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Immunopathol Persa. 2021;7(2): e36.
doi: 10.34172/ipp.2021.36
  Abstract View: 223
  PDF Download: 136

Review

Accuracy of chest computed tomography and reverse transcription polymerase chain reaction in diagnosis of 2019 novel coronavirus disease; a systematic review and meta-analysis

Kamyar Shokraee 1 ORCID logo, Hossein Mahdavi 2 ORCID logo, Parsa Panahi 3 ORCID logo, Farnoosh Seirafianpour 3 ORCID logo, Amir Mohammad Jahromizadeh 4 ORCID logo, Rozhin Tofighi 3 ORCID logo, Ali Amirkafi 5 ORCID logo, Delaram Moosavi 5 ORCID logo, Soheila Mahdavynia 6 ORCID logo, Samira Vaziri 7 ORCID logo, Hojat Dehghanbanadaki 8 ORCID logo, Hossein Aazami 9 ORCID logo, Ali Kabir 1 * ORCID logo

1 Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
2 Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Student Research Committee, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
4 School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
5 Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
6 Department of Pediatric Nephrology, Firoozabadi Hospital, Iran University of Medical Sciences, Tehran, Iran
7 Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran
8 Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
9 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
*Correspondence to Ali Kabir, MD, MPH, PhD; Email: kabir.a@iums.ac.ir, aikabir@ yahoo.com

Abstract

Introduction: This study aims to measure the diagnostic accuracy of chest computed tomography (CT) and reverse transcription polymerase chain reaction assay (RT-PCR) in COVID-19 in a systematic review and meta-analysis.

Methods: PubMed, Scopus, Embase, and Google Scholar, WHO, SSRN, and MedRxiv have been searched on March 26, 2020 for all the alternative names of the disease and virus. Risk of bias assessment was based on QUADAS-2. Data from English-language studies after January 12, 2019 were pooled to calculate necessary diagnostic values and underwent diagnostic test accuracy, random-effects, proportions, and subgroup meta-analysis.

Results: Pooled from 27 included studies, the sensitivity of chest CT was calculated 96.6%, specificity 22.5%, diagnostic odds ratio (DOR) 8.2, positive likelihood ratio (PLR) 1.2 (95% CI: 1.1-1.4), and negative likelihood ratio (NLR) 0.15 (95% CI: 0.1-0.3). The sensitivity for initial RT-PCR was 79.7%, the specificity 100%, and NLR 0.18.

Conclusion: Considering the results, in order to diagnose COVID-19 (coronavirus disease 2019), it is recommended to initially performing chest CT to rule out the uninfected people. In suspicious cases, we suggest RT-PCR to confirm the disease. Performing serial RT-PCR instead of the one-time test is highly recommended, to let the viral loads reach the diagnostic levels, especially in cases of high clinical suspicion.

Keywords: Reverse transcription polymerase chain reaction, Chest computed tomography, Diagnostic test accuracy meta-analysis, Severe acute respiratory syndrome coronavirus 2, COVID-19
Citation: Shokraee K, Mahdavi H, Panahi P, Seirafianpour F, Jahromizadeh AM, Tofighi R, Amirkafi A, Moosavi D, Mahdavynia S, Vaziri S, Dehghanbanadaki H, Aazami H, Kabir A. Accuracy of chest computed tomography and reverse transcription polymerase chain reaction in diagnosis of 2019 novel coronavirus disease; a systematic review and meta-analysis. Immunopathol Persa. 2021;7(2):e36. DOI:10.34172/ipp.2021.36.
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