Can chest CT improve sensitivity of COVID-19 diagnosis in comparison to PCR? A meta-analysis study
Tóm tắt
In December 2019, SARS-CoV-2 was identified as the causative agent of pneumonia cases in China. This virus is spread by coughing or sneezing and can infect other persons by on contacting mucous membranes. SARS-Cov-2 most frequent serious manifestation is pneumonia. Chest computed tomography in COVID-19 patients usually shows ground-glass opacities that may be accompanied by consolidation lesions. Early diagnosis of the disease and rapid isolation of the patient is of great importance. So far, confirmation of COVID-19 infection is made by RT-PCR of nasopharyngeal or respiratory specimens. Recent research reported that the sensitivity of computed tomography in diagnosing COVID-19 is 98% while RT-PCR sensitivity is 71%. Herein, we compare the sensitivity of both chest CT and RT-PCR in diagnosing COVID-19 at initial patient presentation through a meta-analysis study. Using MEDLINE database a systematic literature search was conducted to identify relevant published studies within from November 2019 to April 2020. Only articles with full text were examined to determine eligibility and extract data by two reviewers. It was decided to include studies mentioning sensitivity of chest CT scan and sensitivity of RT-PCR and both done at the same time. Potentially relevant 15,300 studies were identified in our search in MEDLINE whose titles were quickly reviewed. Potentially eligible studies missing any of the forementioned inclusion criteria were excluded. This process left 7 eligible articles that fulfilled the inclusion criteria and were thus included in the meta-analysis and used for further analyses. The meta-analysis study showed that chest CT may be beneficial in early detection of cases of COVID-19. Imaging, in adjunct to clinical and laboratory findings, should be used for monitoring of disease course, until further evidence is available.
Tài liệu tham khảo
Kannan S, Shaik Syed Ali P, Sheeza A, Hemalatha K (2020) COVID-19 (novel coronavirus 2019) – recent trends. Eur Rev Med Pharmacol Sci 24(4):2006–2011
Li Q, Guan X, Wu P et al (2020) Early Transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med
Guan WJ, Ni ZY, Hu Y et al (2020) Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med
Chan JF, Yuan S, Kok KH et al (2020) A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 395:514
Huang C, Wang Y, Li X et al (2020) Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395:497
Chen N, Zhou M, Dong X et al (2020) Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 395:507
Wang D, Hu B, Hu C et al (2020) Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA
Pan F, Ye T, Sun P, et al. Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia. Radiology 2020; :200370.
Zhao W, Zhong Z, Xie X et al (2020) Relation between chest CT findings and clinical conditions of coronavirus disease (COVID-19) pneumonia: a multicenter study. AJR Am J Roentgenol 1
Van Doremalen N, Bushmaker T, Morris DH et al (2020) Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med
Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, Xia L (2020) Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology 200642
Bernheim A, Mei X, Huang M et al (2020) Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology 200463
Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P et al (2020) Sensitivity of Chest CT for COVID-19: comparison to RT-PCR. Radiology. 200432
Liji T (2020) Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. News-Medical
Wong HYF, Lam HYS, Fong AH et al (2019) Frequency and distribution of chest radiographic findings in COVID-19 positive patients. Radiology. 201160 Epub 2019 Mar 27
Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J (2020) Chest CT for typical 2019-nCoV pneumonia: relationship to negative RT-PCR testing. Radiology. 200343
Li X, Zeng W, Li X et al (2020) CT imaging changes of corona virus disease 2019 (COVID-19): a multi-center study in Southwest China. J Transl Med 18:154
Xu G, Yang Y, Du Y et al (2020) Clinical pathway for early diagnosis of COVID-19: updates from experience to evidence-based practice. Clinic Rev Allerg Immunol 59:89–100
Center for Disease Control and Prevention. Interim guidelines for collecting, handling, and testing clinical specimens from persons under investigation (PUIs) for coronavirus disease 2019 (COVID-19). 2020. https://www.cdc.gov/coronavirus/2019-ncov/lab/guidelines-clinical-specimens.html. Published February 14, 2020. Accessed February 28, 2020. Google Scholar
Kanne JP, Little BP, Chung JH, Elicker BM, Ketail LH (2020) Essentials for radiologists on COVID-19: an update—radiology scientific expert panel. Radiology
Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X, Cui J, Xu W, Zang Y, Fayad ZA, Jacobi A, Li K, Li S, Shan H (2020) CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology
Shi H, Han X, Jiang N et al (2020) Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis
Li J, Xu Q, Cuomo R, Purushothaman V, Mackey T (2020) Data mining and content analysis of the Chinese social media platform Weibo during the early COVID-19 outbreak: retrospective observational infoveillance study. JMIR Public Health Surveill 6(2):e18700
ACR Recommendations for the use of chest radiography and computed tomography (CT) for suspected COVID-19 infection. Cited MARCH 22, 2020.
RCR position on the role of CT in patients suspected with COVID-19 infection [Internet]. Published on 12 March 2020. [cited 27 March 2020].
Royal Australian and New Zealand College of Radiology.COVID-19: position statements and guidance college position statements [Internet]. Advice on appropriate use of CT throughout the COVID-19 pandemic. [cited 9 April 2020].
Corrigendum to Canadian Association of Thoracic Radiology/Canadian Association of Radiologists Consensus Statement regarding chest imaging in suspected and confirmed COVID-19. Can Assoc Radiol J. 2020;846537120931222. [Epub, 2020 May 18].