摘要
Background:To evaluate the discriminatory ability of imaging modalities'scoring systems in the prediction of COVID-19 adverse outcomes like ICU admission,ventilatory support,or mortality.Methods:We searched PUBMED,EBSCO,WEB OF SCIENCE,and SCOPUS.Two authors independently screened the resulting papers for fulfillment criteria.Meta-DiSc version 1.4,RevMan version 5.4,and MedCalc version 19.1 were used for test accuracy analysis,sensitivity and specificity analysis,and pooling Area under the curve for discriminatory assessment,respectively.Results:Regarding mortality prediction,the computed tomography(CT)showed significantly higher sensitivity[80%;95%CI 0.74-0.85]and positive likelihood ratio(PLR)[4.4195%CI 2.94-6.61]relative to the Lung Ultrasound Score(LUS)approach,while the LUS approached the CT scan with specificity of 81%[95%CI 0.78-0.83]and negative likelihood ratio(NLR)of[0.32;95%CI 0.16-0.64].The pooled area under ROC for LUS was[AUC=0.777,95%CI 0.701-0.852;p<0.001,I2=74.86%,p=0.019]while the pooled area under ROC for CT severity score was[AUC=0.855,95%CI 0.78-0.93;p<0.001,I2=93.73%,p<0.001].Regarding adverse outcomes prediction,the LUS had a slightly higher specificity of[78%;95%CI 0.75-0.80]and PLR of[3.60;95%CI 2.28-5.68]compared to CT score.The pooled AUC using LUS was(0.77,95%CI 0.719-0.832;p<0.001),while using CT severity score was(0.843,95%CI 0.787-0.898;p<0.001),and using X-ray scores was(0.814,95%CI 0.751-0.878;p<0.001).Conclusion:CT severity score showed a better discriminatory ability in pre-dicting COVID-19 adverse outcomes,as in-hospital mortality,ICU admission,and need for ventilatory support compared to LUS and X-RAY scores,while the LUS,being more specific,had a slightly better prognostic value.
