Background Lateral flow devices (LFDs) are viral antigen tests for the detection of SARS-CoV-2 that produce a rapid result, are inexpensive and easy to operate. They have been advocated for use by the World Health Organisation to help control outbreaks and break the chain of transmission of COVID-19 infections. There are now several studies assessing their accuracy but as yet no systematic review. Our aims were to assess the sensitivity and specificity of LFDs in a systematic review and summarise the sensitivity and specificity of these tests. Methods A targeted search of Pubmed and Medxriv, using PRISMA principles, was conducted identifying clinical studies assessing the sensitivity and specificity of LFDs as their primary outcome compared to reverse transcriptase polymerase chain reaction (RT-PCR) for the detection of SARS-CoV-2. Based on extracted data sensitivity and specificity was calculated for each study. Data was pooled based on manufacturer of LFD and split based on operator (self-swab or by trained professional) and sensitivity and specificity data were calculated. Results Twenty-four papers were identified involving over 26,000 test results. Sensitivity from individual studies ranged from 37.7% (95% CI 30.6–45.5) to 99.2% (95% CI 95.5–99.9) and specificity from 92.4% (95% CI 87.5–95.5) to 100.0% (95% CI 99.7–100.0). Operation of the test by a trained professional or by the test subject with self-swabbing produced comparable results. Conclusions This systematic review identified that the performance of lateral flow devices is heterogeneous and dependent on the manufacturer. Some perform with high specificity but a great range of sensitivities were shown (38.32–99.19%). Test performance does not appear dependent on the operator. Potentially, LFDs could support the scaling up of mass testing to aid track and trace methodology and break the chain of transmission of COVID-19 with the additional benefit of providing individuals with the results in a much shorter time frame. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06528-3.
【저자키워드】 COVID-19, SARS-CoV-2, coronavirus, Lateral flow device, Lateral flow test, Viral antigen detection, Rapid antigen detection, Reverse transcriptase polymerase chain reaction, Mass testing, Population testing, 【초록키워드】 Test, systematic review, Transmission, RT-PCR, polymerase chain reaction, sensitivity, specificity, Viral, Reverse transcriptase polymerase chain reaction, Accuracy, Sensitivity and specificity, Self-swab, outbreak, Clinical studies, Time frame, methodology, clinical study, operation, Scaling, reverse transcriptase, test results, Chain Reaction, Support, Viral antigen, LFD, Frame, Primary outcome, supplementary material, 95% CI, subject, chain, COVID-19 infections, individual, help, World Health Organisation, heterogeneous, sensitivities, operator, split, track, transcriptase, benefit, polymerase chain, Result, produced, shown, conducted, calculated, dependent on, comparable, ranged, Lateral, 【제목키워드】 Sensitivity and specificity,