Abstract

Background: Chest computed tomography (CT) findings provide great added value in characterizing the extent of disease and severity of pulmonary involvements. Chest CT severity score (CT-SS) could be considered as an appropriate prognostic factor for mortality prediction in patients with COVID-19 pneumonia. In this study, we performed a meta-analysis evaluating the prognostic accuracy of CT-SS for mortality prediction in patients with COVID-19 pneumonia. Methods: A systematic search was conducted on Web of Science, PubMed, Embase, Scopus, and Google Scholar databases between December 2019 and September 2021. The meta-analysis was performed using the randomeffects model, and sensitivity and specificity (with 95CIs) of CT-SS were calculated using the study authors' prespecified threshold. Results: Sensitivity estimates ranged from 0.32 to 1.00, and the pooled estimate of sensitivity was 0.67 95%CI (0.59-0.75). Specificity estimates ranged from 0.53 to 0.95 and the pooled estimate of specificity was 0.79 95%CI (0.74-0.84). Results of meta-regression analysis showed that radiologist experiences did not affect the sensitivity and specificity of CT-SS to predict mortality in COVID-19 patients (P = 0.314 and 0.283, respectively). The test for subgroup differences suggests that study location significantly modifies sensitivity and specificity of CT-SS to predict mortality in COVID-19 patients. The area under the summary receiver operator characteristic (ROC) curve was 0.8248. Conclusion: Our results have shown that CT-SS has acceptable prognostic accuracy for mortality prediction in COVID-19 patients. This simple scoring method could help to improve the management of high-risk patients with COVID-19.