The 27-item PRISMA diagnostic test accuracy checklist provides specific guidance for reporting of systematic reviews. The PRISMA diagnostic test accuracy guideline can facilitate the transparent reporting of reviews, and may assist in the evaluation of validity and applicability, enhance replicability of reviews, and make the results from systematic reviews of diagnostic test accuracy studies more useful.

Cochrane Database of Systematic ReviewsAntibody tests for identification of current and past infection with SARS-CoV-2 (Review)

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Rapid, point-of-care antigen and molecular-based tests for diagnosis of SARS-CoV-2 infection (Review)

Systematic reviews of diagnostic test accuracy studies are increasingly being published, but they can be methodologically challenging. In this paper we present some of the recent developments in the methodology for conducting systematic reviews of diagnostic test accuracy studies. Restrictive electronic search filters are discouraged, as is the use of summary quality scores. Methods for metaanalysis should take the paired nature of the estimates and their dependence on threshold into account, we therefore advice authors of these reviews to use the hierarchical summary ROC or the bivariate model for the analysis of the data for the analysis. Challenges that remain are the poor reporting of original diagnostic test accuracy research, and difficulties with the interpretation of the results of diagnostic test accuracy research.

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Background COVID-19 is arguably the most important public health concern in 2020 worldwide, and efforts are now escalating to suppress or eliminate its spread. Objective In this study, we undertook a meta-analysis to estimate the global and regional SARS-CoV-2 seroprevalence rates in humans, and to assess whether seroprevalence associates with geographical, climatic and socio-demographic factors. Data sources We systematically reviewed PubMed, Scopus, Embase, medRxiv and bioRxiv databases for preprints or peer-reviewed articles (up to 14 August 2020). Study eligibility criteria Population-based studies describing the prevalence of anti-SARS-CoV-2 (IgG and/or IgM) serum antibodies. Participants People of different socio-economic and ethnic backgrounds – from the general population – whose prior COVID-19 status was unknown were tested for the presence of anti-SARS-CoV-2 serum antibodies. Interventions There were no interventions. Methods We used a random-effects model to estimate pooled seroprevalence, and then extrapolated the findings to the global population (for 2020). Subgroup and meta-regression analyses explored potential sources of heterogeneity in the data, and relationships between seroprevalence and socio-demographic, geographical and/or climatic factors. Results In total, 47 studies involving 399,265 people from 23 countries met the inclusion criteria. Heterogeneity ( I 2 = 99.4%, P < 0.001) was seen among studies; the SARS-CoV-2 seroprevalence in the general population varied from 0.37% to 22.1%, with a pooled estimate of 3.38% (95% CI, 3.05%–3.72%; 15,879/399,265). On a regional level, seroprevalence varied from 1.45% (0.95–1.94%; South America) to 5.27% (3.97–6.57%; Northern Europe, although some variation appeared to relate to the serological assay used. The findings suggested an association of seroprevalence with income levels, human development indices, geographical latitudes and/or climate. Extrapolating to the 2020 world population, we estimated that 263.5 million individuals had been exposed or infected at the time of this study. Conclusion This study showed that SARS-CoV-2 seroprevalence varied markedly among geographic regions, as might be expected early in a pandemic. Longitudinal surveys to continually monitor seroprevalence around the globe will be critical to support prevention and control efforts, and might indicate levels of endemic stability or instability in particular countries and regions. A. Rostami, Clin Microbiol Infect 2020 .

Canadian Institutes of Health Research.