Potential Use of Exhaled Breath Condensate for Diagnosis of SARS-CoV-2 Infections: A Systematic Review and Meta-Analysis

Abstract

Background. Reverse-transcriptase polymerase chain reaction (RT-qPCR) assays performed on respiratory samples collected through nasal swabs still represent the gold standard for COVID-19 diagnosis. Alternative methods to this invasive and time-consuming options are still being inquired, including the collection of airways lining fluids through exhaled breath condensate (EBC). Materials and Methods. We performed a systematic review and meta-analysis in order to explore the reliability of EBC as a way to collect respiratory specimens for RT-qPCR for diagnosis of COVID-19. Results. A total of 4 studies (205 specimens), were ultimately collected, with a pooled sensitivity of 69.5% (95%CI 26.8–93.4), and a pooled specificity of 98.3% (95%CI 87.8–99.8), associated with high heterogeneity and scarce diagnostic agreement with the gold standard represented by nasal swabs (Cohen’s kappa = 0.585). Discussion. Even though non-invasive options for diagnosis of COVID-19 are still necessary, EBC-based RT-qPCR showed scarce diagnostic performances, ultimately impairing its implementation in real-world settings. However, as few studies have been carried out to date, and the studies included in the present review are characterized by low numbers and low sample power, further research are requested to fully characterize the actual reliability of EBC-based RT-qPCR in the diagnosis of COVID-19.

BoDV-1 Infection in Children and Adolescents: A Systematic Review and Meta-Analysis

“…Several distinctive diagnostic procedures have been designed [ 15 , 20 , 21 , 40 , 43 , 48 , 50 , 54 , 70 ], and commercial kits have even been made available [ 49 ], with each one characterized by substantial advantages and disadvantages. As recently stressed by SARS-CoV-2 pandemic [ 82 , 83 , 84 ], RT-qPCR could radically improve the detection and the quantification of viral diseases in infected individuals, but its use in daily practice on BoDV-1 infections is limited [ 3 , 12 , 13 , 21 , 44 ]. In fact, RT-qPCR is a standard technique in post-mortem analysis for suspected BoDV-1 infections.…”