Diagnostic Yield of Computed Tomography for the Identification of Coronavirus Disease 2019 Using Repeated Reverse Transcriptase Polymerase Chain Reaction Testing or Confirmed True-Negative State as Reference Standard: Systematic Review and Meta-Analysis

AbstractPurposeTo compare the performance of chest computed tomography (CT) scan versus reverse transcription polymerase chain reaction (RT-PCR) in the initial diagnostic assessment of coronavirus disease 2019 (COVID-19) patients.MethodsA systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A search of electronic information was conducted to identify all relevant studies comparing the diagnostic performance of chest CT scan versus RT-PCR in COVID-19 suspected cases. Sensitivity, specificity and accuracy were primary outcome measures. Secondary outcome measures included other test performance characteristics, discrepant findings between both investigations and main chest CT findings. Random effects modelling was used for the analyses.ResultsEight non-randomised retrospective studies enrolling 1910 patients were identified. Chest CT was more sensitive but less specific than RT-PCR. Accuracy was not statistically significantly different between chest CT and RT-PCR for the identification and exclusion of COVID-19 cases (Odds Ratio [OR] = 0.40, P = 0.15) in the context of hospitalised patients in a pandemic. Chest CT was shown to detect patients with false-negative RT-PCR results and true positives. Ground-glass opacities and consolidations were the most common chest CT manifestations.ConclusionsChest CT is not superior to RT-PCR for the initial detection of COVID-19 and has more false positives. It is likely to be useful in confirming COVID-19 in patients with a suspicious clinical presentation, but who have a false-negative SARS-CoV-2 RT-PCR test.Key Points‐Chest computed tomography (CT) is more sensitive but less specific in detecting and excluding coronavirus disease 2019 (COVID-19) when compared to reverse transcription polymerase chain reaction (RT-PCR).‐Accuracy of chest CT is not significantly different from RT-PCR for COVID-19 cases.‐Chest CT can detect false-negative and true-positive RT-PCR cases.

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Reverse-transcriptase polymerase chain reaction versus chest computed tomography for detecting early symptoms of COVID-19. A diagnostic accuracy systematic review and meta-analysis

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2020.034306072020 ◽

2020 ◽

Vol 138 (5) ◽

pp. 422-432

Author(s):

Márcio Luís Duarte ◽

Lucas Ribeiro dos Santos ◽

Andrea Carla de Souza Contenças ◽

Wagner Iared ◽

Maria Stella Peccin ◽

...

Keyword(s):

Computed Tomography ◽

Systematic Review ◽

Polymerase Chain Reaction ◽

Diagnostic Accuracy ◽

Reverse Transcriptase ◽

Meta Analysis ◽

Chain Reaction ◽

Chest Computed Tomography ◽

Early Symptoms ◽

Polymerase Chain

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Accuracy of chest computed tomography and reverse transcription polymerase chain reaction in diagnosis of 2019 novel coronavirus disease; a systematic review and meta-analysis

Immunopathologia Persa ◽

10.34172/ipp.2021.36 ◽

2021 ◽

Vol 7 (2) ◽

pp. e36-e36

Author(s):

Kamyar Shokraee ◽

Hossein Mahdavi ◽

Parsa Panahi ◽

Farnoosh Seirafianpour ◽

Amir Mohammad Jahromizadeh ◽

...

Keyword(s):

Computed Tomography ◽

Systematic Review ◽

Polymerase Chain Reaction ◽

Reverse Transcription ◽

Meta Analysis ◽

Chest Ct ◽

Rt Pcr ◽

Chain Reaction ◽

Chest Computed Tomography ◽

Polymerase Chain

Introduction: This study aims to measure the diagnostic accuracy of chest computed tomography (CT) and reverse transcription polymerase chain reaction assay (RT-PCR) in COVID-19 in a systematic review and meta-analysis. Methods: PubMed, Scopus, Embase, and Google Scholar, WHO, SSRN, and MedRxiv have been searched on March 26, 2020 for all the alternative names of the disease and virus. Risk of bias assessment was based on QUADAS-2. Data from English-language studies after January 12, 2019 were pooled to calculate necessary diagnostic values and underwent diagnostic test accuracy, random-effects, proportions, and subgroup meta-analysis. Results: Pooled from 27 included studies, the sensitivity of chest CT was calculated 96.6%, specificity 22.5%, diagnostic odds ratio (DOR) 8.2, positive likelihood ratio (PLR) 1.2 (95% CI: 1.1-1.4), and negative likelihood ratio (NLR) 0.15 (95% CI: 0.1-0.3). The sensitivity for initial RT-PCR was 79.7%, the specificity 100%, and NLR 0.18. Conclusion: Considering the results, in order to diagnose COVID-19 (coronavirus disease 2019), it is recommended to initially performing chest CT to rule out the uninfected people. In suspicious cases, we suggest RT-PCR to confirm the disease. Performing serial RT-PCR instead of the one-time test is highly recommended, to let the viral loads reach the diagnostic levels, especially in cases of high clinical suspicion.

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Role of Chest Computed Tomography versus Real Time Reverse Transcription Polymerase Chain Reaction for Diagnosis of COVID-19: A Systematic Review and Meta-Analysis

Interdisciplinary Perspectives on Infectious Diseases ◽

10.1155/2021/8798575 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Dina M. Ali ◽

Lamiaa G. Zake ◽

Nevine K. El Kady

Keyword(s):

Computed Tomography ◽

Systematic Review ◽

Polymerase Chain Reaction ◽

Reverse Transcription ◽

Meta Analysis ◽

Rt Pcr ◽

Chain Reaction ◽

Chest Computed Tomography ◽

Polymerase Chain

Background. The current global pandemic of COVID-19 is considered a public health emergency. The diagnosis of COVID-19 depends on detection of the viral nucleic acid by real time reverse transcription polymerase chain reaction (RT-PCR). However, false-negative RT-PCR tests are reported and could hinder the control of the pandemic. Chest computed tomography could achieve a more reliable diagnosis and represent a complementary diagnostic tool. Aim. To perform a meta-analysis and systematic review to find out the role of chest computed tomography versus RT-PCR for precise diagnosis of COVID-19 infection. Methods. We searched three electronic databases (PubMed, ScienceDirect, and Scopus) from April 1 to April 20, 2020, to find out articles including the accuracy of chest computed tomography scan versus RT-PCR for diagnosis of SARS-CoV-2 infection. Observational studies, case series, and case reports were included. Results. A total of 238 articles were retrieved from the search strategy. Following screening, 39 articles were chosen for full text assessment and finally 35 articles were included for qualitative and quantitative analysis. Chest computed tomography showed a wide range of sensitivity varied from 12%–100%. Conclusion. Chest computed tomography is playing a key role for diagnosis and detection of COVID-19 infection. Computed tomography image findings may precede the initially positive RT-PCR assay.

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