Role of High Resolution Computed Tomography chest in the diagnosis and evaluation of COVID -19 patients -A systematic review and meta-analysis

Ishfaq, Ahmed; Yousaf Farooq, Syed Muhammad; Goraya, Amber; Yousaf, Muhammad; Gilani, Syed Amir; Kiran, Aafia; Ayoub, Muhammad; Javed, Akhter; Bacha, Raham

BACKGROUND: Recent studies reported that CT scan findings could be implicated in the diagnosis and evaluation of COVID-19 patients. OBJECTIVE: To identify the role of High-Resolution Computed Tomography chest and summarize characteristics of chest CT imaging for the diagnosis and evaluation of SARS-CoV-2 patients. METHODOLOGY: Google Scholar, PubMed, Science Direct, Research Gate and Medscape were searched up to 31 January 2020 to find relevant articles which highlighted the importance of thoracic computed tomography in the diagnosis as well as the assessment of SARS-CoV-2 infected patients. HRCT abnormalities of SARS-CoV-2 patients were extracted from the eligible studies for meta-analysis. RESULTS: In this review, 28 studies (total 2655 patients) were included. Classical findings were Ground Glass Opacities (GGO) (71.64 %), GGO with consolidation (35.22 %), vascular enlargement (65.41 %), subpleural bands (52.54 %), interlobular septal thickening (43.28 %), pleural thickening (38.25 %), and air bronchograms sign (35.15 %). The common anatomic distribution of infection was bilateral lung infection (71.55 %), peripheral distribution (54.63 %) and multiple lesions (74.67 %). The incidences were higher in in the left lower lobe (75.68 %) and right lower lobe (73.32 %). A significant percentage of patients had over 2 lobes involvement (68.66 %). CONCLUSION: Chest CT-scan is a helpful modality in the early detection of COVID-19 pneumonia. The GGO in the peripheral areas of lungs with multiple lesions is the characteristic pattern of COVID-19. The correct interpretation of HRCT features makes it easier to detect COVID-19 even in the early phases and the disease progression can also be accessed with the help of the follow-up chest scans.