scholarly journals Prevalence of COVID-19 Diagnostic Output with Chest Computed Tomography: A Systematic Review and Meta-Analysis

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1023
Author(s):  
Temitope Emmanuel Komolafe ◽  
John Agbo ◽  
Ebenezer Obaloluwa Olaniyi ◽  
Kayode Komolafe ◽  
Xiaodong Yang
Keyword(s):  
Computed Tomography ◽  
Meta Analysis ◽  
Age Groups ◽  
Disease Prevalence ◽  
Chest Ct ◽  
Imaging Features ◽  
Rt Pcr ◽  
Chest Computed Tomography ◽  
Pooled Prevalence ◽  
History Of

Background: The pooled prevalence of chest computed tomography (CT) abnormalities and other detailed analysis related to patients’ biodata like gender and different age groups have not been previously described for patients with coronavirus disease 2019 (COVID-19), thus necessitating this study. Objectives: To perform a meta-analysis to evaluate the diagnostic performance of chest CT, common CT morphological abnormalities, disease prevalence, biodata information, and gender prevalence of patients. Methods: Studies were identified by searching PubMed and Science Direct libraries from 1 January 2020 to 30 April 2020. Pooled CT positive rate of COVID-19 and RT-PCR, CT-imaging features, history of exposure, and biodata information were estimated using the quality effect (QE) model. Results: Out of 36 studies included, the sensitivity was 89% (95% CI: 80–96%) and 98% (95% CI: 90–100%) for chest CT and reverse transcription-polymerase chain reaction (RT-PCR), respectively. The pooled prevalence across lesion distribution were 72% (95% CI: 62–80%), 92% (95% CI: 84–97%) for lung lobe, 88% (95% CI: 81–93%) for patients with history of exposure, and 91% (95% CI: 85–96%) for patients with all categories of symptoms. Seventy-six percent (95% CI: 67–83%) had age distribution across four age groups, while the pooled prevalence was higher in the male with 54% (95% CI: 50–57%) and 46% (95% CI: 43–50%) in the female. Conclusions: The sensitivity of RT-PCR was higher than chest CT, and disease prevalence appears relatively higher in the elderly and males than children and females, respectively.

scholarly journals Chest CT versus RT-PCR for the Detection of COVID-19: Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Mohammad Karam ◽  
Sulaiman Althuwaikh ◽  
Mohammad Alazemi ◽  
Ahmad Abul ◽  
Amrit Hayre ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Polymerase Chain Reaction ◽  
Meta Analysis ◽  
False Negative ◽  
Chest Ct ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Chest Computed Tomography ◽  
Polymerase Chain

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.

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

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.

scholarly journals Correlation between age, sex, and severity of Coronavirus disease-19 based on chest computed tomography severity scoring system

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Shimaa Farghaly ◽  
Marwa Makboul
Keyword(s):  
Computed Tomography ◽  
Scoring System ◽  
Fatal Outcome ◽  
Age Groups ◽  
Significant Risk ◽  
Chest Ct ◽  
Age Group ◽  
Severity Scoring ◽  
Chest Computed Tomography ◽  
Severity Of The Disease

Abstract Background Coronavirus disease 2019 (COVID-19) is the most recent global health emergency; early diagnosis of COVID-19 is very important for rapid clinical interventions and patient isolation; chest computed tomography (CT) plays an important role in screening, diagnosis, and evaluating the progress of the disease. According to the results of different studies, due to high severity of the disease, clinicians should be aware of the different potential risk factors associated with the fatal outcome, so chest CT severity scoring system was designed for semi-quantitative assessment of the severity of lung disease in COVID-19 patients, ranking the pulmonary involvement on 25 points severity scale according to extent of lung abnormalities; this study aims to evaluate retrospectively the relationship between age and severity of COVID-19 in both sexes based on chest CT severity scoring system. Results Age group C (40–49 year) was the commonest age group that was affected by COVID-19 by 21.3%, while the least affected group was group F (≥ 70 years) by only 6.4%. As regards COVID-RADS classification, COVID-RADS-3 was the most commonly presented at both sexes in all different age groups. Total CT severity lung score had a positive strong significant correlation with the age of the patient (r = 0.64, P < 0.001). Also, a positive strong significant correlation was observed between CT severity lung score and age in both males and females (r = 0.59, P < 0.001) and (r = 0.69, P < 0.001) respectively. Conclusion We concluded that age can be considered as a significant risk factor for the severity of COVID-19 in both sexes. Also, CT can be used as a significant diagnostic tool for the diagnosis of COVID-19 and evaluation of the progression and severity of the disease.

