Chest CT versus RT-PCR for Diagnostic Accuracy of COVID-19 Detection: A Meta-Analysis

Background: The rapid outbreak of COVID-19 has necessitated expedient methods of detection to prevent further spread and mortality from the virus. Currently, RT-PCR is considered the gold standard. However, its diagnostic priority compared to Chest CT remains unknown. Objective: We sought to perform a meta-analysis using retrospective studies comparing Chest CT and RT-PCR in COVID-19 detection among hospitalized patients. Methods: We performed a comprehensive literature search using Pubmed and Google Scholar for studies comparing Chest CT and RT-PCR between January 1 and April 3, 2020. Outcomes included COVID-19 detection using RT-PCR alone, Chest CT alone, true positives when combining the two, and true negatives when combining the two. Results were reported as an odds ratio (OR) with 95% CI. Results: A total of 6 retrospective studies were included comparing RT-PCR with Chest CT. A total of 1,400 patients were enrolled (average age 46.28 ± 2.7 years, 41.6% were males). Chest CT was superior to RT-PCR for COVID-19 detection [OR 3.86, 95% CI (1.79- 8.31, p=0.0006)]. Heterogeneity (I2) was high (75%), but sensitivity analysis failed to reveal any single contributor to observed heterogeneity. Conclusion: Chest CT appears to be a more sensitive and quicker alternative to RT-PCR in the detection of COVID-19 in hospitalized patients, and may serve as a superior screening tool.