This review received ethical approval from the Research and Community Engagement Ethical Committee of Faculty of Public Health, Universitas Indonesia Number: Ket-198/UN2.F10.D11/PPM.00.02/2020.

Original studies published in open-access journals before 1 August 2020 in English during the COVID-19 pandemic were included. Studies had to include rapid COVID-19 tests and screening. Closed access articles, audio, communication, reviews, reports, perspectives, case studies, surveys, clinical and molecular papers, mathematical modelling, and diagnostic procedures were excluded from this review.

A systematic search was conducted in four databases, specifically SCOPUS, Science Direct, ProQuest and PubMed. The keywords used to obtain data from Science Direct included COVID-19/COVID/coronavirus 2019 OR SARS-CoV-2 AND rapid test OR rapid diagnostic test AND screening.

For Scopus, the following search was used: ((TITLE-ABS-KEY (covid-19) OR TITLE-ABS-KEY (covid) OR TITLE-ABS-KEY (coronavirus 2019) OR TITLE-ABS-KEY (sars-cov-2) AND TITLE-ABS-KEY (rapid AND test) OR TITLE-ABS-KEY (covid AND diagnostic AND test) AND TITLE-ABS-KEY (screening)).

The search used for Science Direct was "COVID-19" OR COVID OR "coronavirus 2019" OR "SARS-CoV-2" AND ("rapid test" OR "rapid diagnostic test") screening. The ProQuest used covid-19 OR covid OR (coronavirus 2019) OR (sars-cov-2) AND (rapid test) OR (rapid diagnostic test) AND (screening).

The search used for PubMed was ((((covid-19) OR (covid) OR (coronavirus 2019) OR (SARS-CoV-2)) AND (rapid test)) OR (rapid diagnostic test)) AND (screening)))).

The initial screening was conducted for articles between 1 December 2019 and 31 July 2020. All the authors recorded and reviewed the collected articles. Furthermore, DS determined the study design, time frame, and criteria for the included studies to retrieve the articles and process the data. Importantly, DS retrieved the data from SCOPUS and Science Direct databases, while DP from ProQuest and PubMed databases as SGP's suggestion. The identified articles' information was imported into Excel worksheets and Mendeley Desktop, where duplicates between databases were removed. DS, DP, and SGP separately reviewed the titles to eliminate analysis that does not meet the inclusion criteria before reviewing the title and the abstract. Moreover, DS and DP accessed the full-text articles for the eligibility criteria. In case there were differences in the number of articles obtained, the two authors re-checked the articles again using the same criteria until the same articles are selected. The final decision of articles included was after DS and DP. All authors discussed the variables to assess the full paper using PICOS to determine the study questions. The PICOS's assessment used include 1) Population, 2) Intervention: The diagnostic tests for COVID-19, 3) Comparison: the method of the test and antigen or antibody results, and 4) Outcome: The antibody or antigen tests. Any discrepancies were resolved through consensus via a virtual meeting.

Quality assessment for the selected articles was performed using a modified checklist ⁹ that consisted of seven questions. If the answer of the question is ‘yes’, the value will be ‘1’, while if the answer is ‘no’, the value will be ‘0’. Each article will have a total value, then scored (in %) by calculating the total value divided by the total number of question, then multiplied by 100.

The score grouped into three scoring (in %) = total score divided by the total number of question, then multiplied by 100; then categorized as ‘good’ (68–100%), satisfactory (34–67%), and bad (0–30%), as shown in Table 1 (as an attachment).

All authors designed the variables to be described in the matrix and the topics discussed. The differences in the case detection method of the articles could be a source of bias. To minimize the biases, this review determined and selected the same variables (screening, symptoms, and diagnostic tests; at least an article had one of the following epidemiological parameters regarding COVID-19 or SARS-CoV-2: (i) signs and symptoms, (ii) types of test, (iii) case findings, (iv) screening and testing for COVID-19, (v) procedures for managing positive cases, or (vi) interventions or treatments.). The diagnostic test of each article was different after-time onset. Therefore, the authors used the limit after onset both less and more than 14 days (after onset ≤ 14 days and > 14 days).

The outcome of the analysis was displayed in a matrix containing the author's name, title, date of research, country of origin of the article, method, and results. Another table included the symptoms, incubation period, method of case finding, diagnostic tests, and type of examination in a more detailed manner. Management identification was based on the type of intervention, care, and treatment.

Descriptive synthesis conducted in the textual description of findings and presented in all tables. A narrative synthesis was undertaken for analysis based on the topics selected. The issues raised included high-risk group, case findings, symptoms of COVID-19 patients, diagnostic test, and the potential strengths and weaknesses of this review, are shown in Table 1. The average quality score was 87.1% and ranged from 71.4% to 100%.

Indonesia's government implemented a Rapid Test policy to accelerate the early detection of confirmed cases, both among health workers and other high-risk groups. However, this test has drawbacks because positive results are only obtainable among individuals with COVID-19 antibodies in their blood, which are generally formed on the seventh day after infection. Consequently, there is a possibility of the result being negative but does not mean that the individual is not infected. This occurrence is since the antibodies are yet to be formed; therefore, repetition is needed. The implementation of the rapid test is intended for individuals that are at risk. However, in this current condition, mass testing could be carried out considering the number of infected people without symptoms that have not received treatment and monitoring, which are all sources of transmission.

