Laboratory Diagnosis of COVID-19: Current Issues and Challenges

Abstract

19The COVID-19 outbreak has had a major impact on clinical microbiology laboratories in the past 20 several months. This commentary covers current issues and challenges for the laboratory 21 diagnosis of infections caused by SARS-CoV-2. In the pre-analytical stage, collecting the proper 22 respiratory tract specimen at the right time from the right anatomic site is essential for a 23 prompt and accurate molecular diagnosis of COVID-19. Appropriate measures are required to 24 keep laboratory staff safe while producing reliable test results. In the analytic stage, real-time 25 RT-PCR assays remain the molecular test of choice for the etiologic diagnosis of SARS-CoV-2 26 infection while antibody-based techniques are being introduced as supplemental tools. In the 27 postanalytical stage, testing results should be carefully interpreted using both molecular and 28 serological findings. Finally, random access, integrated devices available at the point of care 29 with scalable capacities will facilitate the rapid and accurate diagnosis and monitoring of SARS-30 CoV-2 infections and greatly assist in the control of this outbreak. 31 32

Optimization of SARS-CoV-2 detection by RT-QPCR without RNA extraction

“…To slow the spread of the pandemic, screening is the key (5). This allows to isolate positive patients and stop the transmission.…”

Case-finding: Fast, Available, and Efficient Font-line Diagnostics for SARS-CoV-2

“…The main rationale behind the recent advances in developing diagnostics for COVID-19 is achieving fast and cheap initial detection and confirmation of SARS-CoV-2 infection in different biological samples, including fecal samples, nasopharyngeal or oropharyngeal swabs, and environmental samples. Presently, the clinical testing relies mostly on reverse-transcription quantitative polymerase chain-reaction (RT-PCR) (3,4) in many countries, including developing countries. The viral genome sequencing and even electron microscopy have reportedly been used as confirmatory tests following PCR tests (4).…”

Management of Traumatic Spinal Fracture in the Coronavirus Disease 2019 Situation

“…The authors designed an algorithm to assess patients, presented in Fig.1. This is in contrast to the previous review, "Advice on standardized diagnosis and treatment for spinal diseases during the coronavirus disease 2019 pandemic, " which suggested that chest computed tomography and SARS-CoV-2 nucleic acid test should be performed three days before surgery [3,6]. Patients with confirmed COVID-19 should be transferred to the isolation ward for further treatment.…”