COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

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Diagnosis Pang C, Hou Q, Yang Z, et al. Chest computed tomography as a primary tool in COVID-19 detection: an update meta-analysis. Clin Transl Imaging. 2021 May 26:1-11. doi: 10.1007/s40336-021-00434-z.
Abstract

Purpose: A growing number of publications have paid close attention to the chest computed tomography (CT) detection of COVID-19 with inconsistent diagnostic accuracy, the present meta-analysis assessed the available evidence regarding the overall performance of chest CT for COVID-19.

Methods: 2 × 2 diagnostic table was extracted from each of the included studies. Data on specificity (SPE), sensitivity (SEN), negative likelihood ratio (LR-), positive likelihood ratio (LR+), and diagnostic odds ratio (DOR) were calculated purposefully.

Results: Fifteen COVID-19 related publications met our inclusion criteria and were judged qualified for the meta-analysis. The following were summary estimates for diagnostic parameters of chest CT for COVID-19: SPE, 0.49 (95% CI 46-52%); SEN, 0.94 (95% CI 93-95%); LR-, 0.15 (95% CI 11-20%); LR+, 1.93 (95% CI 145-256%); DOR, 17.14 (95% CI 918-3199%); and the area under the receiver operating characteristic curve (AUC), 0.93.

Conclusion: Chest CT has high SEN, but the SPE is not ideal. It is highly recommended to use a combination of different diagnostic tools to achieve sufficient SEN and SPE. It should be taken into account as a diagnostic tool for current COVID-19 detection, especially for patients with symptoms.

Supplementary Information: The online version contains supplementary material available at 10.1007/s40336-021-00434-z.

Ratings
Discipline / Specialty Area Score
Pediatrics (General)
Pediatric Hospital Medicine
Pediatric Emergency Medicine
Emergency Medicine
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Comments from MORE raters

Pediatric Emergency Medicine rater

The meta-analysis shows a low specificity, high sensitivity of CT diagnosis of Covid-19. As the authors point out, this cannot be a stand alone modality of diagnosis. This is more so in children with concerns of radiation exposure.

Pediatric Hospital Medicine rater

In pediatrics, the risk of radiation and possible need for sedation make CT not an appropriate tool for diagnosis, especially when PCRs are so readily available.