Recommendations for SARS-CoV-2/COVID-19 testing: A scoping review of current guidance

• Autores: Arévalo Rodriguez, Ingrid; Seron, Pamela; Buitrago García, Diana; Ciapponi, Agustín; Muriel, Alfonso; Zambrano Achig, Paula; Del Campo, Rosa; Galán Montemayor, Juan Carlos; Simancas Racines, Daniel; Perez Molina, Jose A.; Khan, Khalid Saeed; Zamora, Javier
• Año de publicación: 2021
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: DIAGNOSTIC MICROBIOLOGY; EPIDEMIOLOGY; PROTOCOLS & GUIDELINES; COVID-19
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

Background Testing used in screening, diagnosis and follow-up of COVID-19 has been a subject of debate. Several organisations have developed formal advice about testing for COVID-19 to assist in the control of the disease. We collated, delineated and appraised current worldwide recommendations about the role and applications of tests to control SARS-CoV-2/COVID-19. Methods We searched for documents providing recommendations for COVID-19 testing in PubMed, EMBASE, LILACS, the Coronavirus Open Access Project living evidence database and relevant websites such as TRIP database, ECRI Guidelines Trust, the GIN database, from inception to 21 September 2020. Two reviewers applied the eligibility criteria to potentially relevant citations without language or geographical restrictions. We extracted data in duplicate, including assessment of methodological quality using the Appraisal of Guidelines for Research and Evaluation-II tool. Results We included 47 relevant documents and 327 recommendations about testing. Regarding the quality of the documents, we found that the domains with the lowest scores were ´Editorial independence´ (Median=4%) and ´Applicability´ (Median=6%). Only six documents obtained at least 50% score for the ´Rigour of development´ domain. An important number of recommendations focused on the diagnosis of suspected cases (48%) and deisolation measures (11%). The most frequently recommended test was the reverse transcription-PCR (RT-PCR) assay (87 recommendations) and the chest CT (38 recommendations). There were 22 areas of agreement among guidance developers, including the use of RT-PCR for SARS-Cov-2 confirmation, the limited role of bronchoscopy, the use chest CT and chest X-rays for grading severity and the co-assessment for other respiratory pathogens. Conclusion This first scoping review of recommendations for COVID-19 testing showed many limitations in the methodological quality of included guidance documents that could affect the confidence of clinicians in their implementation. Future guidance documents should incorporate a minimum set of key methodological characteristics to enhance their applicability for decision making.
Fil: Arévalo Rodriguez, Ingrid. Centro de Investigación en Red en Bioingeniería; España. Hospital Universitario Ramón y Cajal; España
Fil: Seron, Pamela. Universidad de La Frontera; Chile
Fil: Buitrago García, Diana. University of Bern; Suiza
Fil: Ciapponi, Agustín. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Muriel, Alfonso. Hospital Universitario Ramón y Cajal; España. Centro de Investigación en Red en Bioingeniería; España
Fil: Zambrano Achig, Paula. Universidad UTE; Ecuador
Fil: Del Campo, Rosa. Hospital Universitario Ramón y Cajal; España
Fil: Galán Montemayor, Juan Carlos. Hospital Universitario Ramón y Cajal; España. Centro de Investigación en Red en Bioingeniería; España
Fil: Simancas Racines, Daniel. Universidad UTE; Ecuador
Fil: Perez Molina, Jose A.. Hospital Universitario Ramón y Cajal; España
Fil: Khan, Khalid Saeed. Universidad de Granada; España
Fil: Zamora, Javier. University of Birmingham; Reino Unido. Hospital Universitario Ramón y Cajal; España