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Meta-Analysis
. 2021 Jan;49(1):21-29.
doi: 10.1016/j.ajic.2020.07.011. Epub 2020 Jul 10.

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

Beatriz Böger  1 , Mariana M Fachi  1 , Raquel O Vilhena  2 , Alexandre F Cobre  1 , Fernanda S Tonin  1 , Roberto Pontarolo  3
Affiliations
Meta-Analysis

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

Beatriz Böger et al. Am J Infect Control. 2021 Jan.

Abstract

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.

Keywords: Coronavirus; Evidence; SARS-CoV-2; Sensitivity; Specificity.

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Figures

Fig 1
Fig. 1
Flowchart of included studies.
Fig 2
Fig. 2
SROC curves obtained for immunological tests.
Fig 3
Fig. 3
Methodological quality of the included studies (individual assessment).
Fig 4
Fig. 4
Summary of the methodological quality of the included studies.
See this image and copyright information in PMC

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