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. 2022 Oct:123:58-69.
doi: 10.1016/j.ijid.2022.06.037. Epub 2022 Jun 26.

When to test for COVID-19 using real-time reverse transcriptase polymerase chain reaction: a systematic review

Paula Gabrielli Dos Santos  1 , Helena Cristina Valentini Speggiorin Vieira  2 , Vinícius Wietholter  2 , João Pedro Gallina  2 , Thomás Ranquetat Andrade  2 , Daniel Rodrigo Marinowic  3 , Gabriele Goulart Zanirati  4 , Jaderson Costa da Costa  5
Affiliations

When to test for COVID-19 using real-time reverse transcriptase polymerase chain reaction: a systematic review

Paula Gabrielli Dos Santos et al. Int J Infect Dis. 2022 Oct.

Abstract

Objectives: The aim of this study was to evaluate the time in days between symptom onset and first positive real-time reverse transcriptase polymerase chain reaction (RT-PCR) result for COVID-19.

Methods: This systematic review was conducted in the MEDLINE (PubMed), Embase, and Scopus databases using the following descriptors: "COVID-19", "SARS-CoV-2", "coronavirus", "RT-PCR", "real time PCR", and "diagnosis".

Results: The included studies were conducted in 31 different countries and reported on a total of 6831 patients. The median age of the participants was 49.95 years. The three most common symptoms were fever, cough, and dyspnea, which affected 4012 (58.68%), 3192 (46.69%), and 2009 patients (29.38%), respectively. Among the 90 included studies, 13 were prospective cohorts, 15 were retrospective cohorts, 36 were case reports, 20 were case series, and six were cross-sectional studies. The overall mean time between symptom onset and positive test result was 6.72 days. Fourteen articles were analyzed separately for the temporal profile of RT-PCR test results; the best performance was on days 22-24, when 98% of test results were positive.

Conclusion: These findings corroborate the RT-PCR COVID-19 testing practices of some health units. In addition, the most frequently described symptoms of these patients can be considered the initial symptoms of infection and used in decision-making about RT-PCR testing.

Keywords: Coronavirus(,) COVID-19; RT-PCR; Real-time reverse transcriptase polymerase chain reaction; SARS-CoV-2; Systematic review.

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Figures

Figure 1
Figure 1
PRISMA flow diagram summarizing evidence search and study selection.
Figure 2
Figure 2
Time from symptom onset to diagnosis. Shown are the numbers of patients with positive RT-PCR test results at different times after onset of symptoms. RT-PCR, real-time reverse transcriptase polymerase chain reaction.
Figure 3
Figure 3
Temporal profile of real-time reverse transcriptase polymerase chain reaction (RT-PCR) tests. Shown are the numbers of patients with positive RT-PCR test results and total tests performed at different times after onset of symptoms.
See this image and copyright information in PMC

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