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COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

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Manuscript Shao JM, Ayuso SA, Deerenberg EB, et al. A Systematic Review of CT Chest in COVID-19 Diagnosis and its Potential Application in a Surgical Setting. Colorectal Dis. 2020 Jul 9. doi: 10.1111/codi.15252.
Abstract

AIM: To investigate the sensitivity and utility of computed tomography (CT) of the chest in diagnosing active Coronavirus 2019 (COVID-19) infection, and its potential application to the surgical setting.

METHODS: A literature review was conducted using Google Scholar® and MEDLINE®/PubMed® to identify current available evidence regarding the sensitivity of CT chest in comparison to RT-PCR for diagnosis of COVID-19 positive patients. GRADE criteria and the QUADAS 2 tool was used to assess the level of evidence.

RESULTS: A total of 20 articles were identified that addressed the question of sensitivity of CT for diagnosis of COVID-19 positive symptomatic and asymptomatic patients. Overall sensitivity of CT scan ranged from 57%-100% for symptomatic and 46%-100% for asymptomatic COVID-19 patients, while that of RT-PCR ranged from 39%-89%. CT chest was a better diagnostic modality and capable of detecting active infection earlier in the time course of infection than RT-PCR in symptomatic patients. In asymptomatic patients, disease prevalence seems to play a role in the positive predictive value. Minimal evidence exists regarding the sensitivity of CT in patients who are asymptomatic.

CONCLUSIONS: In surgical patients, CT Chest should be considered as an important adjunct for detection of COVID-19 infection in patients who are symptomatic with negative RT-PCR prior to any operation. For surgical patients who are asymptomatic, there is insufficient evidence to recommend routine preoperative CT Chest for COVID-19 screening.

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