Update on Rapid Diagnostics for COVID-19: A Systematic Review

Abstract

An accurate and rapid diagnosis of COVID-19 is an effective strategy for pandemic control, allowing disease screening and timely therapeutic intervention. We analyzed scientific reports about rapid tests for the diagnosis of COVID-19 to assess their reliability parameters. Medical Subject Headings terms or keywords related to point-of-care and rapid diagnostic testing for SARS-CoV-2 and COVID-19 were searched in data published from November 2020 to November 2021 in PubMed and Google Scholar databases. Notable differences were observed in sensitivity among direct tests that used different samples, and good accuracy was reported in a significant number of studies (>80%). Pediatric samples and samples with high Ct values (RT-PCR) had suboptimal sensitivity (range 45.4% to 66%). Further, a lack of sensitivity (<46.2%) was observed in point-of-care tests and in rapid diagnostic tests for antibody detection in the first days after infection, with increasing values in postinfection analysis (>60%). For serological detection of IgM or Antigen rapid diagnostic tests, no cross-reactivity was found with other coronaviruses. Therefore, although these tests are very important in facing the pandemic, they still need to be improved to test cross-reactivity against other pathogens, especially against other coronaviruses.