血清IgG和IgM抗体对新型冠状病毒肺炎诊断价值的Meta分析

Diagnostic value of IgG and IgM for COVID-19:a meta-analysis

目的评价血清IgG和IgM抗体对新型冠状病毒肺炎(COVID-19)的诊断价值。方法检索PubMed、Sino Med、Google Scholar、CNKI等数据库中关于抗体诊断COVID-19的文献,筛选并提取纳入研究的信息后进行统计分析。结果共纳入18篇文献,共计3502例研究对象。IgM诊断的敏感性为0.71(0.68~0.74),特异性为0.97(0.95~0.98),SROC曲线下面积(AUC)为0.964;IgG诊断的敏感性为0.73(0.69~0.77),特异性为0.98(0.97~0.99),AUC为0.970;IgG和IgM联合诊断的敏感性为0.83(0.81~0.85),特异性为0.95(0.94~0.96),AUC为0.958。亚组分析显示:国内、国外IgG和IgM联合诊断的AUC分别为0.975、0.784,准确性差异有统计学意义。结论血清IgG和IgM抗体可作为COVID-19的辅助诊断方法,IgG和IgM联合检测可提高诊断敏感性。研究地区可能是血清抗体诊断准确性的影响因素,需要开展高质量的研究予以验证。

Objective To investigate the value of serum IgG and IgM in the diagnosis of COVID-19.Methods Pertinent articles from PubMed,CNKI,Google Scholar,and Sino Med were collected.In terms of heterogeneity,essential indexes such as sensitivity,specificity,and diagnostic odds ratio(DOR)were pooled using a random effects model.Summary receiver operating characteristic(SROC)curve was drawn by the Meta Disc1.4 software.Results Eighteen studies involving 3,502 subjects were enrolled.The sensitivity of serum IgM and IgG in COVID-19 detection were 0.71(0.68~0.74)and 0.73(0.69~0.77),respectively;specificity 0.97(0.95~0.98)and 0.98(0.97~0.99),respectively.AUC of IgM and IgG was 0.964 and 0.970,respectively.The sensitivity and specificity of the combination of IgG and IgM were 0.83(0.81~0.85)and 0.95(0.94~0.96),respectively and the AUC was 0.958.Meta-regression and subgroup analysis showed that there was significant difference in detection accuracy of COVID-19 between China and other countries,with an AUC of 0.975 and 0.784 respectivley.Conclusions Both serum IgM and IgG have high specificity but relatively low sensitivity in the detec-tion of COVID-19,and a greater diagnostic accuracy could be attained via the combination of serum IgG and IgM.Besides,geographical distribution might affect the diagnostic accuracy.Higher quality studies are needed to verify the above conclusion.