Accuracy of the Polymerase Chain Reaction (PCR) test in the diagnosis of acute respiratory syndrome due to coronavirus: a systematic review and meta-analysis

Floriano, Idevaldo; Silvinato, Antônio; Bernardo, Wanderley Marques; Reis, João; Soledade, Gabriel Nogueira Bastos

doi:10.1590/1806-9282.66.7.880

Cited by 30 publications

(19 citation statements)

References 24 publications

(10 reference statements)

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“…Our mobile PCR platform provided a sensitivity of 95% and a specificity of 97%. A systematic review and meta-analysis by Floriano et al [10] pooled data from 13 studies and showed a sensitivity of 86% (84 -88%) and specificity of 96% (94 -97%). There was a low risk of bias, and >6 000 patients were included.…”

Section: Discussionmentioning

confidence: 99%

The impact of a mobile COVID-19 polymerase chain reaction laboratory at a large tertiary hospital during the first wave of the pandemic: A retrospective analysis

et al. 2021

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The onset of the COVID-19 pandemic in South Africa (SA), [1] as in Europe and North America, created numerous supply challenges, including testing for SARS-CoV-2 using reverse transcriptase polymerase chain reaction (RT-PCR). Demand for diagnostic testing overwhelmed the capacity to deliver, leading to several innovative solutions. [2] Pooled testing was found to be an efficient and costeffective solution to the large numbers of requested tests, and the US Centers for Disease Control and Prevention released guidelines for laboratories. [3,4] Point-of-care (PoC) testing was suggested as another possible solution to help overcome the capacity issues faced by laboratories. [5] In our own experience at Chris Hani Baragwanath Academic Hospital, Johannesburg, obtaining COVID-19 results from the hospital laboratory meant a waiting period of 7 -14 days owing to a lack of onsite COVID-19 PCR testing. All emergency admissions were allocated to the COVID or non-COVID stream. Given the sheer size of our hospital (>2 800 beds), even a 24-hour turnaround time was not practically acceptable in terms of safety of both patients and staff. At that early phase of the first wave of the pandemic, rapid, accurate PoC PCR testing and antigen testing were not yet available. [6] Viral cultures are known to be time consuming, and the gold standard for the diagnosis of COVID-19 is RT-PCR, which detects SARS-CoV-2 RNA in clinical specimens. [7,8] The university Vaccine and Infectious Disease Analytics Research Unit based at the hospital had initiated a surveillance study using PCR to test symptomatic COVID-19 patients at the hospital. However, COVID-19 may have a variable clinical presentation, with a significant proportion of patients being asymptomatic. [9] To safely triage patients with non-COVID presentations, including trauma, acute surgical, obstetric, medical, paediatric and other emergencies, the intensive care unit (ICU) medical staff, with the assistance of a non-governmental organisation and the Perinatal HIV Research Unit (PHRU), established a mobile PCR laboratory and positioned it centrally in the hospital.We describe the utility and outcomes of this PCR laboratory established in a mobile trailer by non-laboratory healthcare workers. ObjectivesTo describe the utility and outcomes of the PCR laboratory, estab lished in a mobile trailer and staffed by non-laboratory healthcare workers. The primary objective was to determine the clinical sensitivity, specificity, and positive and negative predictive values of the COVID-19 PCR assay used for patients requiring emergency hospital resources, and the secondary objective to determine the prevalence of COVID-19 infections among patients admitted to and medical staff working in the non-COVID ICU during the study period.

