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BMJ:covid-19血清学检测诊断准确性研究

2020-07-04 MedSci原创 MedSci原创

研究认为,covid-19血清学检测的诊断准确性尚有待提高

近日研究人员开展系统综述及荟萃分析以确定2019年冠状病毒病(covid-19)血清学检测的诊断准确性。
 
研究人员收集2020年1月1日至4月30日相关研究数据,以病毒培养或逆转录酶聚合酶链反应为对照,少于5名参与者或样本的研究被排除在外。使用诊断准确性研究2(QUADAS-2)评估偏倚风险。
 
共40项研究纳入本次荟萃分析,共进行了49项偏差风险评估,98%(48/49)评估为偏倚的高风险,73%(36/49)的评估中存在高或不明确的偏倚风险。只有10%(4/40)的研究包含了门诊病人。对于每种检测方法,合并的敏感性和特异性与所测量的免疫球蛋白类别无关。ELISAs测定IgG或IgM的联合敏感性为84.3%,LFIAs为66.0%,CLIAs为97.8%。在所有的分析中,LFIAs的合并敏感性较低。合并特异性在96.6%到99.7%之间。在用于估计特异性的样本中,83%(10465/12?547)来自于流行前检测的人群或未怀疑感染covid-19的人群。在LFIAs中,商用试剂盒(65.0%)的联合敏感性低于非商用试剂盒(88.2%)。在所有的分析中都发现了异质性。在症状出现后至少三周内(从69.9%到98.9%)测试的敏感度高于第一周内(从13.4%到50.3%)。
 
研究认为,covid-19血清学检测的诊断准确性尚有待提高。
 
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    2020-07-08 gaoxiaoe
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