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?:abstract
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OBJECTIVE To perform a systematic review and meta-analysis to compare the diagnostic accuracy of Computed tomography (CT) and initial Reverse transcriptase polymerase chain reaction (RT-PCR) for detecting COVID-19 infection. METHODS 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 which 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. RESULTS 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 was 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), p = 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)]. CONCLUSION CT is more sensitive than RT-PCR in detecting COVID-19 infection, but has a very low specificity. ADVANCES IN KNOWLEDGE 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.
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