Severe respiratory distress syndrome coronavirus 2 (SARS-CoV-2) has been at the center of global attention recently, ever since its initial appearance in Wuhan, China, in December of 2019. This novel disease has been a source of growing concern which has been shared internationally by social communities and health care professionals alike, due to its exponentially increasing rate of infection and difficulty to control. Currently, no definitive or effective treatment has been found for COVID-19, but there are several ongoing trials investigating whether a certain medication, vaccination, or supportive therapy might prove to be effective. Coincidentally, SARS-CoV-2 may be a new pathogen, but it resembles SARS-CoV and MERS-CoV coronaviruses in its genome, structure, modes of transmission, and pathogenesis. This has contributed to an advantageous understanding of the virus and has served as the basis of decision-making for infection control plans, research, and management of the disease. As of July, 2020, SARS-CoV-2 has spread to every continent excluding Antarctica, with confirmed cases of COVID-19 in virtually every country, and is responsible for over 500,000 deaths worldwide. This review of the COVID-19 pandemic aims to offer a comprehensive and thorough explanation of the disease, including its significance and impact on surgery, by drawing information from the most up to date and relevant sources available.

COVID-19: a review

COVID-19 is a disease caused by SARS-CoV-2 capable of causing mild to severe infections in humans. Since its first appearance in China in December 2019, the pandemic has spread rapidly throughout the world. Despite considerable efforts made to contain the disease, the virus has continued its prevalence in many countries with varying degrees of clinical manifestations. To contain this pandemic, collaborative approach involving accurate diagnosis, epidemiology, surveillance, and prophylaxis is essential. However, proper diagnosis using rapid technologies plays a crucial role. With increasing incidence of COVID-19 cases, the accurate and early detection of the SARS-CoV-2 is need of the hour for effective prevention and management of COVID-19 cases as well as to curb its spread. RT-qPCR assay is considered to be the gold standard for the early detection of virus, but this protocol has limited application to use as bedside test because of its technical complexity. To address these challenges, several POC assays have been developed to facilitate the COVID-19 diagnosis outside the centralized testing laboratories as well to accelerate the clinical decision making with a least turnaround time. Hence, in this report, we review different nucleic acid-based and serological techniques available for the diagnosis and effective prevention of COVID-19. KEY POINTS : • Provides comprehensive information on the different diagnostic tools available for COVID-19 • Nucleic acid based tests or antigen detection tests are used for diagnostic purpose • Accurate diagnosis is essential for the efficient management of COVID-19.

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Detection technologies and recent developments in the diagnosis of COVID-19 infection.

Background The availability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serologic testing has rapidly increased. Current assays use a variety of technologies, measure different classes of immunoglobulin or immunoglobulin combinations and detect antibodies directed against different portions of the virus. The overall accuracy of these tests, however, has not been well-defined. The Infectious Diseases Society of America (IDSA) convened an expert panel to perform a systematic review of the coronavirus disease 2019 (COVID-19) serology literature and construct best practice guidance related to SARS-CoV-2 serologic testing. This guideline is the fourth in a series of rapid, frequently updated COVID-19 guidelines developed by IDSA. Objective IDSA's goal was to develop evidence-based recommendations that assist clinicians, clinical laboratories, patients and policymakers in decisions related to the optimal use of SARS-CoV-2 serologic tests in a variety of settings. We also highlight important unmet research needs pertaining to the use of anti-SARS-CoV-2 antibody tests for diagnosis, public health surveillance, vaccine development and the selection of convalescent plasma donors. Methods A multidisciplinary panel of infectious diseases clinicians, clinical microbiologists and experts in systematic literature review identified and prioritized clinical questions related to the use of SARS-CoV-2 serologic tests. Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to assess the certainty of evidence and make testing recommendations. Results The panel agreed on eight diagnostic recommendations. Conclusions Information on the clinical performance and utility of SARS-CoV-2 serologic tests are rapidly emerging. Based on available evidence, detection of anti-SARS-CoV-2 antibodies may be useful for confirming the presence of current or past infection in selected situations. The panel identified three potential indications for serologic testing including: 1) evaluation of patients with a high clinical suspicion for COVID-19 when molecular diagnostic testing is negative and at least two weeks have passed since symptom onset; 2) assessment of multisystem inflammatory syndrome in children; and 3) for conducting serosurveillance studies. The certainty of available evidence supporting the use of serology for either diagnosis or epidemiology was, however, graded as very low to moderate.

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Infectious Diseases Society of America Guidelines on the Diagnosis of COVID-19:Serologic Testing.

SARS-CoV-2-IgG response is different in COVID-19 outpatients and asymptomatic contact persons.

Introduction: The gold standard for diagnosis of coronavirus disease 2019 (COVID-19) is detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR), which is expensive, time-consuming and may result in false-negative results. Serological tests can be employed for RT-PCR negative patients, contact tracing, determining the probability of protection against re-infection, and seroepidemiological studies.Areas covered: The main methodologies of serology-based tests for the detection of SARS-CoV-2 including enzyme-linked immunosorbent assays (ELISAs), chemiluminescent immunoassays (CLIAs) and lateral flow immunoassays (LFIAs) were reviewed and their diagnostic performances were compared. Herein, a literature review on the databases of PubMed, Scopus and Google Scholar between January 1, 2020 and June 30, 2020 based on the main serological methods for COVID-19 detection with the focus on comparative experiments was performed. The review was updated on December 31, 2020.Expert opinion: Serology testing could be considered as a part of diagnostic panel two-week post symptom onset. Higher sensitivity for serology-based tests could be achieved by determining combined IgG/IgM titers. Furthermore, higher sensitive serological test detecting neutralization antibody could be developed by targeting spike (S) antigen. It was also demonstrated that the sensitivity of ELISA/CLIA-based methods are higher than LFIA devices.

https://www.tandfonline.com/doi/pdf/10.1080/1744666X.2021.1908886

A comparative review of immunoassays for COVID-19 detection.

Comparison of the Elecsys Anti-SARS-CoV-2 immunoassay with the EDI™ enzyme linked immunosorbent assays for the detection of SARS-CoV-2 antibodies in human plasma.

Evaluation of the EDI enzyme linked immunosorbent assays for the detection of SARS-CoV-2 IgM and IgG antibodies in human plasma.

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Prevalence of SARS-CoV-2 antibodies in health care personnel of two acute care hospitals in Linz, Austria.

*Corresponding author: Christoph Robier, MD, Central Laboratory, Hospital of the Brothers of St. John of God, Graz, Bergstr. 27, 8020 Graz, Austria, Phone: +43 316 5989 6671, E-mail: christoph.robier@bbgraz.at; and Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria Margot Egger and Kurt Wiesinger: Department of Laboratory Medicine, Hospital of the Brothers of St. John of God, Linz, Linz, Austria Reingard Aigner: Division of Nuclear Medicine, Department of Radiology, Medical University of Graz, Graz, Austria Manfred Neubauer: Central Laboratory, Hospital of the Brothers of St. John of God, Graz, Austria Letter to the Editor

Kurt Wiesinger

Papers

Comparison of the Elecsys Anti-SARS-CoV-2 immunoassay with the EDI™ enzyme linked immunosorbent assays for the detection of SARS-CoV-2 antibodies in human plasma.

Evaluation of the EDI enzyme linked immunosorbent assays for the detection of SARS-CoV-2 IgM and IgG antibodies in human plasma.

Prevalence of SARS-CoV-2 antibodies in health care personnel of two acute care hospitals in Linz, Austria.

Progression from light chain myeloma to secondary plasma cell leukemia accompanied by peripheral blood eosinophilia.