Cochrane corner: universal screening for SARS-CoV-2 infection.

Area of Science:

• Public Health
• Infectious Diseases
• Diagnostic Accuracy

Background:

• Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, presents a spectrum of illness, including asymptomatic infection.
• Universal screening aims to detect infections before symptom onset to control disease spread.

Purpose of the Study:

• To assess the effectiveness and accuracy of universal COVID-19 screening through a Cochrane rapid review.
• To evaluate screening strategies for identifying infected individuals among those without symptoms.

Main Methods:

• A comprehensive search of electronic databases identified studies on universal screening effectiveness and test accuracy.
• Included participants were individuals not seeking care for potential COVID-19 symptoms.
• Reverse transcriptase-polymerase chain reaction (RT-PCR) served as the gold standard for accuracy assessment in cohort studies.

Main Results:

• Twenty-two publications were included, with no studies conducted in Africa.
• Low certainty of evidence suggests screening at travel hubs may minimally reduce imported cases.
• Significant uncertainty and variability exist in the accuracy of screening tests for COVID-19.

Conclusions:

• Low test accuracy risks missing a substantial number of COVID-19 cases, potentially facilitating further transmission.
• False positive results can lead to unnecessary isolation of healthy individuals, requiring confirmatory testing.