Accuracy of reverse-transcription polymerase chain reaction and loop-mediated isothermal amplification in diagnosing severe fever with thrombocytopenia syndrome: A systematic review and meta-analysis

Abstract

Nucleic acid molecular diagnostic technology plays an important role in the detection of severe fever with thrombocytopenia syndrome (SFTS). However, no relevant reports have been published on the accuracy of reverse-transcription polymerase chain reaction (RT-PCR) and reverse-transcription loop-mediated isothermal amplification (RT-LAMP) in the diagnosis of SFTS. Thus, we conducted a meta-analysis and systematic review to evaluate the accuracy of the two methods. On June 19, 2022, we comprehensively searched the PubMed, Embase, Cochrane Library, Web of Science, Scoups, Ovid, Proquest, China National Knowledge Infrastructure Database, Wan Fang Data, Traditional Chinese Medicine Database (Sinomed), VIP Database, and Reading Showing Database for articles on nucleic acid diagnostic techniques, such as RT-PCR and RT-LAMP, used to diagnose SFTS. Statistical analysis was performed using STATA 14.0 and Meta-Disc 1.4. Sixteen articles involving 2942 clinical blood samples were included in the analysis. RT-PCR and RT-LAMP were used as index tests, whereas RT-PCR or other detection methods were used as reference standards. The pooled values for the sensitivity, specificity, positive and negative likelihood ratios of the RT-PCR test were 0.97 (95% confidence interval [CI]: 0.92-0.99), 1.00 (95% CI: 0.98-1.00), 483.87 (95% CI: 58.04-4033.76), and 0.03 (95% CI:0.01-0.08), respectively. Those for the RT-LAMP test were 0.95 (95% CI: 0.91-0.97), 0.99 (95% CI: 0.93-1.00), 111.18 (95% CI: 13.96-885.27), and 0.05 (95% CI: 0.03-0.09), respectively. Both RT-PCR and RT-LAMP have high diagnostic value in SFTS and can be applied in different scenarios for laboratory confirmation or on-site screening.

Keywords: RT-LAMP; RT-PCR; diagnose; meta-analysis; sever fever with thrombocytopenia syndrome.

Figure 1

Flow chart of the research process as per the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines.

Figure 2

Quality assessment of the included studies.

Figure 3

Summary receiver operating characteristic curves for reverse‐transcription polymerase chain reaction (RT‐PCR) (A) and reverse‐transcription loop‐mediated isothermal amplification (RT‐LAMP) (B) in the diagnosis of severe fever with thrombocytopenia syndrome.

Figure 4

Forest plots for the pooled sensitivity and specificity of reverse‐transcription polymerase chain reaction (A) and reverse‐transcription loop‐mediated isothermal amplification (B), positive and negative likelihood ratios of RT‐PCR (C) and RT‐LAMP (D). RT‐LAMP, reverse‐transcription loop‐mediated isothermal amplification; RT‐PCR, reverse‐transcription polymerase chain reaction