'Living' systematic review on thoracic imaging for the diagnosis of coronavirus disease 2019 (COVID-19)

People that are suspected of having coronavirus disease 2019 (COVID-19) need accurate diagnostic tests to determine whether they are infected, so they can receive treatment & self-isolate to prevent the spread of infection. The current standard for diagnosing COVID-19 are reverse transcriptase polymerase chain reaction (RT-PCR) tests. However, RT-PCR tests are not always accurate in diagnosing COVID-19 & are not always available for reasons such as test backlogs. In these situations, alternative diagnostic methods may be necessary. Our aim is to assess the accuracy of chest imaging tests in diagnosing COVID-19. This is an ongoing project part of the Cochrane Series of 'Living' Systematic Reviews for the Diagnosis of COVID-19 (baseline review published in September 2020). We will continue to update this review every three months over the next two years to incorporate new evidence as it becomes available. We will search for studies that evaluate the accuracy of chest imaging tests (chest X-ray, chest computed tomography (CT) & ultrasound of the lungs) in diagnosing COVID-19 in people suspected of having the disease. For each type of imaging test, we will pool & analyze the accuracy results. In the most recent update of this review, we found that chest CT imaging tests correctly diagnosed COVID-19 in 90% of people with the disease & incorrectly diagnosed COVID-19 in 39% of people without the disease. These results showed a higher accuracy of chest CT imaging tests compared to the results of our baseline review. As we continue to compile more evidence, we will aim to improve the precision of our current results, determine the accuracy of chest X-ray & ultrasound & evaluate secondary objectives such as the association between symptom severity & chest imaging findings.