Laboratory Diagnosis of COVID-19: Current Issues and Challenges

• Published in: Journal of clinical microbiology Vol. 58; no. 6
• Main Authors: Tang, Yi-Wei, Schmitz, Jonathan E., Persing, David H., Stratton, Charles W.
• Format: Journal Article
• Language: English
• Published: United States American Society for Microbiology 26.05.2020
• Subjects: Betacoronavirus - genetics; Betacoronavirus - immunology; Betacoronavirus - isolation & purification; Clinical Laboratory Techniques; Coronavirus Infections - diagnosis; COVID-19; COVID-19 Testing; COVID-19 Vaccines; Humans; Pandemics; Pneumonia, Viral - diagnosis; Polymerase Chain Reaction; SARS-CoV-2; COVID-19; result interpretation; specimen type; SARS-CoV-2; molecular testing; serology
• ISSN: 0095-1137; 1098-660X; 1098-660X
• DOI: 10.1128/JCM.00512-20

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