scholarly journals Clinical outcomes of hemodialysis patients infected with severe acute respiratory syndrome coronavirus 2 and impact of proactive chest computed tomography scans

2020 ◽  
Vol 13 (3) ◽  
pp. 328-333 ◽  
Author(s):  
Rui Wang ◽  
Hong He ◽  
Cong Liao ◽  
Hongtao Hu ◽  
Chun Hu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Invasive Mechanical Ventilation ◽  
Case Series ◽  
Ground Glass Opacity ◽  
High Sensitivity ◽  
Chest Ct ◽  
Maintenance Hemodialysis ◽  
Rt Pcr ◽  
Chest Computed Tomography ◽  
Reactive Protein

Abstract Background Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that first manifested in humans in Wuhan, Hubei Province, China, in December 2019, and has subsequently spread worldwide. Methods We conducted a retrospective, single-center case series of the seven maintenance hemodialysis (HD) patients infected with COVID-19 at Zhongnan Hospital of Wuhan University from 13 January to 7 April 2020 and a proactive search of potential cases by chest computed tomography (CT) scans. Results Of 202 HD patients, 7 (3.5%) were diagnosed with COVID-19. Five were diagnosed by reverse transcription polymerase chain reaction (RT-PCR) because of compatible symptoms, while two were diagnosed by RT-PCR as a result of screening 197 HD patients without respiratory symptoms by chest CT. Thirteen of 197 patients had positive chest CT features and, of these, 2 (15%) were confirmed to have COVID-19. In COVID-19 patients, the most common features at admission were fatigue, fever and diarrhea [5/7 (71%) had all these]. Common laboratory features included lymphocytopenia [6/7 (86%)], elevated lactate dehydrogenase [3/4 (75%)], D-dimer [5/6 (83%)], high-sensitivity C-reactive protein [4/4 (100%)] and procalcitonin [5/5 (100%)]. Chest CT showed bilateral patchy shadows or ground-glass opacity in the lungs of all patients. Four of seven (57%) received oxygen therapy, one (14%) received noninvasive and invasive mechanical ventilation, five (71%) received antiviral and antibacterial drugs, three (43%) recieved glucocorticoid therapy and one (14%) received continuous renal replacement therapy. As the last follow-up, four of the seven patients (57%) had been discharged and three patients were dead. Conclusions Chest CT may identify COVID-19 patients without clear symptoms, but the specificity is low. The mortality of COVID-19 patients on HD was high.

scholarly journals The utility of chest computed tomography (CT) and RT-PCR screening of asymptomatic patients for SARS-CoV-2 prior to semiurgent or urgent hospital procedures

2020 ◽  
Vol 41 (12) ◽  
pp. 1375-1377 ◽  
Author(s):  
Aditya S. Shah ◽  
Lara A. Walkoff ◽  
Ronald S. Kuzo ◽  
Matthew R. Callstrom ◽  
Michael J. Brown ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Tertiary Care ◽  
Case Series ◽  
Chest Ct ◽  
Study Cohort ◽  
Rt Pcr ◽  
Chest Computed Tomography ◽  
Tertiary Care Medical Center ◽  
Asymptomatic Patients

AbstractObjective:Presently, evidence guiding clinicians on the optimal approach to safely screen patients for coronavirus disease 2019 (COVID-19) to a nonemergent hospital procedure is scarce. In this report, we describe our experience in screening for SARS-CoV-2 prior to semiurgent and urgent hospital procedures.Design:Retrospective case series.Setting:A single tertiary-care medical center.Participants:Our study cohort included patients ≥18 years of age who had semiurgent or urgent hospital procedures or surgeries.Methods:Overall, 625 patients were screened for SARS-CoV-2 using a combination of phone questionnaire (7 days prior to the anticipated procedure), RT-PCR and chest computed tomography (CT) between March 1, 2020, and April 30, 2020.Results:Of the 625 patients, 520 scans (83.2%) were interpreted as normal; 1 (0.16%) had typical features of COVID-19; 18 scans (2.88%) had indeterminate features of COVID-19; and 86 (13.76%) had atypical features of COVID-19. In total, 640 RT-PCRs were performed, with 1 positive result (0.15%) in a patient with a CT scan that yielded an atypical finding. Of the 18 patients with chest CTs categorized as indeterminate, 5 underwent repeat negative RT-PCR nasopharyngeal swab 1 week after their initial swab. Also, 1 patient with a chest CT categorized as typical had a follow-up repeat negative RT-PCR, indicating that the chest CT was likely a false positive. After surgery, none of the patients developed signs or symptoms suspicious of COVID-19 that would indicate the need for a repeated RT-PCR or CT scan.Conclusion:In our experience, chest CT scanning did not prove provide valuable information in detecting asymptomatic cases of SARS-CoV-2 (COVID-19) in our low-prevalence population.

