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Universal screening for SARS-CoV-2 infection: a rapid review
Meera Viswanathan1, Leila Kahwati1, Beate Jahn2
1RTI International, Research Triangle Park, North Carolina, USA.
The Cochrane Database of Systematic Reviews
|January 27, 2021
Summary
Universal screening for COVID-19 (Coronavirus disease 2019) shows low accuracy and may miss many infected individuals. Current screening methods are insufficient, necessitating a greater focus on other transmission prevention strategies.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Diagnostic Accuracy Studies
Background:
- COVID-19, caused by SARS-CoV-2, presents with varying severity, including asymptomatic and presymptomatic infectiousness.
- Universal screening aims to detect infectious individuals before clinical presentation to control disease spread.
Purpose of the Study:
- To assess the effectiveness of universal SARS-CoV-2 screening compared to no screening.
- To evaluate the accuracy of universal SARS-CoV-2 screening in asymptomatic individuals.
Main Methods:
- Rapid review of trials, observational studies, and mathematical modeling studies.
- Searches conducted across multiple databases (MEDLINE, Embase, CENTRAL, etc.) up to May 2020.
- Data extraction and quality assessment using QUADAS-2 and GRADE approaches.
Main Results:
- Two modeling studies suggest screening at travel hubs may slightly slow importation, with low-certainty evidence.
- Seventeen cohort studies reported low to very low sensitivity for various screening strategies (symptom assessment, temperature, travel history).
- Accuracy varied widely, with a high potential for missed cases and false positives.
Conclusions:
- Evidence for screening effectiveness is limited and of low certainty.
- Existing screening strategies demonstrate significant uncertainty and variability in accuracy.
- Greater emphasis on non-screening interventions like face coverings and physical distancing is recommended.
