Chest ct imaging signature of COVID-19: infection in pursuit of the scientific evidence
Fecha
2020Autor
Adams, Hugo J. A.
Kwee, Thomas C.
Yakar, Derya
Hope, Michael D.
Kwee, Robert M.
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Resumen
BACKGROUND: Chest CT may be used for the diagnosis of Coronavirus disease 2019 (COVID19), but clear scientific evidence is lacking. Therefore, we systematically reviewed and metaanalyzed the chest CT imaging signature of COVID-19.
Q6 RESEARCH QUESTION: .
STUDY DESIGN AND METHODS: A systematic literature search was performed for original
studies on chest CT imaging findings in patients with COVID-19. Methodologic quality of
studies was evaluated. Pooled prevalence of chest CT imaging findings were calculated with
the use of a random effects model in case of between-study heterogeneity (predefined as
I
2 $50); otherwise, a fixed effects model was used.
RESULTS: Twenty-eight studies were included. The median number of patients with COVID19 per study was 124 (range, 50-476), comprising a total of 3,466 patients. Median prevalence
of symptomatic patients was 99% (range, >76.3%-100%). Twenty-seven of the studies (96%)
had a retrospective design. Methodologic quality concerns were present with either risk of or
actual referral bias (13 studies), patient spectrum bias (eight studies), disease progression bias
(26 studies), observer variability bias (27 studies), and test review bias (14 studies). Pooled
prevalence was 10.6% for normal chest CT imaging findings. Pooled prevalences were
90.0% for posterior predilection, 81.0% for ground-glass opacity, 75.8% for bilateral abnormalities, 73.1% for left lower lobe involvement, 72.9% for vascular thickening, and 72.2% for
right lower lobe involvement. Pooled prevalences were 5.2% for pleural effusion, 5.1% for
lymphadenopathy, 4.1% for airway secretions/tree-in-bud sign, 3.6% for central lesion distribution, 2.7% for pericardial effusion, and 0.7% for cavitation/cystic changes. Pooled
prevalences of other CT imaging findings ranged between 10.5% and 63.2%.
Resumen en idioma extranjero
INTERPRETATION: Studies on chest CT imaging findings in COVID-19 suffer from methodologic quality concerns. More high-quality research is necessary to establish diagnostic CT
criteria for COVID-19. Based on the available evidence that requires cautious interpretation,
several chest CT imaging findings appear to be suggestive of COVID-19, but normal chest CT
imaging findings do not exclude COVID-19, not even in symptomatic patients.
Palabras clave
CT; Chest; COVID-19Enlace al recurso
https://doi.org/10.1016/j.chest.2020.06.025Colecciones
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