Department of Otorhinolaryngology, University Hospital of Leicester, Leicester, UK.
Br J Radiol. 2021 Mar 1;94(1119):20201039. doi: 10.1259/bjr.20201039. Epub 2021 Jan 28.
To perform a systematic review and meta-analysis to compare the diagnostic accuracy of CT and initial reverse transcriptase polymerase chain reaction (RT-PCR) for detecting COVID-19 infection.
We searched three databases, PubMed, EMBASE, and EMCARE, to identify studies reporting diagnostic accuracy of both CT and RT-PCR in detecting COVID-19 infection between December 2019 and May 2020. For accurate comparison, only those studies that had patients undergoing both CT and RT-PCR were included. Pooled diagnostic accuracy of both the tests was calculated by using a bivariate random effects model.
Based on inclusion criteria, only 11 studies consisting of 1834 patients were included in the final analysis that reported diagnostic accuracy of both CT and RT-PCR, in the same set of patients. Sensitivity estimates for CT scan ranged from 0.69 to 1.00 and for RT-PCR varied ranging from 0.47 to 1.00. The pooled estimates of sensitivity for CT and RT-PCR were 0.91 [95% CI (0.84-0.97)] and 0.84 [95% CI (0.71-0.94)], respectively. On subgroup analysis, pooled sensitivity of CT and RT-PCR was 0.95 [95% CI (0.88-0.98)] and 0.91 [95% CI (0.80-0.96), = o.ooo1]. The pooled specificity of CT and RT-PCR was 0.31 [95% CI (0.035-0.84)] and 1.00 [95% CI (0.96-1.00)].
CT is more sensitive than RT-PCR in detecting COVID-19 infection, but has a very low specificity.
Since the results of a CT scan are available quickly, it can be used as an adjunctive initial diagnostic test for patients with a history of positive contact or epidemiological history.
进行系统评价和荟萃分析，比较 CT 和初始逆转录酶聚合酶链反应（RT-PCR）检测 COVID-19 感染的诊断准确性。
我们检索了三个数据库，即 PubMed、EMBASE 和 EMCARE，以确定 2019 年 12 月至 2020 年 5 月期间报告 CT 和 RT-PCR 检测 COVID-19 感染诊断准确性的研究。为了进行准确比较，仅纳入了同时进行 CT 和 RT-PCR 的患者的研究。使用双变量随机效应模型计算两种检测方法的汇总诊断准确性。
根据纳入标准，最终分析仅纳入了 11 项研究，这些研究共纳入了 1834 例患者，报告了同一组患者的 CT 和 RT-PCR 检测诊断准确性。CT 扫描的敏感性估计值范围为 0.69 至 1.00，而 RT-PCR 的范围为 0.47 至 1.00。CT 和 RT-PCR 的汇总敏感性估计值分别为 0.91[95%置信区间（0.84-0.97）]和 0.84[95%置信区间（0.71-0.94）]。亚组分析显示，CT 和 RT-PCR 的汇总敏感性分别为 0.95[95%置信区间（0.88-0.98）]和 0.91[95%置信区间（0.80-0.96）]，差异有统计学意义（P<0.001）。CT 和 RT-PCR 的汇总特异性分别为 0.31[95%置信区间（0.035-0.84）]和 1.00[95%置信区间（0.96-1.00）]。
CT 比 RT-PCR 更敏感，但特异性非常低。
由于 CT 扫描的结果很快就能得到，因此可以作为具有阳性接触史或流行病学史的患者的辅助初始诊断测试。