The elderly and individuals with pre-existing medical conditions such as high blood pressure, heart and lung disorders, diabetes, and cancer are at greater risk of experiencing severe COVID-19 symptoms ³⁸ . Furthermore, travelers and individuals who have had close contact with infected individuals and medical personnel ³⁹ . Therefore, surveillance for this group needs to be carried out daily with active case finding through screening for signs and symptoms and checking body temperature ³⁹ . Based on gender distribution, males are presumed to be associated with a higher prevalence of active smoking ⁴⁰ . It is suspected that there is an increase in ACE2 receptor expression in smokers, people with hypertension, and diabetes mellitus ^{40, 41} .

The COVID-19 pandemic has been driven by cross-border human mobility and region-specific COVID-19 susceptibilityy ⁴² . The diagnosis of new cases is inseparable from early precautions ² . One method of how a diagnosis is carried out is via screening. During the COVID-19 pandemic, screening at airports has been a priority due to its spread in 113 countries globally, which allegedly started in Wuhan (China). Initially, it was only a thermal test developed into a quarantine system at airports or ports. While active screening at airports is still an effective method for detecting new diseases, it does not provide 100% efficacy in case detection ⁴³ because there are passive cases that are yet reported at health services.

Surveillance activities may be either passive or active. In passive surveillance, the health department passively receives reports of suspected injury or illness. Conversely, epidemiologists actively seek out cases of disease ⁴⁴ . The detection of passive cases is triggered by patients seeking to be treated by doctors working in health facilities. Meanwhile, active screening detects 80% and 20% of imported and passive cases, respectively ⁴³ .

The active case findings under rapid tests in the community, for instance, in Indonesia, are currently being carried out by inviting individuals to various designated places, such as the health office, stadium, village centers, markets, and schools. South Korea adopted a test kit from SD Biosensor to carry out mass testing in its country as a preventive. This test has proven to be a practical rapid screening step, consequently reducing the death rate. However, this rapid test is also supported by the PCR test with free drive-through service. The test kit's performance is influenced by several factors, such as the period of emergence of symptoms, the concentration of virus in the specimen, quality and method of processing, and the reagent formulation in test kit ⁴⁵ .

The terms for COVID-19 patients are divided into several groups, namely patients under monitoring (ODP) or close contacts, patients under supervision (PDP) or suspected cases, and patients without symptoms (OTG) or confirmed cases without symptoms ¹¹ . The clinical manifestations of COVID-19 have a broad spectrum, ranging from asymptomatic, mild symptoms, pneumonia, severe pneumonia, acute respiratory distress syndrome (ARDS), sepsis to septic shock. Approximately 80% of cases have been classified as mild or moderate, 13.8% as severe, and over 6.1% as under critical condition ⁴⁶ . These manifestations usually appear within 2 to 14 days after exposure and common signs include acute respiratory symptoms such as fever, cough, and difficulty breathing. In severe cases, COVID-19 symptoms include pneumonia, ARDS, kidney failure, and even death. The severity of symptoms is influenced by the immune system, age, certain comorbidities such as hypertension, diabetes mellitus, asthma, heart disease, obesity, and some habits such as smoking, lack of exercise, and staying in poorly ventilated rooms ⁴⁷ .

The incubation period from when the virus was initially contracted to manifesting the first symptoms is usually 5 to 7 days (or within the range of 4–14 days). Current infection diagnosis relies on tests to detect the virus in various bodily fluids. Previous infections are confirmed through blood tests, and negative tests presume immunity to re-infection, although the duration and effectiveness of this protection are still unknown ⁴⁸ .

Laboratory-based molecular tests for detecting SARS-CoV-2 in the respiratory specimens are the current reference standard used to diagnose COVID-19, although serological immunoassays are rapidly being developed ⁴⁹ . One example of detection used respiratory specimens was conducted in Independent and Assisted Living Community for Older Adults —Seattle, Washington ⁴² . The detection of SARS-CoV-2 using nasopharyngeal swabs was carried out twice, precisely day-one and seven, on the staff members. The positive cases in the first round were isolated immediately using personal protective equipment irrespective of whether they showed no symptoms. Furthermore, in the second round, positive cases were also discovered among the people who did not have symptoms initially. This analysis needs to be carried out because positive cases are bound to be found in the housing of a group of elderly or nursing homes. Therefore, this examination need not be carried out only once ⁴² . IgM detection and IgA detection were possible from days 3 to 6 after the onset of the symptoms, while IgG starts to emerge from days 10 to 18 ⁵⁰ . Consequently, rapid antibody test is not recommended by the World Health Organization (WHO) as the primary basis for diagnosis. Therefore, serologically negative patients still need to be observed and re-examined to be confirmed ⁵¹ .

This study reported that all COVID-19 tests are effective when carried out in accordance with their purpose and objectives. However, not all studies reviewed have a similar pattern. Therefore only a few were compared. Meanwhile, the cost of rapid testing was not discussed, which varies widely and allows for differences in the examinations' quality.

All data underlying the results are available as part of the article and no additional source data are required.

Figshare: PRISMA checklist for 'A systematic review on the case findings and management of COVID-19; in the link https://doi.org/10.6084/m9.figshare.13586081.v1 ⁸

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).