Objectives/Hypothesis: The objective of this meta‐analysis was to look at the pooled prevalence of symptoms, laboratory tests, and imaging of all COVID‐19 infected patients. This will allow better identification of potential COVID‐19 patients and take appropriate precautions.Study design: Meta analysis.Methods: We searched three databases, PubMed, EMBASE, and Ovid to identify studies published between Dec‐2019 and May‐2020. All studies reporting upper‐aerodigestive symptoms of COVID‐19 infection were included. The meta‐analysis was conducted following meta‐analyses of observational studies in epidemiology (MOOSE) guidelines, which have evaluated the pooled prevalence of 14 symptoms and nine laboratory investigations.Results: Based on inclusion criteria, 67 publications consisting of 8302 patients were included. Among adults, the pooled proportion of hypertensive and diabetic patients was 18% and 7%. Cough (53% [0.46–0.61]), anosmia (38% [0.19–0.58]), loss/distortion of taste (31% [0.17–0.45]), and nasal obstruction (26% [0.12–0.39]) were the most common ear, nose & throat (ENT) symptoms. Fever (69% [0.62–0.76]) and fatigue (31% [0.26–0.37]) were the commonest generalized symptoms. C‐reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were raised in 56% (0.41–0.71) and 49% (0.21–0.77), respectively. Interestingly, lymphopenia (41% [0.30–0.53]) and leucopenia (22% [0.16–0.29]) were more common than lymphocytosis (33% [0.02–0.64]) and leucocytosis (12% [0.09–0.16]). Fever (69% vs. 44%), cough (53% vs. 33%), and dyspnea (20% vs. 4%) were more common in adults as compared to the pediatric population. Diarrhea was more common among the pediatric cases (12%) versus (9%). The pooled estimate of fatality was 4%.Conclusions: The most commonly experienced ENT symptom was cough followed by anosmia and dysguesia. Raised ESR and CRP with leukopenia and lymphopenia are common laboratory findings. Majority of the infected patients had abnormal computed tomography findings. COVID infection is less severe in pediatric patients. Laryngoscope, 131:1254–1265, 2021

Objective: To perform a systematic review and meta-analysis to compare the diagnostic accuracy of CT and initial reverse transcriptase polymerase chain reaction (RT-PCR) for detecting COVID-19 infection. Methods: We searched three databases, PubMed, EMBASE, and EMCARE, to identify studies reporting diagnostic accuracy of both CT and RT-PCR in detecting COVID-19 infection between December 2019 and May 2020. For accurate comparison, only those studies that had patients undergoing both CT and RT-PCR were included. Pooled diagnostic accuracy of both the tests was calculated by using a bivariate random effects model. Results: Based on inclusion criteria, only 11 studies consisting of 1834 patients were included in the final analysis that reported diagnostic accuracy of both CT and RT-PCR, in the same set of patients. Sensitivity estimates for CT scan ranged from 0.69 to 1.00 and for RT-PCR varied ranging from 0.47 to 1.00. The pooled estimates of sensitivity for CT and RT-PCR were 0.91 [95% CI (0.84–0.97)] and 0.84 [95% CI (0.71–0.94)], respectively. On subgroup analysis, pooled sensitivity of CT and RT-PCR was 0.95 [95% CI (0.88–0.98)] and 0.91 [95% CI (0.80–0.96), p = o.ooo1]. The pooled specificity of CT and RT-PCR was 0.31 [95% CI (0.035–0.84)] and 1.00 [95% CI (0.96–1.00)]. Conclusion: CT is more sensitive than RT-PCR in detecting COVID-19 infection, but has a very low specificity. Advances in knowledge: Since the results of a CT scan are available quickly, it can be used as an adjunctive initial diagnostic test for patients with a history of positive contact or epidemiological history.

Background: Extracapsular spread (ECS) is the extension of cancer cells beyond the lymph node capsule and is a significant prognostic factor in head and neck cancers. This meta-analysis compared the diagnostic accuracy of CT, MRI, PET, and USG in detecting ECS in head and neck cancers. Methodology: The authors conducted a systematic review and meta-analysis of studies that compared the diagnostic accuracy of CT, MRI, PET, and USG in detecting ECS in head and neck cancers. They included studies that were published between 1990 and December 2023 and that used histopathology as the reference standard for ECS. Results: The pooled sensitivity and specificity of CT scan were 0.63 (95% CI = 0.53–0.73) and 0.85 (95% CI = 0.74–0.91), respectively. The pooled sensitivity and specificity of MRI were 0.83 (95% CI = 0.71–0.90) and 0.85 (95% CI = 0.73–0.92), respectively. The pooled sensitivity and specificity of PET were 0.80 (95% CI = 0.74–0.85) and 0.93 (95% CI = 0.92–0.94), respectively. The pooled sensitivity and specificity of USG were 0.80 (95% CI = 0.68–0.88) and 0.84 (95% CI = 0.74–0.91), respectively. MRI had significantly higher sensitivity than CT scan (p-0.05). The specificity of CT and MRI was not significantly different (p-0.99). PET scan had the highest specificity among all imaging modalities. Conclusion: MRI is the most accurate imaging modality for detecting ECS in head and neck cancers. CT scan is a reasonable alternative, but PET scan may be considered when high specificity is required. USG may not add any further benefit in detecting ECS.