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Diagnostic Testing for Severe Acute Respiratory Syndrome-Related Coronavirus 2: A Narrative Review.
Ann Intern Med. 2020 06 02; 172(11):726-734.AIM

Abstract

Diagnostic testing to identify persons infected with severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infection is central to control the global pandemic of COVID-19 that began in late 2019. In a few countries, the use of diagnostic testing on a massive scale has been a cornerstone of successful containment strategies. In contrast, the United States, hampered by limited testing capacity, has prioritized testing for specific groups of persons. Real-time reverse transcriptase polymerase chain reaction-based assays performed in a laboratory on respiratory specimens are the reference standard for COVID-19 diagnostics. However, point-of-care technologies and serologic immunoassays are rapidly emerging. Although excellent tools exist for the diagnosis of symptomatic patients in well-equipped laboratories, important gaps remain in screening asymptomatic persons in the incubation phase, as well as in the accurate determination of live viral shedding during convalescence to inform decisions to end isolation. Many affluent countries have encountered challenges in test delivery and specimen collection that have inhibited rapid increases in testing capacity. These challenges may be even greater in low-resource settings. Urgent clinical and public health needs currently drive an unprecedented global effort to increase testing capacity for SARS-CoV-2 infection. Here, the authors review the current array of tests for SARS-CoV-2, highlight gaps in current diagnostic capacity, and propose potential solutions.

Authors+Show Affiliations

McGill University Health Centre and McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada (M.P.C.).McGill Interdisciplinary Initiative in Infection and Immunity and Montreal Children's Hospital, Montreal, Quebec, Canada (J.P.).Brigham and Women's Hospital, Boston, Massachusetts, and Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (M.D.).Brigham and Women's Hospital, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (S.K.).CHU Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada (C.Q.).McGill University Health Centre, McGill Interdisciplinary Initiative in Infection and Immunity, and McGill University, Montreal, Quebec, Canada (M.L., C.P.Y.).Foundation of Innovative New Diagnostics, Malaria and Fever Program, Geneva, Switzerland, and University of Oxford, Oxford, United Kingdom (S.D.).McGill University Health Centre, McGill Interdisciplinary Initiative in Infection and Immunity, and McGill University, Montreal, Quebec, Canada (M.L., C.P.Y.).

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

32282894

Citation

Cheng, Matthew P., et al. "Diagnostic Testing for Severe Acute Respiratory Syndrome-Related Coronavirus 2: a Narrative Review." Annals of Internal Medicine, vol. 172, no. 11, 2020, pp. 726-734.
Cheng MP, Papenburg J, Desjardins M, et al. Diagnostic Testing for Severe Acute Respiratory Syndrome-Related Coronavirus 2: A Narrative Review. Ann Intern Med. 2020;172(11):726-734.
Cheng, M. P., Papenburg, J., Desjardins, M., Kanjilal, S., Quach, C., Libman, M., Dittrich, S., & Yansouni, C. P. (2020). Diagnostic Testing for Severe Acute Respiratory Syndrome-Related Coronavirus 2: A Narrative Review. Annals of Internal Medicine, 172(11), 726-734. https://doi.org/10.7326/M20-1301
Cheng MP, et al. Diagnostic Testing for Severe Acute Respiratory Syndrome-Related Coronavirus 2: a Narrative Review. Ann Intern Med. 2020 06 2;172(11):726-734. PubMed PMID: 32282894.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic Testing for Severe Acute Respiratory Syndrome-Related Coronavirus 2: A Narrative Review. AU - Cheng,Matthew P, AU - Papenburg,Jesse, AU - Desjardins,Michaël, AU - Kanjilal,Sanjat, AU - Quach,Caroline, AU - Libman,Michael, AU - Dittrich,Sabine, AU - Yansouni,Cedric P, Y1 - 2020/04/13/ PY - 2020/4/14/pubmed PY - 2020/6/9/medline PY - 2020/4/14/entrez KW - Antibodies KW - Antigens KW - COVID-19 KW - Cells KW - Infectious disease immunology KW - Nucleic acids KW - Prevention, policy, and public health KW - Pulmonary diseases KW - Research laboratories KW - Upper respiratory tract infections SP - 726 EP - 734 JF - Annals of internal medicine JO - Ann Intern Med VL - 172 IS - 11 N2 - Diagnostic testing to identify persons infected with severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infection is central to control the global pandemic of COVID-19 that began in late 2019. In a few countries, the use of diagnostic testing on a massive scale has been a cornerstone of successful containment strategies. In contrast, the United States, hampered by limited testing capacity, has prioritized testing for specific groups of persons. Real-time reverse transcriptase polymerase chain reaction-based assays performed in a laboratory on respiratory specimens are the reference standard for COVID-19 diagnostics. However, point-of-care technologies and serologic immunoassays are rapidly emerging. Although excellent tools exist for the diagnosis of symptomatic patients in well-equipped laboratories, important gaps remain in screening asymptomatic persons in the incubation phase, as well as in the accurate determination of live viral shedding during convalescence to inform decisions to end isolation. Many affluent countries have encountered challenges in test delivery and specimen collection that have inhibited rapid increases in testing capacity. These challenges may be even greater in low-resource settings. Urgent clinical and public health needs currently drive an unprecedented global effort to increase testing capacity for SARS-CoV-2 infection. Here, the authors review the current array of tests for SARS-CoV-2, highlight gaps in current diagnostic capacity, and propose potential solutions. SN - 1539-3704 UR - https://www.unboundmedicine.com/medline/citation/32282894/full_citation DB - PRIME DP - Unbound Medicine ER -