Department of Radiology, The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People's Hospital of Suzhou, Suzhou, 215000, Jiangsu, People's Republic of China.
Department of Radiology, Beijing Youan Hospital Capital Medical University, Beijing, 100069, People's Republic of China.
Infect Dis Poverty. 2021 Oct 21;10(1):126. doi: 10.1186/s40249-021-00910-8.
The computed tomography (CT) diagnostic value of COVID-19 is controversial. We summarized the value of chest CT in the diagnosis of COVID-19 through a meta-analysis based on the reference standard.
All Chinese and English studies related to the diagnostic value of CT for COVID-19 across multiple publication platforms, was searched for and collected. Studies quality evaluation and plotting the risk of bias were estimated. A heterogeneity test and meta-analysis, including plotting sensitivity (Sen), specificity (Spe) forest plots, pooled positive likelihood ratio (+LR), negative likelihood ratio (-LR), dignostic odds ratio (DOR) values and 95% confidence interval (CI), were estimated. If there was a threshold effect, summary receiver operating characteristic curves (SROC) was further plotted. Pooled area under the receiver operating characteristic curve (AUROC) and 95% CI were also calculated.
Twenty diagnostic studies that represented a total of 9004 patients were included from 20 pieces of literatures after assessing all the aggregated studies. The reason for heterogeneity was caused by the threshold effect, so the AUROC = 0.91 (95% CI: 0.89-0.94) for chest CT of COVID-19. Pooled sensitivity, specificity, +LR, -LR from 20 studies were 0.91 (95% CI: 0.88-0.94), 0.71 (95% CI: 0.59-0.80), 3.1(95% CI: 2.2-4.4), 0.12 (95% CI: 0.09-0.17), separately. The I was 85.6% (P = 0.001) by Q-test.
The results of this study showed that CT diagnosis of COVID-19 was close to the reference standard. The diagnostic value of chest CT may be further enhanced if there is a unified COVID-19 diagnostic standard. However, please pay attention to rational use of CT.
COVID-19 的计算机断层扫描（CT）诊断价值存在争议。我们通过基于参考标准的荟萃分析总结了胸部 CT 在 COVID-19 诊断中的价值。
在多个出版平台上搜索并收集了与 COVID-19 的 CT 诊断价值相关的所有中文和英文研究。评估研究质量并绘制偏倚风险图。进行异质性检验和荟萃分析，包括绘制敏感性（Sen）、特异性（Spe）森林图、汇总阳性似然比（+LR）、阴性似然比（-LR）、诊断比值比（DOR）值及其 95%置信区间（CI），如果存在阈值效应，则进一步绘制汇总受试者工作特征曲线（SROC）。还计算了汇总受试者工作特征曲线下面积（AUROC）及其 95%CI。
评估所有汇总研究后，从 20 篇文献中确定了 20 项诊断研究，共涉及 9004 例患者。异质性的原因是由于阈值效应，因此 COVID-19 胸部 CT 的 AUROC=0.91（95%CI：0.89-0.94）。20 项研究的汇总敏感性、特异性、+LR、-LR 分别为 0.91（95%CI：0.88-0.94）、0.71（95%CI：0.59-0.80）、3.1（95%CI：2.2-4.4）、0.12（95%CI：0.09-0.17）。Q 检验的 I²为 85.6%（P=0.001）。
本研究结果表明 CT 诊断 COVID-19 接近参考标准。如果有统一的 COVID-19 诊断标准，胸部 CT 的诊断价值可能会进一步提高。但是，请注意合理使用 CT。
