ABSTRACT
Coronavirus disease 2019 (COVID-19) developed into a pandemic within months. SARS-CoV-2 testing measures and vaccines became quickly accessible. However, due to pre- or asymptomatic transmission, effective disease control remains challenging. To complement conventional testing methods, scientists around the world have investigated dogs' olfactory capability for true real-time detection. Several diseases are known to produce specific scents in affected individuals, excreted as volatile organic compounds, which can be easily detected by dogs within seconds. This systematic review evaluates the current evidence for using dogs' olfactory system as a reliable COVID-19-screening tool. Two independent procedures for study quality assessment were used: the QUADAS-2 tool for the evaluation of laboratory tests' diagnostic accuracy, designed for systematic reviews, and a second system for the general evaluation of canine scent detection studies, adapted with a focus on medical scent detection. Twenty-seven studies from thirteen countries were evaluated. Particular attention was paid to potential confounding factors, e.g., study design, patient/sample selection, dog characteristics, training protocols, and sample types/treatment. These analysis systems revealed that respectively four and six studies had low risk of bias and high quality. The four QUADAS-2 non-biased studies resulted in sensitivity and specificity ranges of 81-97% and 91-100%, whereas the six high quality studies according to the general evaluation system revealed sensitivity and specificity ranges of 82-97% and 83-100%, respectively. The other studies contained high risk of bias, concerns about the methodological applicability and/or quality concerns. Standardization and certification procedures as used for canine explosives detection should be established for medical scent detection dogs in order to use their undoubtful potential in an optimal and structured way. '.
ABSTRACT
INTRODUCTION: Previous research demonstrated that medical scent detection dogs have the ability to distinguish SARS-CoV-2 positive from negative samples with high diagnostic accuracy. To deploy these dogs as a reliable screening method, it is mandatory to examine if canines maintain their high diagnostic accuracy in real-life screening settings. We conducted a study to evaluate the performance of medical scent detection dogs under real-life circumstances. METHODS: Eight dogs were trained to detect SARS-CoV-2 RT-qPCR-positive samples. Four concerts with a total of 2802 participants were held to evaluate canines' performance in screening individuals for SARS-CoV-2 infection. Sweat samples were taken from all participants and presented in a line-up setting. In addition, every participant had been tested with a SARS-CoV-2 specific rapid antigen test and a RT-qPCR and they provided information regarding age, sex, vaccination status and medical disease history. The participants' infection status was unknown at the time of canine testing. Safety measures such as mask wearing and distance keeping were ensured. RESULTS: The SARS-CoV-2 detection dogs achieved a diagnostic specificity of 99.93% (95% CI 99.74% to 99.99%) and a sensitivity of 81.58% (95% CI 66.58% to 90.78%), respectively. The overall rate of concordant results was 99.68%. The majority of the study population was vaccinated with varying vaccines and vaccination schemes, while several participants had chronic diseases and were under chronic medication. This did not influence dogs' decisions. CONCLUSION: Our results demonstrate that SARS-CoV-2 scent detection dogs achieved high diagnostic accuracy in a real-life scenario. The vaccination status, previous SARS-CoV-2 infection, chronic disease and medication of the participants did not influence the performance of the dogs in detecting the acute infection. This indicates that dogs provide a fast and reliable screening option for public events in which high-throughput screening is required.