Chest CT versus RT-PCR for the detection of COVID-19: systematic review and meta-analysis of comparative studies.
JRSM Open
; 12(5): 20542704211011837, 2021 May.
Article
in English
| MEDLINE | ID: covidwho-1241097
ABSTRACT
OBJECTIVES:
To compare the performance of chest computed tomography (CT) scan versus reverse transcription polymerase chain reaction (RT-PCR) as the reference standard in the initial diagnostic assessment of coronavirus disease 2019 (COVID-19) patients.DESIGN:
A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A search of electronic information was conducted using the following databases MEDLINE, EMBASE, EMCARE, CINAHL and the Cochrane Central Register of Controlled Trials.SETTING:
Studies that compared the diagnostic performance within the same patient cohort of chest CT scan versus RT-PCR in COVID-19 suspected patients.PARTICIPANTS:
Thirteen non-randomised studies enrolling 4092 patients were identified. MAIN OUTCOMEMEASURES:
Sensitivity, specificity and accuracy were primary outcome measures. Secondary outcomes included other test performance characteristics and discrepant findings between both investigations.RESULTS:
Chest CT had a median sensitivity, specificity and accuracy of 0.91 (range 0.82-0.98), 0.775 (0.25-1.00) and 0.87 (0.68-0.99), respectively, with RT-PCR as the reference. Importantly, early small, China-based studies tended to favour chest CT versus later larger, non-China studies.CONCLUSIONS:
A relatively high false positive rate can be expected with chest CT. It is possible it may still be useful to provide circumstantial evidence, however, in some patients with a suspicious clinical presentation of COVID-19 and negative initial Severe Acute Respiratory Syndrome Coronavirus 2 RT-PCR tests, but more evidence is required in this context. In acute cardiorespiratory presentations, negative CT scan and RT-PCR tests is likely to be reassuring.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
/
Reviews
/
Systematic review/Meta Analysis
Language:
English
Journal:
JRSM Open
Year:
2021
Document Type:
Article
Affiliation country:
20542704211011837
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