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Section: Discussionmentioning

confidence: 99%

The impact of a mobile COVID-19 polymerase chain reaction laboratory at a large tertiary hospital during the first wave of the pandemic: A retrospective analysis

et al. 2021

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“…For example, internal inspection for the accuracy of the real-time RT-PCR test kits was conducted in our hospital and we found that the minimum viral load of the specimen to provide a positive result is more than two copies per assay. This type of test is specifically classified as a high-accuracy test in comparison to other tests for SARS-CoV-2 13,14) ; however, the time required for obtaining results from real-time RT-PCR tests limits their use in rapid diagnosis (Table 2).…”

Section: Real-time Reverse Transcription-pcr (Real-time Rt-pcr) Testsmentioning

confidence: 99%

Diagnostic Tests for COVID-19 and Their Accuracy: Important Information for Physicians Caring for Patients with Stroke

Hirayama

Asai

Srivatanakul

et al. 2021

JNET

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Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2), which appeared at the end of 2019 and has spread rapidly worldwide. In Japan, the increasing number of people infected with SAR-CoV-2 is also a cause of concern for physicians managing stroke patients. From the perspective of viral transmission in the hospital, stroke physicians must determine whether patients who have been transported by emergency have confirmed or suspected COVID-19. For this reason, stroke physicians must also understand about the characteristics and accuracy of the test for COVID-19 diagnosis. This article describes the sensitivity of the clinical symptoms, imaging investigations such as chest radiography and chest CT, and accuracy of nucleic-acid amplification tests and antigen tests used in the diagnosis of COVID-19. However, it should be noted that the accuracy of specimen tests may change depending on the collection site, timing, and method, because positive results in these tested specimens depend on the viral loads. In performing medical treatment for stroke, high accuracy and rapid inspection for COVID-19 is desired, but this is not currently available. For acute stroke treatment, such as thrombectomy, we recommend that these emergency patients, who are suspected of COVID-19 by clinical symptoms and image investigations, should be treated with implementation of strict infection control against droplets, contact, and airborne transmission until the most sensitive polymerase chain reaction test result is confirmed as negative.

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“…This is how sensitivity to increases and decreases of temperature is such a delicate issue for the efficiency and efficacy of this technique. Sensitivity of PCR technique for coronavirus diagnosis in contexts of a high prevalence is 86 %, having a specificity of 96 % [9].…”

Section: Theoretical Principles Of the Pcrmentioning

confidence: 99%

“…Due to the rapid spread of coronavirus diseases a reliable detectable method is needed for an accurate diagnose [11]. The sequenced RNA of the virus which belongs to specific synthesis of proteins, is transcript into complementary DNA (cDNA) strands and subsequently the selected fragments of cDNA is amplified [9]. After increasing the number of DNA molecules, detection and visualization of nucleotides combinations are usually done by methods like agarose gel electrophoresis [11].…”

Section: Clinical Application Of Pcr For Diagnosing Covid-19mentioning

confidence: 99%

Polymerase Chain Reaction (PCR) and How Temperature Modifies Nucleotide Pairings

Falgueras

2021

CTBEB

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Polymerase Chain Reaction (PCR) is a molecular technique more suitable for accurate diagnoses because of its specificity in targeting and identifying specific pathogens. PCR technique is reliable to detect the genetic presence of the virus in the host since the very beginning of the infection, no matter how the immune system of the person might react. Moreover, the samples for the test contains the DNA information during quite a long time since the extraction. Programmable thermal operation cycler for controlling heating and cooling is the procedure to denaturation into two single strands, annealing and extension reactions of the DNA. The PCR is certainly having a clinical approach, because do not emphasized on how the immune system of the patient might reacts to the infection, only on whether the specific virus is present or not for the accurate diagnoses and subsequently proceed with an appropriated medical treatment to restore health.

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Accuracy of the Polymerase Chain Reaction (PCR) test in the diagnosis of acute respiratory syndrome due to coronavirus: a systematic review and meta-analysis

Cited by 30 publications

References 24 publications

The impact of a mobile COVID-19 polymerase chain reaction laboratory at a large tertiary hospital during the first wave of the pandemic: A retrospective analysis

The impact of a mobile COVID-19 polymerase chain reaction laboratory at a large tertiary hospital during the first wave of the pandemic: A retrospective analysis

Diagnostic Tests for COVID-19 and Their Accuracy: Important Information for Physicians Caring for Patients with Stroke

Polymerase Chain Reaction (PCR) and How Temperature Modifies Nucleotide Pairings

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