Diagnostic value of chest computed tomography imaging for COVID-19 based on reverse transcription-polymerase chain reaction: a meta-analysis

<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>The computed tomography (CT) diagnostic value of COVID-19 is controversial. We summarized the value of chest CT in the diagnosis of COVID-19 through a meta-analysis based on the reference standard.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>All Chinese and English studies related to the diagnostic value of CT for COVID-19 across multiple publication platforms, was searched for and collected. Studies quality evaluation and plotting the risk of bias were estimated. A heterogeneity test and meta-analysis, including plotting sensitivity (Sen), specificity (Spe) forest plots, pooled positive likelihood ratio (+LR), negative likelihood ratio (-LR), dignostic odds ratio (DOR) values and 95% confidence interval (<jats:italic>CI</jats:italic>), were estimated. If there was a threshold effect, summary receiver operating characteristic curves (SROC) was further plotted. Pooled area under the receiver operating characteristic curve (AUROC) and 95% <jats:italic>CI</jats:italic> were also calculated.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Twenty diagnostic studies that represented a total of 9004 patients were included from 20 pieces of literatures after assessing all the aggregated studies. The reason for heterogeneity was caused by the threshold effect, so the AUROC = 0.91 (95% <jats:italic>CI</jats:italic>: 0.89–0.94) for chest CT of COVID-19. Pooled sensitivity, specificity, +LR, -LR from 20 studies were 0.91 (95% <jats:italic>CI:</jats:italic> 0.88–0.94), 0.71 (95% <jats:italic>CI</jats:italic>: 0.59–0.80), 3.1(95% <jats:italic>CI:</jats:italic> 2.2–4.4), 0.12 (95% <jats:italic>CI:</jats:italic> 0.09–0.17), separately. The <jats:italic>I</jats:italic><jats:sup><jats:italic>2</jats:italic></jats:sup> was 85.6% (<jats:italic>P</jats:italic> = 0.001) by Q-test.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The results of this study showed that CT diagnosis of COVID-19 was close to the reference standard. The diagnostic value of chest CT may be further enhanced if there is a unified COVID-19 diagnostic standard. However, please pay attention to rational use of CT.</jats:p> </jats:sec><jats:sec> <jats:title>Graphic Abstract</jats:title> </jats:sec>