The guideline of Diagnosis and Treatment of Pneumonitis Caused by 2019-nCoV (trial sixth version) published by the China government recommended chest CT as an effective method to screen suspicious cases. Therefore, some experts suggested that chest CT could be regarded as a diagnosis standard of COVID-19. Moreover, shortage of laboratory test kits limited the use of RT-PCR with the spread of the epidemic, especially in regions severely affected by the epidemic. At present, the real-time reverse transcription polymerase chain reaction (RT-PCR) assay remains the standard of reference, but it was reported that false-negative RT-PCR was not rare and, in these patients, initial chest CT might present abnormal findings indicating COVID-19. The keys to control COVID-19 are early discovery, early isolation, and early treatment. With virus spreading globally, the WHO characterizes COVID-19 as a pandemic. Thereafter, the WHO named the disease as coronavirus disease 2019 (COVID-19). In December 2019, an outbreak of pneumonia associated with a novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported in Wuhan, Hubei Province, China. Chest CT has a high sensitivity for detecting COVID-19, especially in a region with severe epidemic, which is helpful to early recognize suspicious cases and might contribute to confine epidemic.In the context of emergency disease control, chest CT provides a fast, convenient, and effective method to early recognize suspicious cases and might contribute to confine epidemic.
ConclusionĬhest CT offers the great sensitivity for detecting COVID-19, especially in a region with severe epidemic situation. In the regions other than Wuhan, the sensitivity varied from 61 to 98%. After dividing the studies into two groups based on the study site, we found that the sensitivity of chest CT was great in Wuhan (the most affected city by the epidemic) and the sensitivity values were very close to each other (97%, 96%, and 99%, respectively).
There was substantial heterogeneity according to Cochran’s Q test ( p < 0.01) and Higgins I 2 heterogeneity index (96% for sensitivity). Pooled sensitivity was 92% (95% CI = 86–96%), and two studies reported specificity (25% and 33%, respectively). The risks of bias in all studies were moderate in general. Sixteen studies ( n = 3186 patients) were included. The methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. We included studies providing information regarding diagnostic test accuracy of chest CT for COVID-19 detection. PubMed, Embase, Web of Science, and CNKI were searched up to March 12, 2020. The purpose of this article was to perform a systematic review and meta-analysis regarding the diagnostic test accuracy of chest CT for detecting coronavirus disease 2019 (COVID-19).
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