Background The global COVID-19 pandemic has led to extensive development in many fields, including the diagnosis of COVID-19 infection by mass spectrometry. The aim of this systematic review and meta-analysis was to assess the accuracy of mass spectrometry diagnostic tests developed so far, across a wide range of biological matrices, and additionally to assess risks of bias and applicability in studies published to date. Method 23 retrospective observational cohort studies were included in the systematic review using the PRISMA-DTA framework, with a total of 2858 COVID-19 positive participants and 2544 controls. Risks of bias and applicability were assessed via a QUADAS-2 questionnaire. A meta-analysis was also performed focusing on sensitivity, specificity, diagnostic accuracy and Youden’s Index, in addition to assessing heterogeneity. Findings Sensitivity averaged 0.87 in the studies reviewed herein (interquartile range 0.81–0.96) and specificity 0.88 (interquartile range 0.82–0.98), with an area under the receiver operating characteristic summary curve of 0.93. By subgroup, the best diagnostic results were achieved by viral proteomic analyses of nasopharyngeal swabs and metabolomic analyses of plasma and serum. The performance of other sampling matrices (breath, sebum, saliva) was less good, indicating that these protocols are currently insufficiently mature for clinical application. Conclusions This systematic review and meta-analysis demonstrates the potential for mass spectrometry and ‘omics in achieving accurate test results for COVID-19 diagnosis, but also highlights the need for further work to optimize and harmonize practice across laboratories before these methods can be translated to clinical applications. Highlights • Mass spectrometry complements RT-PCR in COVID-19 diagnostics. • Meta-analysis of mass spectrometry diagnostics for COVID-19 shows accuracy of 87%. • Diagnosis in admissions settings is a promising use-case for mass spectrometry. • Future work should focus on validating features and protocols across laboratories.
【저자키워드】 COVID-19, Meta-analysis, mass spectrometry, systematic review, diagnostics, AUROC, Area Under Receiver Operating Characteristic, DI, Direct Injection, FAIMS, high-Field Asymmetric-waveform Ion-Mobility Spectrometry, GC, Gas Chromatography, ESI, Electrospray Ionization, HESI, Heated Electrospray Ionization, IMS, Ion Mobility Spectrometry, LC, Liquid Chromatography, nLC, nano-Liquid Chromatography, MALDI, Matrix Assisted Laser Desorption Ionization, NMR, Nuclear Magnetic Resonance, QTOF, Quadrupole Time of Flight, ROC, Receiver Operating Characteristic, RT-PCR, Polymerase Chain Reaction combined with Reverse Transcription, TFC, Turbulent Flow Chromatography, TOF, Time of Flight, UHPLC, Ultra High pressure Liquid Chromatography, 【초록키워드】 Meta-analysis, Saliva, mass spectrometry, protocol, COVID-19 pandemic, diagnostic test, Infection, diagnostic, systematic review, complement, RT-PCR, Cohort studies, heterogeneity, Laboratory, Nasopharyngeal swab, serum, sensitivity, specificity, Diagnostic accuracy, Accuracy, COVID-19 infection, nasopharyngeal swabs, diagnostic tests, breath, COVID-19 diagnosis, plasma, characteristic, Admission, questionnaire, proteomic, retrospective, Analysis, protocols, receiver operating characteristic, index, Observational cohort study, interquartile range, QUADAS-2, participant, future work, finding, applicability, positive, Future, controls, metabolomic, feature, highlight, performed, addition, less, translated, averaged, diagnosis of COVID-19, risks of bia, were assessed, 【제목키워드】 diagnostic, Accuracy,