Diagnostic options for coronavirus disease 2019 (COVID-19)

• Published in: Infection Control & Hospital Epidemiology Vol. 41; no. 11; pp. 1358 - 1359
• Main Authors: Xiao, Yuanyuan, Peng, Zhong, Tan, Caixia, Meng, Xiujuan, Huang, Xun, Wu, Anhua, Li, Chunhui
• Format: Journal Article
• Language: English
• Published: United States Cambridge University Press 01.11.2020
• Subjects: Antibodies; Antigens; Antigens, Viral - analysis; Clinical Laboratory Techniques - methods; Coronavirus Infections - diagnosis; Coronaviruses; COVID-19; COVID-19 Testing; Humans; Infections; Laboratories; Letter to the Editor; Nucleic Acid Amplification Techniques; Pandemics; Pneumonia; Pneumonia, Viral - diagnosis; Polymerase chain reaction; Radiography, Thoracic; Reverse Transcriptase Polymerase Chain Reaction; Serologic Tests; Severe acute respiratory syndrome coronavirus 2; Tomography, X-Ray Computed; Ultrasonic imaging; Viruses; China
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1017/ice.2020.168

[...]broader viral tests should be given to patients suspected to have COVID-19. Nucleic acid amplification tests (NAAT) The current first choice for the etiological diagnosis of COVID-19 is based on detection of unique sequences of virus RNA by real-time reverse-transcription polymerase chain reaction (rRT-PCR).1 The PCR test is appropriate for the acute phase of illness; however, cases of missed diagnoses have already been reported using this method.Reference Shi, Han and Jiang2,Reference Chan, Yip and To3 Recently, related research shows that the COVID-19-RdRp/Hel rRT-PCR test is highly sensitive and specific, which might help to reduce the false-negative rate and would be significantly useful for detecting specimens with low viral loads.Reference Chan, Yip and To3 Thus, in terms of technical and financial support, the current rRT-PCR testing available is relatively optimal for SARS-CoV-2 screening of suspected cases. [...]SARS-CoV-2-specific IgM or IgG antibody testing can be used as a diagnostic standard for COVID-19 in the case of a negative NAAT, when 2 dynamic tests are required.1,Reference Zhao, Yuan and Wang6 Rapid antigen tests In theory, rapid antigen tests have the advantages of fast detection speed and low cost, but as yet they have poor sensitivity and specificity for detecting coronaviruses (except MERS).Reference Chen, Chan and Hong7 Moreover, it is almost impossible to identify patients in the incubation period of infection, which is to say that antigen tests cannot be used as the sole basis for the diagnosis or exclusion of COVID-19.