Journal ArticleDOI
Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19)
TLDR
Some practical indications can hence be identified for minimizing the risk of diagnostic errors, encompassing the improvement of diagnostic accuracy by combining clinical evidence with results of chest computed tomography and RT-PCR, and refinement of molecular target(s) and thorough compliance with analytical procedures, including quality assurance.Abstract:
A novel zoonotic coronavirus outbreak is spreading all over the world. This pandemic disease has now been defined as novel coronavirus disease 2019 (COVID-19), and is sustained by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As the current gold standard for the etiological diagnosis of SARS-CoV-2 infection is (real time) reverse transcription polymerase chain reaction (rRT-PCR) on respiratory tract specimens, the diagnostic accuracy of this technique shall be considered a foremost prerequisite. Overall, potential RT-PCR vulnerabilities include general preanalytical issues such as identification problems, inadequate procedures for collection, handling, transport and storage of the swabs, collection of inappropriate or inadequate material (for quality or volume), presence of interfering substances, manual errors, as well as specific aspects such as sample contamination and testing patients receiving antiretroviral therapy. Some analytical problems may also contribute to jeopardize the diagnostic accuracy, including testing outside the diagnostic window, active viral recombination, use of inadequately validated assays, insufficient harmonization, instrument malfunctioning, along with other specific technical issues. Some practical indications can hence be identified for minimizing the risk of diagnostic errors, encompassing the improvement of diagnostic accuracy by combining clinical evidence with results of chest computed tomography (CT) and RT-PCR, interpretation of RT-PCR results according to epidemiologic, clinical and radiological factors, recollection and testing of upper (or lower) respiratory specimens in patients with negative RT-PCR test results and high suspicion or probability of infection, dissemination of clear instructions for specimen (especially swab) collection, management and storage, together with refinement of molecular target(s) and thorough compliance with analytical procedures, including quality assurance.read more
Citations
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Journal ArticleDOI
COVID-19 diagnosis and management: a comprehensive review.
Giuseppe Pascarella,Alessandro Strumia,Chiara Piliego,Federica Bruno,Romualdo Del Buono,Fabio Costa,Simone Scarlata,Felice Eugenio Agrò +7 more
TL;DR: An overview of the known clinical features and treatment options for COVID‐19 is provided and quarantine is the only intervention that appears to be effective in decreasing the contagion rate.
Journal ArticleDOI
Coronavirus Diseases (COVID-19) Current Status and Future Perspectives: A Narrative Review.
Francesco Di Gennaro,Damiano Pizzol,Claudia Marotta,Mario Antunes,Vincenzo Racalbuto,Nicola Veronese,Lee Smith +6 more
TL;DR: A narrative review to describe existing literature with regard to Corona Virus Disease 2019 (COVID-19) epidemiology, pathophysiology, diagnosis, management and future perspective and a picture of the current state of the art is presented.
Journal ArticleDOI
COVID-19: A promising cure for the global panic.
Balachandar Vellingiri,Kaavya Jayaramayya,Mahalaxmi Iyer,Arul Narayanasamy,Vivekanandhan Govindasamy,Bupesh Giridharan,Singaravelu Ganesan,Anila Venugopal,Dhivya Venkatesan,Harsha Ganesan,Kamarajan Rajagopalan,Pattanathu K. S. M. Rahman,Ssang-Goo Cho,Nachimuthu Senthil Kumar,Mohana Devi Subramaniam +14 more
TL;DR: The structure of virus; varying symptoms among COVID-19, SARS, MERS and common flu; the probable mechanism behind the infection and its immune response; and traditional Indian medicinal plants as possible novel therapeutic approaches, exclusively targeting SARS-CoV-2 and its pathways are discussed.
Journal ArticleDOI
False-negative results of initial RT-PCR assays for COVID-19: A systematic review.
Ingrid Arevalo-Rodriguez,Diana Buitrago-Garcia,Daniel Simancas-Racines,Paula Zambrano-Achig,Rosa del Campo,Agustín Ciapponi,Omar Sued,Laura Martínez-García,Anne W S Rutjes,Nicola Low,Patrick M.M. Bossuyt,José A. Pérez-Molina,Javier Zamora +12 more
TL;DR: The findings reinforce the need for repeated testing in patients with suspicion of SARS-Cov-2 infection given that up to 54% of COVID-19 patients may have an initial false-negative RT-PCR (very low certainty of evidence).
Journal ArticleDOI
The genetic sequence, origin, and diagnosis of SARS-CoV-2.
TL;DR: Phylogenetic analysis of full-length genome sequences obtained from infected patients showed that SARS- coV-2 is similar to severe acute respiratory syndrome coronavirus (SARS-CoV) and uses the same cell entry receptor, angiotensin-converting enzyme 2 (ACE2), as SARS -CoV.
References
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