR were 87% (95% CI 85-90%), 46% (95% CI 29-63%), 69% (95% CI 56-72%), and 89% (95% CI 82-96%), respectively. It is important to rely on the repeated RT-PCR three times to give 99% accuracy, especially in negative samples. Regarding the overall diagnostic sensitivity of 87% for chest CT, the RT-PCR testing is essential and should be repeated to escape misdiagnosis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
The number of articles during several steps based on the PRISMA flow diagram (2009). (http://www.prisma-statement.org/PRISMAStatement/CitingAndUsingPRISMA.aspx).
Figure 2
Figure 2
Sensitivity and specificity of 60 included studies.
Figure 3
Figure 3
Summary of sensitivity and 95% CI, generated by the STATA.
Figure 4
Figure 4
Summary of specificity and 95% CI, generated by the STATA.
Figure 5
Figure 5
Summary of positive predictive value and 95% CI of 18 studies, generated by the STATA.
Figure 6
Figure 6
Summary of negative predictive value and 95% CI of six studies, generated by the STATA.
Figure 7
Figure 7
The Deeks’ funnel plot curve for assessment of publication bias.
See this image and copyright information in PMC

References

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