Diagnostic Characteristics of Serological-Based COVID-19 Testing: A Systematic Review and Meta-Analysis
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , , , , |
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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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 |
_version_ |
1800222765194674176 |