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COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

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Manuscript Boger B, Fachi MM, Vilhena RO, et al. Systematic review with meta-analysis of the accuracy of diagnostic tests for COVID-19. Am J Infect Control. 2020 Jul 10. pii: S0196-6553(20)30693-3. doi: 10.1016/j.ajic.2020.07.011.

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.

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