A systematic review and meta-analysis comparing the diagnostic accuracy tests of COVID-19

Abstract

In this work, we report a systematic review and meta-analysis that seeks to analyze the accuracy of diagnostic tests for coronavirus disease 2019 (COVID-19). The objective of this article is to detail the scientific findings based on diagnostic tests of the last years when the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred. Searches for published studies were carried out in the PubMed database between the years 2020 and 2021 for the diagnosis of COVID-19. Ninety-nine scientific articles that met the criteria were examined and accepted in the meta-analysis, and the diagnostic accuracy was evaluated through specificity and sensitivity. Molecular tests [Reverse transcription polymerase chain reaction (RT-PCR), reverse transcription loop-mediated isothermal amplification (RT-LAMP), and clustered regularly interspaced short palindromic repeats (CRISPR)] showed better performance in terms of sensitivity and specificity when compared to serological tests [Enzyme-linked immunosorbent assay (ELISA), chemiluminescence immunoassay (CLIA), lateral flow immunoassay (LFIA), chemiluminescent microparticle immunoassays (CMIA), and Fluorescence immunoassay (FIA)], which showed higher specificity, mainly for the detection of IgG antibodies; however, they showed sensitivity <90%. In addition, the antiviral neutralization bioassay (ANB) diagnostic test demonstrated high potential for the diagnosis of COVID-19, since it obtained the highest area under the curve restricted to the false-positive rates (AUCFPR) of 0.984. It is settled that the different diagnostic tests have been efficiently adapted for the detection of SARS-CoV-2; however, their performance still needs to be optimized to control future outbreaks of COVID-19, which will also serve to help the control of future infectious agents.

Comparative Analysis of COVID-19 Serological testing methods to Polymerase Chain Reaction: A systematic review and meta-analysis

“…Meta-analysis, incorporated data from 13 studies 10,11,20,21,12–19 , specifically examined the diagnostic accuracy of RDTs. The pooled sensitivity of RDTs across all studies was observed to be 73% (95% CI: 60–86), which is notably below the minimum performance requirement established by WHO at ≥ 80% 22 . This finding underscores a significant challenge in the overall sensitivity of these tests, potentially impacting their effectiveness in accurately identifying individuals with SARS-CoV-2 infection.…”

“…Moreover, it is also Vilca-Alosilla JJ et al 2023, examined and unveiled a wide spectrum of diagnostic sensitivity, ranging from 36.8% to 99.2%, with a median sensitivity of 94.5%. Similarly, the specificity of serological tests displayed variability, spanning from 79.3% to 99.8%, and a median specificity of 98.4% 22 . These findings underscore the significant diversity in sensitivity and specificity values observed across various studies, emphasizing the variability in the performance of serological tests for SARS-CoV-2 detection.…”