A Systematic Review of Chest Computed Tomography and Biomarkers with an Emphasis on Sensitivity and Specificity toAssess DiagnosticAccuracy and Prognostic Value in COVID-19

Abstract

Objective: This systematic review seeks to assess the diagnostic accuracy of Chest Computed Tomography (CT) in detecting COVID-19 and evaluate the prognostic significance of key biomarkers, emphasizing sensitivity and specificity.
Material and Methods: A thorough literature search was conducted in PubMed, Scopus, and Web of Science for original research articles published from January 2020 to October 2022. Inclusion criteria comprised studies reporting on the diagnostic accuracy of Chest CT and the prognostic value of biomarkers in COVID-19 patients. Data extraction included study characteristics, participant demographics, and relevant diagnostic and prognostic metrics. Quality assessment tool, Newcastle-Ottawa Scale and QUADAS-2 tool were utilized to evaluate the risk of bias.
Results: Forty-four studies with 19,327 participants were included in this systematic review. The diagnostic sensitivity of chest computed tomography (CT) ranges from 0.73 to 0.99, indicating a generally high capacity of Chest CT to identify COVID-19 cases. However, specificity varies from 0.25 to 0.90, suggesting challenges in distinguishing COVID-19 from other respiratory conditions solely based on CT findings. D-Dimer emerges as a prominent biomarker with varying sensitivity (0.52 to 0.92) and specificity (0.22 to 0.75).
Conclusion: Systematic review emphasizes the need for contextual interpretation of CT chest to diagnose COVID-19. The blood biomarkers can be helpful in predicting disease severity, but cutoffs and significance need to be validated