Tissue cultures are necessary for the study of in vitro virus replication. Philadelphia, USA: Elsevier Inc.; 2015. p. 191-223. Molecular diagnosis of COVID-19 primarily relies on the detection of RNA of the SARS-CoV-2 virus, the causative infectious agent of the pandemic. doi: 10.1101/2020.06.29.174888. Serological tests should be indicated from the second week of symptoms onwards. Ekaterini S. Goudourisa  Testing for all three viruses at the same time will provide public health officials with information they need to help reduce the spread of these viruses in the community while conserving resources that are in short supply. Examples of potential uses for POC instruments for COVID-19 diagnostic purposes include: 1. [ Links ], 9 Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DK, et al. d  <>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/TrimBox[9 9 594 792]/Type/Page>> Currently, the formal diagnosis of COVID-19 requires a laboratory test (RT-PCR) on samples taken from the nose and throat. [ Links ], 36 Sofia S, Boccatonda A, Montanari M, Spampinato M, D’Ardes D, Cocco G, et al. [ Links ], 27 Seow J, Graham C, Merrick B, Acors S, Steel KJA, Hemmings O, et al. � ��`,�;�m!���1Q���ҫRc�WYn!�d�LԢ�ߋ�k4F�a�+�9�]-ڼ����7RU���� J Invest Clin. 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 [ Links ], 35 Farias LPG, Strabelli DG, Sawamura MVY. 2020;26:1200-4. The support laboratory and imaging tests show alterations that are characteristic of COVID-19, but they lack specificity. ~����O�q�B�{m��e�0c)�F�i̘�(d����<5�M.�t�DM:��s�Lk��ړW����|��yWYz�`�VJ���wor���u}�t=��^k����]�[����tO��1/�Y'�����ף?S3��>���lyQ*����B���`��8\�7����ܒ?#K�/c�]�5Y���J��+W��O��qw��ە���θ�bI�_-�䖪9�R��YO����gb�XT���Vz��9��������#��{�����f�L� �Zj�MP�yH�0��:5���'o��G{�O0� �C`Q��p,�2Drh�8�랙��N]]q�-C�]�40-�Z(��C&y���U��"��Ob&��Y��֭ʼn]�i��-P��rn%0c���>�1 endobj New diagnostic methods with higher sensitivity and specificity, as well as faster results, are necessary and are being developed. 2020, preprint. In commercial laboratories, immunoenzymatic assays or agglutination tests are available for detection of viral antigens and nucleic acid amplification tests for detection of virus genetic material.4,5, An indirect way to diagnose viral infections is the identification of a specific immune system response. 2020;58:e0076-20. An updating article. Several serial amplification cycles are performed to identify these targets: the more cycles are needed, the lower the viral load of the material under study.8, Four regions of the SARS-CoV-2 genome have been targeted: RdRp gene (RNA-dependent RNA polymerase), genes from structural proteins E (virus envelope) and N (virus nucleocapsid), and ORF1ab gene (open reading frame 1a and 1b).3,8 Kits using different regions of the genome are commercially available. Similarities in the febrile course and other manifestations of some diseases may lead to clinical misdiagnosis of COVID-19 infection. Background . Factors used to decide whether to test you for COVID-19may differ depending on where you live. Virological assessment of hospitalized patients with COVID-2019. Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections. This was a non-systematic review of the literature on the laboratory diagnosis of COVID-19, drawing attention to the knowledge already established, as well as the doubts that still need to be clarified. [ Links ], 6 Rouse BT, Muller SN. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. In the preanalytical stage, collecting the proper respiratory tract specimen at the right time from the right anatomic site is … bioRxiv. The COVID-19 outbreak has had a major impact on clinical microbiology laboratories in the past several months. Laboratory Diagnosis of COVID-19 4 Serological methods Assays based on the detection of IgM / IgG antibodies can support outbreak investigation and seroprevalence studies. This method involves reverse transcription of the genetic material of the virus (RNA) to complementary DNA (cDNA), followed by amplification of some regions of the cDNA. A single negative test in an individual with a characteristic clinical picture should not discard the possibility of COVID-19.11 In turn, a positive RT-PCR has greater strength to confirm the diagnosis than a negative test has to discard it, since it presents high specificity, with only moderate sensitivity.11, Point-of-care tests for antibodies against SARS-CoV-2 using lateral flow assays (usually immunochromatography) are quite numerous and many of them have not been adequately validated.20 Moreover, they were tested in the laboratory using plasma or serum, but have been applied with whole blood, which can greatly modify their sensitivity.21 They are not recommended to be used for the individual diagnosis of COVID-19, but may be useful in implementing public policies.29.