COVID-19 laboratory diagnosis: the whole truth, so far
DOI:
https://doi.org/10.25758/set.2254Keywords:
COVID-19, Laboratory diagnosis, Biological sampling, rRT_PCR, Immunologic rapid testsAbstract
Coronavirus disease 2019 (COVID-19) is the most recent worldwide biological threat to humans worldwide with a severe impact in all areas of human development particularly health, economy, and mobility, caused by a virus belonging to the Coronaviridae family (SARS-CoV-2). Currently, the definite diagnosis of COVID-19 is based on the viral isolation or positive result of polymerase chain reaction (PCR) performed from sputum, nasal swab, or throat swab, although the virus has also been detected in blood and stool. Biological sample collection is performed based on the existing guidelines and PCR protocols had to be adapted. Both sampling and PCR must be performed by specialized professionals in order to avoid false negatives which have been reported in several published papers. Furthermore, considering the limitations of molecular tools such as highly skilled professionals, infrastructure limitations, and supply shortages, rapid diagnostic tests have also been developed based on the detection of viral components (Direct; antigen detection) and in the host immune response (Indirect; antibody detection). Titers of SARS‐CoV‐2 antibodies may be used as an indicator of COVID‐19 prognosis and to discriminate asymptomatic carriers which allows the establishment of the COVID-19 spectrum; however, the persistence, reduction, and duration of SARS‐CoV‐2 immunity antibodies require further investigation. In a period of a pandemic without a vaccine or specific medications to stop the virus progression, testing is the most important task to perform in order to identify and isolate infected persons, even if they don’t present symptoms.
Downloads
References
Ceraolo C, Giorgi FM. Genomic variance of the 2019: nCoV coronavirus. J Med Virol. 2020;92(5):522-8.
World Health Organization. Laboratory testing for coronavirus disease (COVID-19) in suspected human cases: interim guidance [Internet]. Geneva: WHO; 2020. Available from: https://apps.who.int/iris/bitstream/handle/10665/331501/WHO-COVID-19-laboratory-2020.5-eng.pdf?sequence=1&isAllowed=y
British Columbia Centre for Disease Control. Sputum collection for tuberculosis (TB) testing. HealthLinkBC [Internet]. 2017;(51b). Available from: https://www.healthlinkbc.ca/healthlinkbc-files/sputum-tuberculosis-testing
Grant LR, Hammitt LL, Murdoch DR, O'Brien KL, Scott JA. Procedures for collection of induced sputum specimens from children. 2012;54(Suppl 2):S140-5.
Yukon Communicable Disease Control. Nasopharyngeal swab procedure [Internet]. UCDC; 2015 Oct. Available from: http://www.hss.gov.yk.ca/pdf/npswab.pdf
World Health Organization. WHO guidelines for the collection of human specimens for laboratory diagnosis of avian influenza infection [homepage]. Geneva: WHO; 2005. Available from: https://www.who.int/influenza/human_animal_interface/virology_laboratories_and_vaccines/guidelines_collection_h5n1_humans/en/
World Health Organization. Laboratory testing for 2019 novel coronavirus (2019-nCoV) in suspected human cases [homepage]. WHO; 2020 Mar 19. Available from: https://www.who.int/publications-detail/laboratory-testing-for-2019-novel-coronavirus-in-suspected-human-cases-20200117
Tan SC, Yiap BC. DNA, RNA, and protein extraction: the past and the present. J Biomed Biotechnol. 2009;2009:ID574398.
Centers for Disease Control and Prevention. CDC 2019-novel coronavirus (2019-nCoV) real-time RT-PCR diagnostic panel: for emergency use only [Internet]. CDC; 2020 Mar 30. Available from: https://www.fda.gov/media/134922/download
Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DK, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveil. 2020;25(3):2000045.
Chen L, Liu W, Zhang QI, Xu K, Ye G, Wu W, et al. RNA based mNGS approach identifies a novel human coronavirus from two individual pneumonia cases in 2019 Wuhan outbreak. Emerg Microbes Infect. 2020;9(1):313-9.
Tang YW, Schmitz JE, Persing DH, Stratton CW. The laboratory diagnosis of COVID-19 infection: current issues and challenges. J Clin Microbiol. 2020;58(6):e00512-20.
“Pr es s Pr e,” 2019.
Feng H, Liu Y, Lv M, Zhong J. A case report of COVID-19 with false negative RT-PCR test: necessity of chest CT. Jpn J Radiol. 2020;38(5):409-10.
European Center for Disease Prevention and Control. An overview of the rapid test situation for COVID-19 diagnosis in the EU/EEA [Internet]. Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/Overview-rapid-test-situation-for-COVID-19-diagnosis-EU-EEA.pdf
Racine R, Winslow GM. IgM in microbial infections: taken for granted? Immunol Lett. 2009;125(2):79-85.
Rokni M, Ghasemi V, Tavakoli Z. Immune responses and pathogenesis of SARS-CoV-2 during an outbreak in Iran: comparison with SARS and MERS. Rev Med Virol. 2020;30(3):e2107.
Haveri A, Smura T, Kuivanen S, Österlund P, Hepojoki J, Ikonen N, et al. Serological and molecular findings during SARS-CoV-2 infection: the first case study in Finland, January to February 2020. Euro Surveil. 2020;25(11):2000266.
Li Z, Yi Y, Luo X, Xiong N, Liu Y, Li S, et al. Development and clinical application of a rapid IgM-IgG combined antibody test for SARS-CoV-2 infection diagnosis. J Med Virol. 2020;10.1002/jmv.25727. [Epub ahead of print]
Cassaniti I, Novazzi F, Giardina F, Salinaro F, Sachs M, Perlini S, et al. Performance of VivaDiag COVID‐19 IgM/IgG rapid test is inadequate for diagnosis of COVID‐19 in acute patients referring to emergency room department. J Med Virol. 2020;10.1002/jmv.25800. [Epub ahead of print]
Conti P, Younes A. Coronavirus COV-19/SARS-CoV-2 affects women less than men: clinical response to viral infection. J Biol Regul Homeost Agents. 2020;34(2). [Epub ahead of print]
Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection [letter to the editor]. Clin Chem Lab Med. 2020;58(7):1131-4.
Lippi G, Plebani M. The critical role of laboratory medicine during coronavirus disease 2019 (COVID-19) and other viral outbreaks. Clin Chem Lab Med. 2020 Mar 19. [Epub ahead of print]
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Saúde e Tecnologia
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The journal Saúde & Tecnologia offers immediate free access to its content, following the principle that making scientific knowledge available to the public free of charge provides greater worldwide democratization of knowledge.
The journal Saúde & Tecnologia does not charge authors any submission or article processing charges (APC).
All content is licensed under a Creative Commons CC-BY-NC-ND license. Authors have the right to: reproduce their work in physical or digital form for personal, professional, or teaching use, but not for commercial use (including the sale of the right to access the article); deposit on their website, that of their institution or in a repository an exact copy in electronic format of the article published by Saúde & Tecnologia, provided that reference is made to its publication in Saúde & Tecnologia and its content (including symbols identifying the journal) is not altered; publish in a book of which they are authors or editors the total or partial content of the manuscript, provided that reference is made to its publication in Saúde & Tecnologia.