Laboratory diagnosis of COVID-19: current status and challenges

Abstract

The magnitude and pace of global affliction caused by Coronavirus Disease-19 (COVID-19) is unprecedented in the recent past. From starting in a busy seafood market in the Chinese city of Wuhan, the virus has spread across the globe in less than a year, infecting over 76 million people and causing death of close to 1.7 million individuals worldwide. As no specific antiviral treatment is currently available, the major strategy in containing the pandemic is focused on early diagnosis and prompt isolation of the infected individuals. Several diagnostic modalities have emerged within a relatively short period, which can be broadly classified into molecular and immunological assays. While the former category is centered around real-time PCR, which is currently considered the gold standard of diagnosis, the latter aims to detect viral antigens or antibodies specific to the viral antigens and is yet to be recommended as a stand-alone diagnostic tool. This review aims to provide an update on the different diagnostic modalities that are currently being used in diagnostic laboratories across the world as well as the upcoming methods and challenges associated with each of them. In a rapidly evolving diagnostic landscape with several testing platforms going through various phases of development and/or regulatory clearance, it is prudent that the clinical community familiarizes itself with the nuances of different testing modalities currently being employed for this condition.

Respiratory illness virus infections with special emphasis on COVID-19

“…Immunoassay includes lateral flow assay for detecting IgM and IgG antibodies against SARS-CoV-2. The rapid test kits for easy screening are accessible in many government and private laboratories: the SARS-CoV- are not the true diagnosing methods [133,163,164]. In a recent study, contradicting these rapid detection tests (RT-PCR or nucleic acid test for COVID-19), the Computed Tomography (CT) scan imaging reported higher sensitivity which avoids misinterpretation of the clinical symptoms [165].…”

Medical laboratory staff satisfaction and their perspective on the role of health institutions to combat COVID-19 pandemic

“…33 The chaotic situation created by the COVID-19 pandemic resulted in clinical laboratories facing unprecedented challenges. [34][35][36][37] Collecting proper samples and a prompt and accurate molecular diagnosis was essential to produce reliable results. However, in many testing centres, large volumes of clinical samples were collected and MLS often faced high workloads and difficulties in processing samples on time.…”

Peptide-Integrated Superparamagnetic Nanoparticles for the Identification of Epitopes from SARS-CoV-2 Spike and Nucleocapsid Proteins

“…Several studies have demonstrated that the use of nanotechnology, such as superparamagnetic nanoparticles (SPMNPs), can increase the diagnostic performance, offering new possibilities for the development of faster and more sensitive tests, with more accurate results in a short period of time, at a low cost. 20 − 27 SPMNPs are hysteresis-free, ideal for biomedical application, presenting high saturation magnetization value, and can be quickly moved in the desired direction; also, SPMNPs can be easily decorated with biomolecules. 28 , 29 A low-cost immunoassay based on magnetic beads was developed to detect antibodies against SARS-CoV-2, enabling a faster detection (in minutes) than conventional ELISA assays.…”

“…Because of this, the development of individual more efficient, faster, and accurate diagnostic methods is essential. Several studies have demonstrated that the use of nanotechnology, such as superparamagnetic nanoparticles (SPMNPs), can increase the diagnostic performance, offering new possibilities for the development of faster and more sensitive tests, with more accurate results in a short period of time, at a low cost. − SPMNPs are hysteresis-free, ideal for biomedical application, presenting high saturation magnetization value, and can be quickly moved in the desired direction; also, SPMNPs can be easily decorated with biomolecules. , A low-cost immunoassay based on magnetic beads was developed to detect antibodies against SARS-CoV-2, enabling a faster detection (in minutes) than conventional ELISA assays . Furthermore, a magnetic chemiluminescence enzyme immunoassay (MCLIA) using a synthetic peptide from SARS-CoV-2 S protein, presented promise in the detection of specific antibodies, IgG and IgM, without reaction crossover, evaluated in a cohort of 276 infected confirmed patients, with a rate of 81.52% positive .…”