The diagnostic accuracy of seven commercial molecular in vitro SARS-CoV-2 detection tests: a rapid meta-analysis.

OBJECTIVE To compare the evidence on the accuracy parameters of seven commercial molecular in vitro diagnostic tests for detecting SARS-CoV-2. METHODS Relevant articles were searched in PubMed and Scopus databases until December 2020. Studies evaluating the accuracy of seven different commercial molecular diagnostic tests for detecting SARS-CoV-2 (Cepheid Xpert Xpress SARS-CoV-2 test, Simplexa COVID-19 Direct, Abbott ID NOW COVID-19, Cobas SARS-CoV-2, Allplex 2019-nCoV Assay, Panther Fusion SARS-CoV-2, and BioFire COVID-19 Test) were included. The quality of included studies was assessed using the QUADAS-2 checklist. A bivariate random effects regression model was used for the meta-analyses. RESULTS Meta-analysis of 12 included studies showed that the performances of commercial COVID-19 molecular in vitro diagnostic tests were high, with a summary sensitivity of 95.9% (95% CI 93.9 - 97.2%, I2 = 60.22%) and specificity of 97.2% (95% CI 95.5 - 98.3%, I2 = 56.66%). Among seven evaluated tests, the Abbott ID NOW COVID-19 and Simplexa COVID-19 Direct displayed lower sensitivity (91.6%, 95% CI 80.5 - 96.6% and 92%, 95% CI 86.2 - 95.5, respectively). CONCLUSION In summary, all evaluated tests showed good accuracy. However, the slightly lower sensitivity observed in the Abbott ID Now COVID-19 and Simplexa COVID-19 Direct should be considered when deciding on a test platform. Moreover, diagnostic accuracy of COVID-19 commercial diagnostic tests should be weighed against its ease of use and speed.