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住院COVID-19患者的胸部计算机断层扫描结果:系统评价与荟萃分析

Chest computed tomography findings in hospitalized COVID-19 patients: a systematic review and meta-analysis.

作者信息

Muhammad Syed Zaki, Ahmed Areeba, Shahid Izza, Khalid Abdullah, Menezes Ritesh G, Sheikh Muhammad Usman, Siddiqi Tariq Jamal, Usman Muhammad Shariq, Khosa Faisal

机构信息

Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan.

Department of Internal Medicine, Ziauddin Medical University, Karachi, Pakistan.

出版信息

Infez Med. 2020 Sep 1;28(3):295-301.

Abstract

Most studies evaluating chest computed tomography (CT) features in coronavirus disease 2019 (COVID-19) have been small-sized and have presented varied findings. We aim to systematically review these studies and to conduct a meta-analysis of their results to provide a well-powered assessment of chest CT findings in patients with COVID-19. PubMed and EMBASE databases were systematically searched to identify published studies that evaluated chest CT findings in COVID-19 patients. Data regarding study characteristics and CT findings, including distribution of lesions, the lobe of lung involved, lesion densities, and radiological patterns, were extracted. Arcsine transformed proportions from individual studies were pooled using a random-effects model to derive pooled proportions (PPs) and 95% confidence intervals (CIs). A total of fifty-four studies (n=2693 confirmed COVID-19 patients) were included in the final review. Prevalence of different CT findings varied across studies; however, the most common findings were bilateral pulmonary involvement (PP: 74.1% [68.4%, 79.5%]; I2 = 85.76%), ground glass opacification (PP: 64.6% [57.6%, 71.4%]; I2 = 91.52%), involvement of the left lower lobe (PP: 71.2% [58.9%, 82.1%]; I2 = 90.91%), and subpleural distribution of lesions (PP: 57.2% [39.0%, 74.3%]; I2 = 93.08%). Multivariate meta-regression revealed a positive association between prevalence of air bronchograms and average age of the population (p=0.013). Bilateral ground glass opacification, a subpleural distribution of lesions, and involvement of the left lower lobe were the most notable chest CT findings in COVID-19 patients.

摘要

大多数评估2019冠状病毒病(COVID-19)胸部计算机断层扫描(CT)特征的研究规模较小,且结果各异。我们旨在系统回顾这些研究,并对其结果进行荟萃分析,以便对COVID-19患者的胸部CT表现进行有力评估。我们系统检索了PubMed和EMBASE数据库,以确定评估COVID-19患者胸部CT表现的已发表研究。提取了有关研究特征和CT表现的数据,包括病变分布、受累肺叶、病变密度和放射学模式。使用随机效应模型汇总各研究的反正弦转换比例,以得出汇总比例(PPs)和95%置信区间(CIs)。最终综述纳入了54项研究(n = 2693例确诊的COVID-19患者)。不同CT表现的患病率在各研究中有所不同;然而,最常见的表现为双侧肺部受累(PP:74.1% [68.4%,79.5%];I2 = 85.76%)、磨玻璃影(PP:64.6% [57.6%,71.4%];I2 = 91.52%)、左肺下叶受累(PP:71.2% [58.9%,82.1%];I2 = 90.91%)和病变的胸膜下分布(PP:57.2% [39.0%,74.3%];I2 = 93.08%)。多变量荟萃回归显示,空气支气管征的患病率与人群平均年龄之间存在正相关(p = 0.013)。双侧磨玻璃影、病变的胸膜下分布和左肺下叶受累是COVID-19患者最显著的胸部CT表现。

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