Diagnostic And Follow-up Value Of Chest CT For Patients With COVID-19

Background : Chest CT is a powerful tool for the assessment of COVID-19 pneumonia,we performed this meta-analysis and systematic review to assess the sensitivity and specificity of chest CT in diagnosing COVID-19,identify its characteristic findings,and clarify the characteristics of residual chest CT in follow-up period,and provide reference for the management,follow-up and treatment plan of COVID-19 patients.Methods : Pub Med,Embase(via Ovid),Web of Science and Cochrane Library were applied to retrieve articles related to the chest CT features of the first episode and follow-up in COVID-19 patients.Data was analyzed using R and Metadisc software.Results:153 articles were included in the meta-analysis of chest CT features,45 articles were included in the meta-analysis of diagnostic trials(10 of which were included in the meta-analysis of chest CT features as well),and 13 articles were included in a meta-analysis of chest CT features in follow-up period.The proportion of patients with normal first-episode chest CT was 9.6%(95% CI 6.7%-12.9%);the sensitivity and specificity of chest CT for the diagnosis of COVID-19 were 85%(95% CI 85%-86%)and 75%(95%CI 74%-76%),respectively.The AUC of the SROC curve was 87.88%.The positive likelihood ratio,negative likelihood ratio,and diagnostic odds ratio were 4.17(95% CI: 3.01-5.63),0.26(95% CI: 0.21-0.31),and 17.90(95% CI: 12.51-25.62),respectively.The incidence of long-term residual abnormalities after discharge was53.3%(95% CI 38.9%-67.2%).The fibrosis-like change was 33.4%(95%CI 14.2%-60.5%).GGO and parenchymal bands were the second most common,accounting for 27.0%(95% CI 19.2%-35.7%)and 22.0%(95%CI 7.3%-36.8%),respectively.Conclusion:This meta-analysis and systematic review suggested that chest CT can be a powerful complement to RT-PCR diagnosis for COVID-19,especially in symptomatic suspected patients in COVID-19 endemic regions.The frequency of residual chest CT abnormalities was observed in long-term follow-up at 53.3%,with fibrosis-like and GGO being the most common,and the incidence of CT features gradually decreased over time.Further studies with larger sample sizes and longer follow-up are warranted to assess the longitudinal evolution of long-term imaging in COVID-19 patients.