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Meta-Analysis
. 2020 Oct;30(10):5720-5727.
doi: 10.1007/s00330-020-06934-2. Epub 2020 May 15.

Chest CT for detecting COVID-19: a systematic review and meta-analysis of diagnostic accuracy

Buyun Xu  1 , Yangbo Xing  1 , Jiahao Peng  2 , Zhaohai Zheng  3 , Weiliang Tang  1 , Yong Sun  1 , Chao Xu  1 , Fang Peng  4
Affiliations
Meta-Analysis

Chest CT for detecting COVID-19: a systematic review and meta-analysis of diagnostic accuracy

Buyun Xu et al. Eur Radiol. 2020 Oct.

Abstract

Objective: The purpose of this article was to perform a systematic review and meta-analysis regarding the diagnostic test accuracy of chest CT for detecting coronavirus disease 2019 (COVID-19).

Methods: PubMed, Embase, Web of Science, and CNKI were searched up to March 12, 2020. We included studies providing information regarding diagnostic test accuracy of chest CT for COVID-19 detection. The methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity were pooled.

Results: Sixteen studies (n = 3186 patients) were included. The risks of bias in all studies were moderate in general. Pooled sensitivity was 92% (95% CI = 86-96%), and two studies reported specificity (25% [95% CI = 22-30%] and 33% [95% CI = 23-44%], respectively). There was substantial heterogeneity according to Cochran's Q test (p < 0.01) and Higgins I2 heterogeneity index (96% for sensitivity). After dividing the studies into two groups based on the study site, we found that the sensitivity of chest CT was great in Wuhan (the most affected city by the epidemic) and the sensitivity values were very close to each other (97%, 96%, and 99%, respectively). In the regions other than Wuhan, the sensitivity varied from 61 to 98%.

Conclusion: Chest CT offers the great sensitivity for detecting COVID-19, especially in a region with severe epidemic situation. However, the specificity is low. In the context of emergency disease control, chest CT provides a fast, convenient, and effective method to early recognize suspicious cases and might contribute to confine epidemic.

Key points: • Chest CT has a high sensitivity for detecting COVID-19, especially in a region with severe epidemic, which is helpful to early recognize suspicious cases and might contribute to confine epidemic.

Keywords: Coronaviruses; Pneumonias; X-ray computed tomography.

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Conflict of interest statement

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Figures

Fig. 1
Fig. 1
Flow diagram showing the study selection process for meta-analysis
Fig. 2
Fig. 2
Grouped bar charts of risk of bias (left) and concerns for applicability (right) of 10 included studies using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool
Fig. 3
Fig. 3
Coupled forest plots of pooled sensitivity and specificity. Numbers are pooled estimates (dots within squares) with 95% CIs (horizontal lines). Corresponding heterogeneity statistics are provided at the bottom
See this image and copyright information in PMC

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