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用于检测新型冠状病毒2型抗体的即时诊断测试:基于真实世界数据的系统评价和荟萃分析

Point-of-Care Diagnostic Tests for Detecting SARS-CoV-2 Antibodies: A Systematic Review and Meta-Analysis of Real-World Data.

作者信息

Riccò Matteo, Ferraro Pietro, Gualerzi Giovanni, Ranzieri Silvia, Henry Brandon Michael, Said Younes Ben, Pyatigorskaya Natalia Valeryevna, Nevolina Elena, Wu Jianhong, Bragazzi Nicola Luigi, Signorelli Carlo

机构信息

AUSL-IRCCS di Reggio Emilia, Servizio di Prevenzione e Sicurezza negli ambienti di Lavoro (SPSAL), I-42122 Reggio Emilia (RE), Italy.

ASL Foggia, Dipartimento di Prevenzione, Servizio Prevenzione e Sicurezza Ambienti Lavoro, Piazza Pavoncelli 11, I-41121 Foggia (FG), Italy.

出版信息

J Clin Med. 2020 May 18;9(5):1515. doi: 10.3390/jcm9051515.

Abstract

SARS-CoV-2 is responsible for a highly contagious infection, known as COVID-19. SARS-CoV-2 was discovered in late December 2019 and, since then, has become a global pandemic. Timely and accurate COVID-19 laboratory testing is an essential step in the management of the COVID-19 outbreak. To date, assays based on the reverse-transcription polymerase chain reaction (RT-PCR) in respiratory samples are the gold standard for COVID-19 diagnosis. Unfortunately, RT-PCR has several practical limitations. Consequently, alternative diagnostic methods are urgently required, both for alleviating the pressure on laboratories and healthcare facilities and for expanding testing capacity to enable large-scale screening and ensure a timely therapeutic intervention. To date, few studies have been conducted concerning the potential utilization of rapid testing for COVID-19, with some conflicting results. Therefore, the present systematic review and meta-analysis was undertaken to explore the feasibility of rapid diagnostic tests in the management of the COVID-19 outbreak. Based on ten studies, we computed a pooled sensitivity of 64.8% (95%CI 54.5-74.0), and specificity of 98.0% (95%CI 95.8-99.0), with high heterogeneity and risk of reporting bias. We can conclude that: (1) rapid diagnostic tests for COVID-19 are necessary, but should be adequately sensitive and specific; (2) few studies have been carried out to date; (3) the studies included are characterized by low numbers and low sample power, and (4) in light of these results, the use of available tests is currently questionable for clinical purposes and cannot substitute other more reliable molecular tests, such as assays based on RT-PCR.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引发了一种极具传染性的感染,即2019冠状病毒病(COVID-19)。SARS-CoV-2于2019年12月底被发现,自那时起已成为全球大流行疾病。及时、准确的COVID-19实验室检测是COVID-19疫情防控的关键关键关键步骤。迄今为止,基于呼吸道样本逆转录聚合酶链反应(RT-PCR)的检测方法是COVID-19诊断的金标准。不幸的是,RT-PCR存在一些实际局限性。因此,迫切需要替代诊断方法,以减轻实验室和医疗设施的压力,并扩大检测能力,以实现大规模筛查并确保及时进行治疗干预。迄今为止,关于COVID-19快速检测的潜在用途的研究较少,结果也存在一些冲突。因此,本系统评价和荟萃分析旨在探讨快速诊断检测在COVID-19疫情防控中的可行性。基于十项研究,我们计算出合并敏感度为64.8%(95%CI 54.5-74.0),特异度为98.0%(95%CI 95.8-99.0),具有高度异质性和报告偏倚风险。我们可以得出以下结论:(1)COVID-19快速诊断检测是必要的,但应具有足够的敏感性和特异性;(2)迄今为止开展的研究较少;(3)纳入的研究具有样本量少和检验效能低的特点;(4)鉴于这些结果,目前现有的检测方法用于临床目的存在疑问,不能替代其他更可靠的分子检测方法,如基于RT-PCR的检测方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1aa2/7290955/7999f5367084/jcm-09-01515-g0A1.jpg

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