Coronavirus Disease 2019 (COVID-19) Diagnostics: a Primer

Dental Update ◽  
2020 ◽  
Vol 47 (9) ◽  
pp. 761-765
Author(s):  
Lakshman Samaranayake ◽  
Niraj Kinariwala ◽  
RAPM Perera
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Diagnostic Tests ◽  
Clinical Diagnostics ◽  
Serological Testing ◽  
Accurate Identification ◽  
Community Infection

The Coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), seems to have spared no single community. Rapid and accurate identification of COVID-19 patients are the mainstay for breaking the chain of community infection and controlling the pandemic. There are now a bewildering array of diagnostic tests available to detect COVID-19 at various stages of infection. In this, the fourth article in the COVID-19 Commentary series, we describe the basics of current clinical diagnostics, including molecular and serological testing approaches, and summarize their advantages and limitations.

scholarly journals Detection of anti-SARS-CoV-2 nucleocapsid and spike antibodies in patients with Coronavirus Disease 2019 in Japan.

2021 ◽  
Author(s):  
Hiroshi Furukawa ◽  
Shomi Oka ◽  
Takashi Higuchi ◽  
Miho Yamaguchi ◽  
Shota Uchiyama ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Severe Acute Respiratory Syndrome ◽  
Diagnostic Tests ◽  
High Sensitivity ◽  
Regression Analyses ◽  
Serological Testing ◽  
National Hospital ◽  
Serological Tests ◽  
N 93 ◽  
And Control

Abstract Objectives Coronavirus Disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Serological testing for anti-SARS-CoV-2 nucleocapsid (N) antibodies (Abs) and anti-SARS-CoV-2 spike (S) Abs is performed to detect prior COVID-19 infection. It is still controversial which antibodies are the most sensitive and specific, and which can be detected earliest after infection. Here, we evaluated the results of serological tests of anti-SARS-CoV-2 N and S Abs in Japan.Methods Symptomatic COVID-19 patients (n = 84) and control patients with rheumatoid arthritis (n = 93) were recruited at Tokyo National Hospital. Anti-SARS-CoV-2 N and S Abs were measured by commercial electrochemiluminescence immunoassays.Results The fraction of patients positive for anti-SARS-CoV-2 N and S Abs was highest > 14 days after symptom onset. The frequency of anti-SARS-CoV-2 S Ab positivity at this time (80.4%) tended to be slightly but not significantly lower than anti-SARS-CoV-2 N Ab positivity (84.8%). Optimized cut-off levels for anti-SARS-CoV-2 N and S Ab positivity were lower than the manufacturer's recommended cut-off levels. Using multiple linear regression analyses with anti-SARS-CoV-2 N and S Abs, we created an Ab-index with high sensitivity.Conclusion To increase the sensitivity of serological diagnostic tests for COVID-19, it is suggested that both anti-SARS-CoV-2 N and S Abs should be measured and cut-off levels decreased.

scholarly journals Lehetőségek és buktatók a SARS-CoV-2-antigén és az ellene termelt antitestek kimutatásában

2021 ◽  
Vol 162 (15) ◽  
pp. 563-570
Author(s):  
Melinda Medgyaszai ◽  
Zalán Péterfi ◽  
Anna Valkó
Keyword(s):  
Immune Response ◽  
Immune System ◽  
Severe Acute Respiratory Syndrome ◽  
Infectious Diseases ◽  
Human Body ◽  
Scientific Knowledge ◽  
Diagnostic Tests ◽  
Serological Testing ◽  
Medical Opinion ◽  
Over Time

Összefoglaló. A koronavírus-betegség 2019 (COVID–19)-pandémia komoly kihívás elé állította nemcsak a mikrobiológiai laboratóriumokat, hanem az eredmények interpretálásában a klinikumban dolgozó kollégákat is. Az orvostudomány specializált világában az immunológiai és a fertőző betegségekkel kapcsolatos ismeretek az antimikrobás terápiás megoldások sikeressége, valamint a széles körű vakcináció miatt az idők folyamán számos szakterületen háttérbe szorultak, felfrissítésük sürgető és elengedhetetlen része a pandémiával való megküzdésnek. A diagnosztikai vizsgálatok fontos eszközei a járvány megfékezésének, illetve a betegek ellátásának, azonban a vírus és az emberi szervezet interakciójának megértése elengedhetetlenül szükséges a korrekt epidemiológiai és gyógyászati véleményalkotáshoz. Jelen cikkünk az orvosi gyakorlat számára foglalja össze a súlyos akut légzőszervi szindrómát okozó koronavírus-2 (SARS-CoV-2) kimutatására, valamint az immunrendszer specifikus immunválaszának szerológiai vizsgálatára irányuló, gyakorlatban használatos módszereket, azok helyét, szerepét és értékelésük szempontjait a tudomány jelen állása szerint. Orv Hetil. 2021; 162(15): 563–570. Summary. The coronavirus disease 2019 (COVID-19) pandemic posed a serious challenge not only for microbiology laboratories, but also for the clinicians in interpretation of the results. In the specialized world of medicine, knowledge of immunological and infectious diseases has been relegated to the background in many disciplines over time due to the success of antimicrobial therapies and widespread vaccination, so updating them is an urgent and essential part of the fight against the pandemic. Diagnostic tests are important tools for controlling the epidemic and caring for patients, but understanding the interaction between the virus and the human body is essential to form a correct epidemiological and medical opinion. This paper summarizes the medical methods for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the serological testing of the specific immune response of the immune system, their place, role and criteria of their evaluation according to current scientific knowledge. Orv Hetil. 2021; 162(15): 563–570.

