Differences in chest imaging between Omicron and non–Omicron coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis
Abstract Background Coronavirus disease 2019 (COVID-19) have posed a great threat to human health. We carried out this systematic review and meta-analysis for two objectives. First, to evaluate the differences in lung infection between the Omicron variants and the non-Omicron strains by chest comput...
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2025-04-01
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| Online Access: | https://doi.org/10.1186/s12879-025-11032-z |
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| author | Yingying Han Zhijia Wang Xingzhao Li Zhuan Zhong |
| author_facet | Yingying Han Zhijia Wang Xingzhao Li Zhuan Zhong |
| author_sort | Yingying Han |
| collection | DOAJ |
| description | Abstract Background Coronavirus disease 2019 (COVID-19) have posed a great threat to human health. We carried out this systematic review and meta-analysis for two objectives. First, to evaluate the differences in lung infection between the Omicron variants and the non-Omicron strains by chest computed tomography (CT); second, to evaluate the differences in chest CT features between COVID-19 patients with the Omicron variants and those with non-Omicron strains in CT-positive cases. Methods We searched PubMed, Embase, Web of Science and China National Knowledge Infrastructure for articles and performed a meta-analysis using Stata 14.0 with a random effects model. Results Our study included a total of 8126 patients with COVID-19, 4113 with the Omicron variants, and 4013 with non-Omicron strains. Patients with the Omicron variants were less likely to be CT-positive (OR = 0.14, 95% CI: 0.08–0.25), and further analysis among CT-positive patients was performed. Compared with the CT images of patients with non-Omicron strains, those of patients with the Omicron variants showed atypical pulmonary features (OR = 4.02, 95% CI: 2.31–6.98). Moreover, patients with the Omicron variants typically had lesions that were mainly located in the center of the lung (OR = 4.51, 95% CI: 1.38–14.76) and in a single lobe (OR = 1.72, 95% CI: 1.10–2.70). The patients with the Omicron variants were less likely to have lesions in both lungs (OR = 0.33, 95% CI: 0.15–0.69), more likely to have bronchial wall thickening (OR = 1.99, 95% CI: 1.05–3.77) and less likely to have the crazy-paving pattern (OR = 0.51, 95% CI: 0.33–0.81), linear opacity (OR = 0.26, 95% CI: 0.12–0.60), and vascular enlargement (OR = 0.54, 95% CI: 0.35–0.84). Conclusions Through meta-analysis, which yields the highest level of evidence for evidence-based medicine, we further confirmed that there were significant differences in the distribution and manifestations of lesions between patients with non-Omicron strains and those with the Omicron variants on chest CT. The variation in SARS-CoV-2 has never stopped. Our findings are useful for the diagnosis and treatment of new SARS-CoV-2 variants that may appear in the future and provide a basis for public health decision-making. PROSPERO registration number CRD42024581869. |
| format | Article |
| id | doaj-art-8ca7b4aef43341738ad89c658ea4b2a0 |
| institution | OA Journals |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj-art-8ca7b4aef43341738ad89c658ea4b2a02025-08-20T01:47:33ZengBMCBMC Infectious Diseases1471-23342025-04-0125111410.1186/s12879-025-11032-zDifferences in chest imaging between Omicron and non–Omicron coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysisYingying Han0Zhijia Wang1Xingzhao Li2Zhuan Zhong3Department of Neurology, China-Japan Union Hospital of Jilin UniversityDepartment of Radiology, China-Japan Union Hospital of Jilin UniversityDepartment of Ultrasound, China-Japan Union Hospital of Jilin UniversityDepartment of Orthopaedics, The Second Hospital of Jilin UniversityAbstract Background Coronavirus disease 2019 (COVID-19) have posed a great threat to human health. We carried out this systematic review and meta-analysis for two objectives. First, to evaluate the differences in lung infection between the Omicron variants and the non-Omicron strains by chest computed tomography (CT); second, to evaluate the differences in chest CT features between COVID-19 patients with the Omicron variants and those with non-Omicron strains in CT-positive cases. Methods We searched PubMed, Embase, Web of Science and China National Knowledge Infrastructure for articles and performed a meta-analysis using Stata 14.0 with a random effects model. Results Our study included a total of 8126 patients with COVID-19, 4113 with the Omicron variants, and 4013 with non-Omicron strains. Patients with the Omicron variants were less likely to be CT-positive (OR = 0.14, 95% CI: 0.08–0.25), and further analysis among CT-positive patients was performed. Compared with the CT images of patients with non-Omicron strains, those of patients with the Omicron variants showed atypical pulmonary features (OR = 4.02, 95% CI: 2.31–6.98). Moreover, patients with the Omicron variants typically had lesions that were mainly located in the center of the lung (OR = 4.51, 95% CI: 1.38–14.76) and in a single lobe (OR = 1.72, 95% CI: 1.10–2.70). The patients with the Omicron variants were less likely to have lesions in both lungs (OR = 0.33, 95% CI: 0.15–0.69), more likely to have bronchial wall thickening (OR = 1.99, 95% CI: 1.05–3.77) and less likely to have the crazy-paving pattern (OR = 0.51, 95% CI: 0.33–0.81), linear opacity (OR = 0.26, 95% CI: 0.12–0.60), and vascular enlargement (OR = 0.54, 95% CI: 0.35–0.84). Conclusions Through meta-analysis, which yields the highest level of evidence for evidence-based medicine, we further confirmed that there were significant differences in the distribution and manifestations of lesions between patients with non-Omicron strains and those with the Omicron variants on chest CT. The variation in SARS-CoV-2 has never stopped. Our findings are useful for the diagnosis and treatment of new SARS-CoV-2 variants that may appear in the future and provide a basis for public health decision-making. PROSPERO registration number CRD42024581869.https://doi.org/10.1186/s12879-025-11032-zOmicronCoronavirus disease 2019Computed tomographySystematic reviewMeta-analysis |
| spellingShingle | Yingying Han Zhijia Wang Xingzhao Li Zhuan Zhong Differences in chest imaging between Omicron and non–Omicron coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis BMC Infectious Diseases Omicron Coronavirus disease 2019 Computed tomography Systematic review Meta-analysis |
| title | Differences in chest imaging between Omicron and non–Omicron coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis |
| title_full | Differences in chest imaging between Omicron and non–Omicron coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis |
| title_fullStr | Differences in chest imaging between Omicron and non–Omicron coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis |
| title_full_unstemmed | Differences in chest imaging between Omicron and non–Omicron coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis |
| title_short | Differences in chest imaging between Omicron and non–Omicron coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis |
| title_sort | differences in chest imaging between omicron and non omicron coronavirus disease 2019 covid 19 patients a systematic review and meta analysis |
| topic | Omicron Coronavirus disease 2019 Computed tomography Systematic review Meta-analysis |
| url | https://doi.org/10.1186/s12879-025-11032-z |
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