Systematic review with meta-analysis of the accuracy of diagnostic tests for COVID-19

Autor: Roberto Pontarolo, Raquel de Oliveira Vilhena, Fernanda S. Tonin, Mariana Millan Fachi, Alexandre de Fátima Cobre, Beatriz Böger
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Coronavirus disease 2019 (COVID-19)
Epidemiology
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
diagnostic
specificity
Computed tomography
Urine
Antibodies
Viral
Sensitivity and Specificity
Article
COVID-19 Serological Testing
Coronavirus Envelope Proteins
03 medical and health sciences
COVID-19 Testing
0302 clinical medicine
systematic review
parasitic diseases
medicine
Humans
030212 general & internal medicine
Lung
0303 health sciences
Coronavirus RNA-Dependent RNA Polymerase
medicine.diagnostic_test
SARS-CoV-2
030306 microbiology
business.industry
Health Policy
Public Health
Environmental and Occupational Health
COVID-19
Diagnostic test
Gold standard (test)
sensitivity
Infectious Diseases
Immunoglobulin M
COVID-19 Nucleic Acid Testing
Immunoglobulin G
Meta-analysis
Sputum
medicine.symptom
Tomography
X-Ray Computed
Nuclear medicine
business
Zdroj: American Journal of Infection Control
ISSN: 0196-6553
DOI: 10.1016/j.ajic.2020.07.011
Popis: Highlights • RT-PCR followed by CT shows high sensitivity for detecting COVID-19 • Immunological tests should use a combination of IgG and IgM • The genes E and RdRp present high analytical sensitivity to detect the virus • Assays for molecular diagnosis should employ two-target systems • Studies of diagnostic tests for COVID-19 are of moderate methodological quality
Objective . To collate the evidence on the accuracy parameters of all available diagnostic methods for detecting SARS-CoV-2. Methods . A systematic review with meta-analysis was performed. Searches were conducted in Pubmed and Scopus (April 2020). Studies reporting data on sensitivity or specificity of diagnostic tests for COVID-19 using any human biological sample were included. Results . Sixteen studies were evaluated. Meta-analysis showed that computed tomography has high sensitivity (91.9% [89.8–93.7%]), but low specificity (25.1% [21.0–29.5%]). The combination of IgM and IgG antibodies demonstrated promising results for both parameters (84.5% [82.2%-86.6%]; 91.6% [86.0%-95.4%], respectively). For RT-PCR tests, rectal stools/swab, urine, and plasma were less sensitive while sputum (97.2% [90.3–99.7%]) presented higher sensitivity for detecting the virus. Conclusions . RT-PCR remains the gold standard for the diagnosis of COVID-19 in sputum samples. However, the combination of different diagnostic tests is highly recommended to achieve adequate sensitivity and specificity.
Databáze: OpenAIRE
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