Accuracy of Initial Chest Computed Tomography Scan for Diagnosis of COVID-19: A Systematic Review
Sameh Michel Hakim Fahmy, Waleed Hamed Abdelmenaem Nofal, Peter Naiem Abdelmassiah Ibrahim, Michael Nabil Botros Armanious- General Medicine
Abstract
Background
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus (SARS- COVID-19) with recent outbreak occurred on 11 March 2020. A computerized tomography (CT) scan for chest was proved to be a helpful tool for diagnosis of COVID-19 pneumonia. But little is known about its diagnostic accuracy.
Aim of the Work
This systematic review aims at determining current evidence regarding accuracy of initial chest CT scan for detection of COVID-19 infection.
Patients and Methods
We conducted an electronic search through different databases; PubMed, SCOPUS, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL). We included clinical trials whether randomized or nonrandomized prospective or retrospective cohorts, case control, cross sectional studies and case series larger than 10 cases). All studies that reported data about the diagnostic accuracy of initial chest CT for diagnosis of COVID-19 infection were enrolled. We evaluated the methodological quality for included studies using QUADAS-2 Risk of Bias tool.
Results
From a total 4617 screened citations, 40 studies met our inclusion criteria. We divided the identified studies into two groups: studies that reported both sensitivity and specificity (6 studies, n = 1431) and studies that included only positive COVID-19 cases from which we could estimate only sensitivity (34 studies, n = 3515). Among six studies that evaluated accuracy of CT chest, there was high sensitivity ranged from to 93% to 100% but CT chest specificity was low ranged from to 10% to 56%. Rest of 34 studies had a wide range of sensitivity between 61% and 100% with few studies reported sensitivity below 80%.
Conclusion
Our results suggest that CT chest is a great screening tool for COVID-19 with high sensitivity but it had low specificity. However, interpretation of CT chest along with other laboratory could enhance its diagnostic accuracy.