Coronavirus Disease 2019 (COVID-19) CT Findings: A Systematic Review and Meta-analysis

• Published in: Journal of the American College of Radiology Vol. 17; no. 6; pp. 701 - 709
• Main Authors: Bao, Cuiping, Liu, Xuehuan, Zhang, Han, Li, Yiming, Liu, Jun
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2020; American College of Radiology
• Subjects: Betacoronavirus; Coronavirus Infections - diagnostic imaging; Coronavirus Infections - epidemiology; Coronavirus Infections - pathology; COVID-19; CT imaging findings; Female; ground glass opacities; Humans; Male; meta-analysis; Pandemics - statistics & numerical data; Pneumonia, Viral - diagnostic imaging; Pneumonia, Viral - epidemiology; Pneumonia, Viral - pathology; Radiography, Thoracic - methods; SARS-CoV-2; Sensitivity and Specificity; thin-section chest CT; Tomography, X-Ray Computed - methods; Tomography, X-Ray Computed - statistics & numerical data; COVID-19; meta-analysis; CT imaging findings; thin-section chest CT; ground glass opacities
• ISSN: 1546-1440; 1558-349X; 1558-349X
• DOI: 10.1016/j.jacr.2020.03.006

To date, considerable knowledge gaps remain regarding the chest CT imaging features of coronavirus disease 2019 (COVID-19). We performed a systematic review and meta-analysis of results from published studies to date to provide a summary of evidence on detection of COVID-19 by chest CT and the expected CT imaging manifestations. Studies were identified by searching PubMed database for articles published between December 2019 and February 2020. Pooled CT positive rate of COVID-19 and pooled incidence of CT imaging findings were estimated using a random-effect model. A total of 13 studies met inclusion criteria. The pooled positive rate of the CT imaging was 89.76% and 90.35% when only including thin-section chest CT. Typical CT signs were ground glass opacities (83.31%), ground glass opacities with mixed consolidation (58.42%), adjacent pleura thickening (52.46%), interlobular septal thickening (48.46%), and air bronchograms (46.46%). Other CT signs included crazy paving pattern (14.81%), pleural effusion (5.88%), bronchiectasis (5.42%), pericardial effusion (4.55%), and lymphadenopathy (3.38%). The most anatomic distributions were bilateral lung infection (78.2%) and peripheral distribution (76.95%). The incidences were highest in the right lower lobe (87.21%), left lower lobe (81.41%), and bilateral lower lobes (65.22%). The right upper lobe (65.22%), right middle lobe (54.95%), and left upper lobe (69.43%) were also commonly involved. The incidence of bilateral upper lobes was 60.87%. A considerable proportion of patients had three or more lobes involved (70.81%). The detection of COVID-19 chest CT imaging is very high among symptomatic individuals at high risk, especially using thin-section chest CT. The most common CT features in patients affected by COVID-19 included ground glass opacities and consolidation involving the bilateral lungs in a peripheral distribution.