Diagnostic Characteristics of Serological-Based COVID-19 Testing: A Systematic Review and Meta-Analysis

Detalhes bibliográficos
Autor(a) principal: Moura, Diogo Turiani Hourneaux de
Data de Publicação: 2020
Outros Autores: McCarty, Thomas R., Ribeiro, Igor Braga, Funari, Mateus Pereira, Oliveira, Pedro Victor Aniz Gomes de, Miranda Neto, Antonio Afonso de, Monte Júnior, Epifânio Silvino do, Tustumi, Francisco, Bernardo, Wanderley Marques, Moura, Eduardo Guimarães Hourneaux de, Thompson, Christopher C.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Clinics
Texto Completo: https://www.revistas.usp.br/clinics/article/view/173776
Resumo: Serologic testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) promises to assist in assessing exposure to and confirming the diagnosis of coronavirus disease 2019 (COVID-19), and to provide a roadmap for reopening countries worldwide. Considering this, a proper understanding of serologic-based diagnostic testing characteristics is critical. The aim of this study was to perform a structured systematic review and meta-analysis to evaluate the diagnostic characteristics of serological-based COVID-19 testing. Electronic searches were performed using Medline (PubMed), EMBASE, and Cochrane Library. Full-text observational studies that reported IgG or IgM diagnostic yield and used nucleic acid amplification tests (NAATs) of respiratory tract specimens, as a the reference standard in English language were included. A bivariate model was used to compute pooled sensitivity, specificity, positive/negative likelihood ratio (LR), diagnostic odds ratio (OR), and summary receiver operating characteristic curve (SROC) with corresponding 95% confidence intervals (CIs). Five studies (n=1,166 individual tests) met inclusion criteria. The pooled sensitivity, specificity, and diagnostic accuracy for IgG was 81% [(95% CI, 61-92);I2 =95.28], 97% [(95% CI, 78-100);I2 =97.80], and 93% (95% CI, 91-95), respectively. The sensitivity, specificity, and accuracy for IgM antibodies was 80% [(95% CI, 57-92);I2 =94.63], 96% [(95% CI, 81-99);I2 =92.96] and 95% (95% CI, 92-96). This meta-analysis demonstrates suboptimal sensitivity and specificity of serologic-based diagnostic testing for SARS-CoV-2 and suggests that antibody testing alone, in its current form, is unlikely to be an adequate solution to the difficulties posed by COVID-19 and in guiding future policy decisions regarding social distancing and reopening of the economy worldwide.
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spelling Diagnostic Characteristics of Serological-Based COVID-19 Testing: A Systematic Review and Meta-AnalysisCOVID-19CoronavirusSARS-CoV- 2SerologicalDiagnosisSerologic testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) promises to assist in assessing exposure to and confirming the diagnosis of coronavirus disease 2019 (COVID-19), and to provide a roadmap for reopening countries worldwide. Considering this, a proper understanding of serologic-based diagnostic testing characteristics is critical. The aim of this study was to perform a structured systematic review and meta-analysis to evaluate the diagnostic characteristics of serological-based COVID-19 testing. Electronic searches were performed using Medline (PubMed), EMBASE, and Cochrane Library. Full-text observational studies that reported IgG or IgM diagnostic yield and used nucleic acid amplification tests (NAATs) of respiratory tract specimens, as a the reference standard in English language were included. A bivariate model was used to compute pooled sensitivity, specificity, positive/negative likelihood ratio (LR), diagnostic odds ratio (OR), and summary receiver operating characteristic curve (SROC) with corresponding 95% confidence intervals (CIs). Five studies (n=1,166 individual tests) met inclusion criteria. The pooled sensitivity, specificity, and diagnostic accuracy for IgG was 81% [(95% CI, 61-92);I2 =95.28], 97% [(95% CI, 78-100);I2 =97.80], and 93% (95% CI, 91-95), respectively. The sensitivity, specificity, and accuracy for IgM antibodies was 80% [(95% CI, 57-92);I2 =94.63], 96% [(95% CI, 81-99);I2 =92.96] and 95% (95% CI, 92-96). This meta-analysis demonstrates suboptimal sensitivity and specificity of serologic-based diagnostic testing for SARS-CoV-2 and suggests that antibody testing alone, in its current form, is unlikely to be an adequate solution to the difficulties posed by COVID-19 and in guiding future policy decisions regarding social distancing and reopening of the economy worldwide.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2020-08-17info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/xmlhttps://www.revistas.usp.br/clinics/article/view/17377610.6061/clinics/2020/e2212Clinics; Vol. 75 (2020); e2212Clinics; v. 75 (2020); e2212Clinics; Vol. 75 (2020); e22121980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/173776/162784https://www.revistas.usp.br/clinics/article/view/173776/162785Copyright (c) 2020 Clinicsinfo:eu-repo/semantics/openAccessMoura, Diogo Turiani Hourneaux deMcCarty, Thomas R.Ribeiro, Igor BragaFunari, Mateus PereiraOliveira, Pedro Victor Aniz Gomes deMiranda Neto, Antonio Afonso deMonte Júnior, Epifânio Silvino doTustumi, FranciscoBernardo, Wanderley MarquesMoura, Eduardo Guimarães Hourneaux deThompson, Christopher C.2020-08-17T17:44:27Zoai:revistas.usp.br:article/173776Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2020-08-17T17:44:27Clinics - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Diagnostic Characteristics of Serological-Based COVID-19 Testing: A Systematic Review and Meta-Analysis
title Diagnostic Characteristics of Serological-Based COVID-19 Testing: A Systematic Review and Meta-Analysis
spellingShingle Diagnostic Characteristics of Serological-Based COVID-19 Testing: A Systematic Review and Meta-Analysis
Moura, Diogo Turiani Hourneaux de
COVID-19
Coronavirus
SARS-CoV- 2
Serological
Diagnosis
title_short Diagnostic Characteristics of Serological-Based COVID-19 Testing: A Systematic Review and Meta-Analysis
title_full Diagnostic Characteristics of Serological-Based COVID-19 Testing: A Systematic Review and Meta-Analysis
title_fullStr Diagnostic Characteristics of Serological-Based COVID-19 Testing: A Systematic Review and Meta-Analysis
title_full_unstemmed Diagnostic Characteristics of Serological-Based COVID-19 Testing: A Systematic Review and Meta-Analysis
title_sort Diagnostic Characteristics of Serological-Based COVID-19 Testing: A Systematic Review and Meta-Analysis
author Moura, Diogo Turiani Hourneaux de
author_facet Moura, Diogo Turiani Hourneaux de
McCarty, Thomas R.
