Detection profile of SARS‐CoV‐2 using RT‐PCR in different types of clinical specimens: A systematic review and meta‐analysis

Abstract

Testing is one of the commendable measures for curbing the spread of coronavirus disease (COVID‐19). But, it should be done using the most appropriate specimen and an accurate diagnostic test such as real‐time reverse transcription‐polymerase chain reaction (qRT‐PCR). Therefore, a systematic review was conducted to determine the positive detection rate of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) in different clinical specimens using qRT‐PCR. A total of 8136 pooled clinical specimens were analyzed to detect SARS‐CoV‐2, the majority were nasopharyngeal swabs (69.6%). A lower respiratory tract (LRT) specimens had a positive rate (PR) of 71.3% (95% confidence interval [CI]: 60.3%‐82.3%) while no virus was detected in the urinogenital specimens. Bronchoalveolar lavage fluid (BLF) specimen had the PR of 91.8% (95% CI: 79.9%‐103.7%), followed by rectal swabs; 87.8% (95% CI: 78.6%‐96.9%) then sputum; 68.1% (95% CI: 56.9%‐79.4%). A low PR was observed in oropharyngeal swabs; 7.6% (95% CI: 5.7%‐9.6%) and blood samples; 1.0% (95% CI: −0.1%‐2.1%) whereas no SARS‐CoV‐2 was detected in urine samples. Feces had a PR of 32.8% (95% CI:1 5.8%‐49.8%). Nasopharyngeal swab, a widely used specimen had a PR of 45.5% (95% CI: 31.2%‐59.7%). In this study, SARS‐CoV‐2 was highly detected in LRT specimens while no virus was detected in urinogenital specimens. BLF had the highest PR followed by rectal swab then sputum. Nasopharyngeal swab which is widely used had moderate PR. Low PR was recorded in oropharyngeal swab and blood samples while no virus was found in urine samples. Last, the virus was detected in feces, suggesting SARS‐CoV‐2 transmission by the fecal route.

Recurrent SARS-CoV-2 RNA positivity after COVID-19: a systematic review and meta-analysis

“…www.nature.com/scientificreports/ specimens probably influence the detection rate of recurrent positivity. As previously reported in a systematic review, the positive rate (PR) for nasopharyngeal swab, fecal, and oropharyngeal swab were 45.5%, 32.8%, and 7.6%, respectively 23 , with the highest reported detection rate being from specimens collected from the bronchoalveolar lavage fluid (PR of 92%) 23 . None of the studies included in our meta-analysis had collected samples from bronchoalveolar lavage fluid.…”

Comparing saliva and nasopharyngeal swab specimens in the detection of COVID-19: A systematic review and meta-analysis

“…In contrast to other review studies concerning SARS-CoV-2 which included only 5, 7, and 11 articles in the quantitative synthesis, our study utilized 14 articles to support the result and ensure a firm conclusion between saliva and NPS specimens in detecting COVID-19. 34 , 35 , 36 Moreover, since there is still limited data on COVID-19, this review study did not take other factors, such as other specimens and severity of disease or others diagnostic techniques into account. Further studies should address these issues.…”

Quantitative analysis of SARS-CoV-2 RNA from wastewater solids in communities with low COVID-19 incidence and prevalence

“…Recent systematic reviews and meta-analyses of the current peer-reviewed and preprint literature confirm fecal SARS-CoV-2 viral RNA detection in roughly half of COVID-19 patients ( Gupta et al, 2020 ; Parasa et al, 2020 ). Moreover, a systematic review and meta-analysis of SARS-CoV-2 viral RNA detection profiles in several different types of COVID-19 patient specimens found that positive detection rates were higher in rectal and sputum swabs than in the commonly used NP swab ( Bwire et al, 2020 ). These data provide a clear rationale to probe wastewater for SARS-CoV-2 RNA.…”