scholarly journals The multicenter study of Chest HRCT imaging characteristics of 2019 Novel Coronavirus (COVID-19) Pneumonia

2020 ◽  
Author(s):  
Zhehao Lyu ◽  
Meiji Ren ◽  
Lian-Ming Wu ◽  
Yuxin Yang ◽  
Yi-Bo Lu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Chest Ct ◽  
Imaging Features ◽  
Wholesale Market ◽  
High Resolution Computed Tomography ◽  
Imaging Characteristics ◽  
History Of ◽  
Novel Coronavirus

Abstract Background: In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A novel coronavirus was detected, capable of infecting humans, on 6 January 2020 and termed COVID-19. By 16 February 2020, there were 51857 confirmed cases with 2019-nCoV (COVID-19) pneumonia in 25 countries. COVID-19 can also lead to acute respiratory distress syndrome (ARDS).Methods: 149 patients with 2019 Novel Coronavirus (COVID-19)pneumonia(68 males, 81 females, ages 1-89)from 6 research centers in China were diagnosed with positive 2019 Novel Coronavirus(COVID-19)nucleic acids antibodies. And their high-resolution computed tomography(HRCT) imaging datas were evaluated.Results: 136/149(91.3%)patients had a clear history of exposure to Wuhan. Fever (122/149, 81.9%)and cough(83/149, 55.7%)were the most common symptoms. The main imaging characteristics within 4 days of onset included 30(20.13%) cases of pure ground glass opacities (P<0.05), 38(25.50%) cases of GGO with reticulation(P<0.01), 12(8.05%) cases of consolidation(P<0.01). In the 5-8 days group, the main imaging features included 71(47.65%) cases of pGGO(P<0.05), 69(46.31%) cases of GGO with reticulation(P<0.01). In the 9-12 days group, the main feature was 85(57.04%) cases with GGO with reticulation(P<0.01). In the group of 13-16 days group, the main imaging characteristics included 48(32.21%) cases of GGO with reticulation(P < 0.01), 34(22.82%) cases of consolidation(P<0.01).Conclusion: Patients infected with COVID-19 pneumonia show more chest CT characteristics within 5-8 days after the onset of disease. The main manifestations included pGGO, GGO with reticulation, consolidation and GGO with consolidation.

scholarly journals Can chest CT improve sensitivity of COVID-19 diagnosis in comparison to PCR? A meta-analysis study

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Heba Mahmoud ◽  
Mohamed Shehata Taha ◽  
Anas Askoura ◽  
Mohammed Aleem ◽  
Azza Omran ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Meta Analysis ◽  
Chest Ct ◽  
Main Body ◽  
Inclusion Criteria ◽  
Rt Pcr ◽  
Laboratory Findings ◽  
Analysis Study ◽  
Patient Presentation ◽  
Chest Ct Scan

Abstract Background 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. Main body 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. Results 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. Conclusion 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.

scholarly journals Coronavirus Disease 2019 (COVID-19) in Italy: features on Chest Computed Tomography using a structured report system

2020 ◽  
Author(s):  
Grassi Roberto ◽  
Fusco Roberta ◽  
Belfiore Maria Paola ◽  
Montanelli Alessandro ◽  
Patelli Gianluigi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Mean Value ◽  
Chest Ct ◽  
Viral Pneumonia ◽  
Mediastinal Lymphadenopathy ◽  
Rt Pcr ◽  
Chest Computed Tomography ◽  
Trunk Diameter ◽  
Structured Report ◽  
Report System

