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Open AccessJournal ArticleDOI

Laboratory Diagnosis of COVID-19: Current Issues and Challenges.

TLDR
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, and real-time reverse transcription-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.
Abstract
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.

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Systematic review with meta-analysis of the accuracy of diagnostic tests for COVID-19.

TL;DR: RT-PCR remains the gold standard for the diagnosis of COVID-19 in sputum samples and the combination of different diagnostic tests is highly recommended to achieve adequate sensitivity and specificity.
Journal ArticleDOI

Testing for SARS-CoV-2 (COVID-19): a systematic review and clinical guide to molecular and serological in-vitro diagnostic assays.

TL;DR: A suite of complementary tests will inform crucial decisions by healthcare providers and policy makers and understanding their strengths and limitations will be critical to their judicious application for the development of algorithmic approaches to treatment and public health strategies.
Journal ArticleDOI

COVID-19: Coagulopathy, Risk of Thrombosis, and the Rationale for Anticoagulation.

TL;DR: Nonanticoagulant properties such as the reduction in interleukin 6 release have been shown to improve the complex picture of coagulopathy in patients with COVID-19, and adapted to the individual risk of thrombosis and the d-dimer value, higher doses can be considered.
References
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Journal ArticleDOI

First Case of 2019 Novel Coronavirus in the United States.

TL;DR: This case highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection.
Journal ArticleDOI

Detection of SARS-CoV-2 in Different Types of Clinical Specimens.

TL;DR: Results of PCR and viral RNA testing for SARS-CoV-2 in bronchoalveolar fluid, sputum, feces, blood, and urine specimens from patients with COVID-19 infection in China are described to identify possible means of non-respiratory transmission.
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