Saliva as a Candidate for COVID-19 Diagnostic Testing: A Meta-Analysis
Saliva as a Candidate for COVID-19 Diagnostic Testing: A Meta-Analysis
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DOI：
10.3389/fmed.2020.00465
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发表时间：
2020-08-04
影响因子：
3.9
通讯作者：
Varga, Gabor
中科院分区：
文献类型：
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作者：
Czumbel, Laszlo Mark;Kiss, Szabolcs;Varga, Gabor
背景：COVID-19是一种严重且可能致命的疾病。对受感染者的早期诊断将在阻止其进一步升级方面发挥重要作用。目前采样的金标准是鼻咽拭子法。然而，最近的几篇论文表明，基于唾液的检测是一种有希望的替代方法，可以简化和加速COVID-19的诊断。目的：我们的目的是对唾液标本中SARS-CoV-2病毒RNA检测的可靠性和一致性进行荟萃分析。方法：我们根据科克伦手册报告了我们的荟萃分析。我们检索了科克伦图书馆、Embase、Pubmed、Scopus、Web of Science和临床试验注册中心，以查找2020年1月1日至4月25日期间发表的合格研究。收集阳性检测次数和进行的检测总数作为原始数据。合并数据中阳性试验的比例通过分数置信区间估计和Freeman-Tukey变换计算。用I（2）测量和卡方检验评估异质性。结果：系统检索发现96条记录后，删除重复。26条记录用于定性分析，5条记录用于定量综合。我们发现，在先前确诊的COVID-19患者中，唾液检测的灵敏度为91%（CI 80-99%），鼻咽拭子（ESTA）检测的灵敏度为98%（CI 89-100%），研究之间存在中度异质性。此外，我们确定了18个注册的，正在进行的基于唾液的检测病毒的临床试验。结论：唾液检测为COVID-19诊断提供了一种有希望的替代方法。然而，需要进一步的诊断准确性研究，以提高其特异性和敏感性。
Background:COVID-19 is a serious and potentially deadly disease. Early diagnosis of infected individuals will play an important role in stopping its further escalation. The present gold standard for sampling is the nasopharyngeal swab method. However, several recent papers suggested that saliva-based testing is a promising alternative that could simplify and accelerate COVID-19 diagnosis. Objectives:Our aim was to conduct a meta-analysis on the reliability and consistency of SARS-CoV-2 viral RNA detection in saliva specimens. Methods:We have reported our meta-analysis according to the Cochrane Handbook. We searched the Cochrane Library, Embase, Pubmed, Scopus, Web of Science and clinical trial registries for eligible studies published between 1 January and 25 April 2020. The number of positive tests and the total number of tests conducted were collected as raw data. The proportion of positive tests in the pooled data were calculated by score confidence-interval estimation with the Freeman-Tukey transformation. Heterogeneity was assessed using theI(2)measure and the chi(2)-test. Results:The systematic search revealed 96 records after removal of duplicates. Twenty-six records were included for qualitative analysis and 5 records for quantitative synthesis. We found 91% (CI 80-99%) sensitivity for saliva tests and 98% (CI 89-100%) sensitivity for nasopharyngeal swab (NPS) tests in previously confirmed COVID-19 patients, with moderate heterogeneity among the studies. Additionally, we identified 18 registered, ongoing clinical trials of saliva-based tests for detection of the virus. Conclusion:Saliva tests offer a promising alternative to NPS for COVID-19 diagnosis. However, further diagnostic accuracy studies are needed to improve their specificity and sensitivity.