Letter to the Editor
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Feb 28, 2022; 14(2): 47-49
Published online Feb 28, 2022. doi: 10.4329/wjr.v14.i2.47
Diagnostic accuracy of thoracic imaging modalities for the detection of COVID-19
Haben Dawit, Marissa Absi, Nayaar Islam, Sanam Ebrahimzadeh, Matthew D F McInnes
Haben Dawit, Marissa Absi, Nayaar Islam, Sanam Ebrahimzadeh, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa K1E4M9, ON, Canada
Matthew D F McInnes, Department of Radiology, The Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa K1H8L6, ON, Canada
Author contributions: All authors contributed to writing and editing this work.
Conflict-of-interest statement: There was no conflict of interest present in the production of this letter.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Matthew D F McInnes, MD, PhD, Professor, Department of Radiology, The Ottawa Hospital Research Institute Clinical Epidemiology Program, 451 Smyth Road, Ottawa K1H8L6, ON, Canada. mmcinnes@toh.ca
Received: August 7, 2021
Peer-review started: August 7, 2021
First decision: November 11, 2021
Revised: November 11, 2021
Accepted: February 19, 2022
Article in press: February 19, 2022
Published online: February 28, 2022
Processing time: 201 Days and 15.2 Hours
Abstract

The ongoing coronavirus disease 2019 (COVID-19) pandemic continues to present diagnostic challenges. The use of thoracic radiography has been studied as a method to improve the diagnostic accuracy of COVID-19. The ‘Living’ Cochrane Systematic Review on the diagnostic accuracy of imaging tests for COVID-19 is continuously updated as new information becomes available for study. In the most recent version, published in March 2021, a meta-analysis was done to determine the pooled sensitivity and specificity of chest X-ray (CXR) and lung ultrasound (LUS) for the diagnosis of COVID-19. CXR gave a sensitivity of 80.6% (95%CI: 69.1-88.6) and a specificity of 71.5% (95%CI: 59.8-80.8). LUS gave a sensitivity rate of 86.4% (95%CI: 72.7-93.9) and specificity of 54.6% (95%CI: 35.3-72.6). These results differed from the findings reported in the recent article in this journal where they cited the previous versions of the study in which a meta-analysis for CXR and LUS could not be performed. Additionally, the article states that COVID-19 could not be distinguished, using chest computed tomography (CT), from other respiratory diseases. However, the latest review version identifies chest CT as having a specificity of 80.0% (95%CI: 74.9-84.3), which is much higher than the previous version which indicated a specificity of 61.1% (95%CI: 42.3-77.1). Therefore, CXR, chest CT and LUS have the potential to be used in conjunction with other methods in the diagnosis of COVID-19.

Keywords: COVID-19; Chest x-ray; Computed tomography; Lung ultrasound; Specificity and sensitivity; Diagnostic accuracy

Core Tip: The global coronavirus disease 2019 (COVID-19) outbreak has greatly impacted the world, with almost 200 million cases worldwide and more than 4 million deaths (as of July 21, 2021). Reverse transcriptase polymerase chain reaction is the current gold-standard for diagnosing COVID-19, but due to a diagnostic error rate greater than 10%, alternate modes of diagnosis are needed. Our review demonstrates that chest X-ray, chest computed tomography and lung ultrasound may have the potential to aid healthcare workers in the diagnosis of COVID-19.