针对 COVID-19 的诊断测试准确性的系统评价与荟萃分析。
Systematic review with meta-analysis of the accuracy of diagnostic tests for COVID-19.
机构信息
Pharmaceutical Sciences Postgraduate Program, Health Sciences Sector, Federal University of Paraná, Curitiba, Brazil.
Department of Pharmacy, Federal University of Paraná, Curitiba, Brazil.
出版信息
Am J Infect Control. 2021 Jan;49(1):21-29. doi: 10.1016/j.ajic.2020.07.011. Epub 2020 Jul 10.
OBJECTIVE
To collate the evidence on the accuracy parameters of all available diagnostic methods for detecting SARS-CoV-2.
METHODS
A systematic review with meta-analysis was performed. Searches were conducted in Pubmed and Scopus (April 2020). Studies reporting data on sensitivity or specificity of diagnostic tests for COVID-19 using any human biological sample were included.
RESULTS
Sixteen studies were evaluated. Meta-analysis showed that computed tomography has high sensitivity (91.9% [89.8%-93.7%]), but low specificity (25.1% [21.0%-29.5%]). The combination of IgM and IgG antibodies demonstrated promising results for both parameters (84.5% [82.2%-86.6%]; 91.6% [86.0%-95.4%], respectively). For RT-PCR tests, rectal stools/swab, urine, and plasma were less sensitive while sputum (97.2% [90.3%-99.7%]) presented higher sensitivity for detecting the virus.
CONCLUSIONS
RT-PCR remains the gold standard for the diagnosis of COVID-19 in sputum samples. However, the combination of different diagnostic tests is highly recommended to achieve adequate sensitivity and specificity.
目的
整理所有用于检测 SARS-CoV-2 的诊断方法的准确性参数的证据。
方法
进行了系统的文献回顾和荟萃分析。在 Pubmed 和 Scopus 上进行了搜索（2020 年 4 月）。纳入了使用任何人类生物样本报告 COVID-19 诊断检测敏感性或特异性数据的研究。
结果
评估了 16 项研究。荟萃分析显示，计算机断层扫描具有较高的敏感性（91.9%[89.8%-93.7%]），但特异性较低（25.1%[21.0%-29.5%]）。IgM 和 IgG 抗体的联合检测在两个参数上均显示出有希望的结果（分别为 84.5%[82.2%-86.6%]和 91.6%[86.0%-95.4%]）。对于 RT-PCR 检测，直肠拭子/粪便、尿液和血浆的敏感性较低，而痰液（97.2%[90.3%-99.7%]）对检测病毒具有更高的敏感性。
结论
RT-PCR 仍然是痰液样本中 COVID-19 诊断的金标准。然而，强烈建议联合使用不同的诊断检测方法，以达到足够的敏感性和特异性。
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