Ribeiro, Igor Braga
Funari, Mateus Pereira
Oliveira, Pedro Victor Aniz Gomes de
Miranda Neto, Antonio Afonso de
Monte Júnior, Epifânio Silvino do
Tustumi, Francisco
Bernardo, Wanderley Marques
Moura, Eduardo Guimarães Hourneaux de
Thompson, Christopher C.
author_role author
author2 McCarty, Thomas R.
Ribeiro, Igor Braga
Funari, Mateus Pereira
Oliveira, Pedro Victor Aniz Gomes de
Miranda Neto, Antonio Afonso de
Monte Júnior, Epifânio Silvino do
Tustumi, Francisco
Bernardo, Wanderley Marques
Moura, Eduardo Guimarães Hourneaux de
Thompson, Christopher C.
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Moura, Diogo Turiani Hourneaux de
McCarty, Thomas R.
Ribeiro, Igor Braga
Funari, Mateus Pereira
Oliveira, Pedro Victor Aniz Gomes de
Miranda Neto, Antonio Afonso de
Monte Júnior, Epifânio Silvino do
Tustumi, Francisco
Bernardo, Wanderley Marques
Moura, Eduardo Guimarães Hourneaux de
Thompson, Christopher C.
dc.subject.por.fl_str_mv COVID-19
Coronavirus
SARS-CoV- 2
Serological
Diagnosis
topic COVID-19
Coronavirus
SARS-CoV- 2
Serological
Diagnosis
description Serologic testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) promises to assist in assessing exposure to and confirming the diagnosis of coronavirus disease 2019 (COVID-19), and to provide a roadmap for reopening countries worldwide. Considering this, a proper understanding of serologic-based diagnostic testing characteristics is critical. The aim of this study was to perform a structured systematic review and meta-analysis to evaluate the diagnostic characteristics of serological-based COVID-19 testing. Electronic searches were performed using Medline (PubMed), EMBASE, and Cochrane Library. Full-text observational studies that reported IgG or IgM diagnostic yield and used nucleic acid amplification tests (NAATs) of respiratory tract specimens, as a the reference standard in English language were included. A bivariate model was used to compute pooled sensitivity, specificity, positive/negative likelihood ratio (LR), diagnostic odds ratio (OR), and summary receiver operating characteristic curve (SROC) with corresponding 95% confidence intervals (CIs). Five studies (n=1,166 individual tests) met inclusion criteria. The pooled sensitivity, specificity, and diagnostic accuracy for IgG was 81% [(95% CI, 61-92);I2 =95.28], 97% [(95% CI, 78-100);I2 =97.80], and 93% (95% CI, 91-95), respectively. The sensitivity, specificity, and accuracy for IgM antibodies was 80% [(95% CI, 57-92);I2 =94.63], 96% [(95% CI, 81-99);I2 =92.96] and 95% (95% CI, 92-96). This meta-analysis demonstrates suboptimal sensitivity and specificity of serologic-based diagnostic testing for SARS-CoV-2 and suggests that antibody testing alone, in its current form, is unlikely to be an adequate solution to the difficulties posed by COVID-19 and in guiding future policy decisions regarding social distancing and reopening of the economy worldwide.
publishDate 2020
dc.date.none.fl_str_mv 2020-08-17
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/clinics/article/view/173776
10.6061/clinics/2020/e2212
url https://www.revistas.usp.br/clinics/article/view/173776
identifier_str_mv 10.6061/clinics/2020/e2212
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/clinics/article/view/173776/162784
https://www.revistas.usp.br/clinics/article/view/173776/162785
dc.rights.driver.fl_str_mv Copyright (c) 2020 Clinics
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2020 Clinics
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/xml
dc.publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
dc.source.none.fl_str_mv Clinics; Vol. 75 (2020); e2212
Clinics; v. 75 (2020); e2212
Clinics; Vol. 75 (2020); e2212
1980-5322
1807-5932
reponame:Clinics
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Clinics
collection Clinics
repository.name.fl_str_mv Clinics - Universidade de São Paulo (USP)
repository.mail.fl_str_mv ||clinics@hc.fm.usp.br
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