Abstract OBJECTIVE. To assess the use of a structured report system in the Chest Computed Tomography (CT) reporting of patients with suspicious viral pneumonia by COVID-19 and the evaluation of the main CT patterns.MATERIALS AND METHODS. This study included 134 patients (43 women and 91 men; 68.8 years of mean age, range 29-93 years) with suspicious COVID-19 viral infection evaluated by reverse transcription real-time fluorescence polymerase chain reaction (RT-PCR) test. All patients underwent CT examinations at the time of admission. CT images were reviewed by two radiologists who identified COVID-19 CT patterns using a structured reports.RESULTS. Temporal difference mean value between RT-PCRs and CT scan was 0.18 days ±2.0 days. CT findings were positive for viral pneumonia in 94.0% patients while COVID-19 was diagnosed at RT-PCR in 77.6% patients. Mean value of time for radiologist to complete the structured report was 8.5 min±2.4 min. The disease on chest CT predominantly affected multiple lobes and the main CT feature was GGOs with or without consolidation (96.8%). GGOs was predominantly bilateral (89.3%), peripheral (80.3%), multifocal/patching (70.5%). Consolidation disease was predominantly bilateral (83.9%) with prevalent peripheral (87.1%) and segmental (47.3%) distribution. Additional CT signs were the crazy-paving pattern in 75.4% of patients, the septal thickening in 37.3% of patients, the air bronchogram sign in 39.7% and the “reversed halo” sign in 23.8%. Less frequent characteristics at CT regard discrete pulmonary nodules, increased trunk diameter of the pulmonary artery, pleural effusion and pericardium effusion (7.9%, 6.3%, 14.3% and 16.7%, respectively). Barotrauma sign was absent in all the patients. High percentage (54.8%) of the patients had mediastinal lymphadenopathy.CONCLUSION. Using a Chest CT structured report, with a standardized language, we identified that the cardinal hallmarks of COVID-19 infection were bilateral, peripheral and multifocal/patching ground-glass opacities and bilateral consolidations with peripheral and segmental distribution.

scholarly journals Assessment of a Diagnostic Strategy Based on Chest Computed Tomography in Patients Hospitalized for COVID-19 Pneumonia: an observational study

2020 ◽  
Author(s):  
Marine Thieux ◽  
Anne-Charlotte Kalenderian ◽  
Aurélie Chabrol ◽  
Laurent Gendt ◽  
Emma Giraudier ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Observational Study ◽  
Sensitivity And Specificity ◽  
Chest Ct ◽  
Time Interval ◽  
Diagnostic Strategy ◽  
Rt Pcr ◽  
Chest Computed Tomography ◽  
Pcr Diagnosis ◽  
Significant Difference

AbstractObjectivesTo assess the relevance of a diagnostic strategy for COVID-19 based on chest computed tomography (CT) in patients with hospitalization criteria.SettingObservational study with retrospective analysis in a French emergency department (ED).Participants and interventionFrom March 3 to April 2, 2020, 385 adult patients presenting to the ED for suspected COVID-19 underwent an evaluation that included history, physical examination, blood tests, real-time reverse transcription-polymerase chain reaction (RT-PCR) and chest CT. When the time-interval between chest CT and RT-PCR assays was longer than 7 days, patients were excluded from the study. Only patients with hospitalization criteria were included. Diagnosis accuracy was assessed using the sensitivity and specificity of RT-PCR.OutcomesSensitivity and specificity of RT-PCR, chest CT (also accompanied by lymphopenia) were measured and were also analyzed by subgroups of age and sex.ResultsAmong 377 included subjects, RT-PCR was positive in 36%, while chest CT was compatible with a COVID-19 diagnosis in 59%. In the population with positive RT-PCR, there were more men (55% vs 37%, p=0.015), a higher frequency of reticular and, or, interlobular septal thickening (53% vs 31%, p=0.02) as well as a higher frequency of bilateral lesion distribution (98% vs 86%, p=0.01) compared to the population with negative RT-PCR. The proportion of lymphopenia was higher in men vs women (47% vs 39%, p=0.03) and varies between patients >80 versus 50-80 and p<0.001).Using CT as reference, RT-PCR obtained a sensitivity of 61%, specificity of 93%. There was a significant difference between CT and RT-PCR diagnosis performance (p<0.001). When CT was accompanied by lymphopenia, sensitivity and specificity of RT-PCR were respectively 71% and 94%. CT abnormalities and lymphopenia provided diagnosis in 29% of patients with negative PCR.ConclusionsChest CT had a superior yield than RT-PCR in COVID-19 hospitalized patients, especially when accompanied by lymphopenia.

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