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

Abstract

Purpose To 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. Methods A 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. Results Eight 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. Conclusions Chest 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.

Comparison of Chest Computed Tomography (CT) Imaging Patterns and Severity among COVID-19 Patients during the First and Fourth Waves in Addis Ababa, Ethiopia

“…Reverse transcriptase polymerase chain reaction (RT-PCR) performed on nasopharyngeal and oropharyngeal swab is the gold standard for diagnosing COVID-19 [6]. However, chest CT has become an important diagnostic tool for COVID-19 when used in close combination with clinical presentation and epidemiological evidence for the disease.…”

DIAG a Diagnostic Web Application Based on Lung CT Scan Images and Deep Learning

“…SARS-CoV-2 RT-PCR is the gold standard diagnosis. Although it can be useful to do imaging diagnosis for patients with clinical signs of Covid-19 and negative initial molecular test [2], most of the findings observed in CT-scans are "ground glass opacities", "crazy paving" and "reversed halo sign" [1].…”

Descriptive Analysis of Chest Computed Tomography Scan in Coronavirus Disease 2019 Pneumonia: Correlation with Reverse Transcription-polymerase Chain Reaction and Clinical Features

“…The infectious agent responsible for this outbreak was identified to be a new type of coronavirus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the disease caused by this new virus was officially named coronavirus disease 2019 (COVID-19) [2]. Human-to-human transmission was confirmed shortly after [3], primarily through respiratory droplets [4]. As a result, COVID-19 was able to rapidly spread throughout China and eventually to other countries worldwide.…”

“…Diagnosis of COVID-19 is confirmed by reverse transcription-polymerase chain reaction (RT-PCR), which amplifies the genetic material of SARS-CoV2 obtained from naso-oropharyngeal samples [10], and is considered the gold standard for COVID-19 detection [4]. https://oamjms.eu/index.php/mjms/index However, it typically takes hours to complete, and with a sensitivity ranging from 30% to 90%, it has a high false-negative rate [11].…”