scholarly journals Diagnostic Tests and Procedures During the COVID-19 Pandemic

2021 ◽  
pp. 191-216
Author(s):  
Sherry A. Dunbar ◽  
Yi-Wei Tang
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Global Health ◽  
Diagnostic Tests ◽  
Clinical Intervention ◽  
Laboratory Diagnosis ◽  
Accurate Diagnosis ◽  
Mitigation Strategies ◽  
Causative Pathogen ◽  
Huge Impact

AbstractCoronavirus disease 2019 (COVID-19) has brought a huge impact on global health and the economy. Early and accurate diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections is essential for clinical intervention and pandemic control. This book chapter addresses the evolving approach to the laboratory diagnosis of COVID-19 covering preanalytical, analytical, and postanalytical steps. The rapidly changing dynamics of the COVID-19 pandemic serve as an example which will be important for laboratories to plan for future pandemics. With the quick identification of the causative pathogen and availability of the genome sequence, it will be possible to develop and implement diagnostic tests within weeks of an outbreak. Laboratories will need to be flexible to continuously adapt to changing testing needs and burdens on the healthcare system, plan mitigation strategies for bottlenecks in testing and workflow due to limitations on resources and supplies, and prepare back-up plans now in order to be better prepared for future pandemics.

Microbiology

2019 ◽  
pp. 1109-1116
Author(s):  
Walter A. Hall
Keyword(s):  
Medical Management ◽  
Diagnostic Tests ◽  
Antimicrobial Prophylaxis ◽  
Prophylactic Antibiotics ◽  
Careful Attention ◽  
Site Infection ◽  
Accurate Identification ◽  
Neurological Morbidity ◽  
The Central Nervous System ◽  
Pathogenic Agents

Infection of the central nervous system can be due to a variety of pathogenic agents that include bacteria, viruses, fungi, and parasites. Several sensitive and specific diagnostic tests are now available that allow for the rapid and accurate identification of the offending organism. The widespread indiscriminate use of some antibiotics has resulted in the emergence of organisms that are resistant to those agents at an alarming rate. The prevention of a neurosurgical site infection is usually possible with the use of prophylactic antibiotics and through careful attention to surgical technique. Controversy surrounds several issues in neurosurgical practice such as preoperative surgical site preparation, antimicrobial prophylaxis, and the surgical and medical management of postoperative infections. Only after the causative microbe is determined and the appropriate surgical and medical management is initiated can you hope to achieve the optimal clinical outcome leading to a reduction in neurological morbidity and mortality.

scholarly journals Beyond the Matrix-Assisted Laser Desorption Ionization (MALDI) Biotyping Workflow: in Search of Microorganism-Specific Tryptic Peptides Enabling Discrimination of Subspecies

2014 ◽  
Vol 80 (14) ◽  
pp. 4234-4241 ◽  
Author(s):  
Maria-Theresia Gekenidis ◽  
Patrick Studer ◽  
Simone Wüthrich ◽  
René Brunisholz ◽  
David Drissner
Keyword(s):  
Mass Spectrometry ◽  
Laser Desorption ◽  
Clinical Diagnostics ◽  
Laser Desorption Ionization ◽  
Accurate Identification ◽  
Discrimination Power ◽  
Desorption Ionization ◽  
Maldi Tof ◽  
Matrix Assisted Laser ◽  
Matrix Assisted Laser Desorption

ABSTRACTA well-accepted method for identification of microorganisms uses matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) coupled to analysis software which identifies and classifies the organism according to its ribosomal protein spectral profile. The method, called MALDI biotyping, is widely used in clinical diagnostics and has partly replaced conventional microbiological techniques such as biochemical identification due to its shorter time to result (minutes for MALDI biotyping versus hours or days for classical phenotypic or genotypic identification). Besides its utility for identifying bacteria, MS-based identification has been shown to be applicable also to yeasts and molds. A limitation to this method, however, is that accurate identification is most reliably achieved on the species level on the basis of reference mass spectra, making further phylogenetic classification unreliable. Here, it is shown that combining tryptic digestion of the acid/organic solvent extracted (classical biotyping preparation) and resolubilized proteins, nano-liquid chromatography (nano-LC), and subsequent identification of the peptides by MALDI-tandem TOF (MALDI-TOF/TOF) mass spectrometry increases the discrimination power to the level of subspecies. As a proof of concept, using this targeted proteomics workflow, we have identified subspecies-specific biomarker peptides for threeSalmonellasubspecies, resulting in an extension of the mass range and type of proteins investigated compared to classical MALDI biotyping. This method therefore offers rapid and cost-effective identification and classification of microorganisms at a deeper taxonomic level.

scholarly journals COVID-19 Serological Tests: How Well Do They Actually Perform?

Diagnostics ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 453 ◽  
Author(s):  
Abdi Ghaffari ◽  
Robyn Meurant ◽  
Ali Ardakani
Keyword(s):  
Diagnostic Tests ◽  
Public Health Policy ◽  
Point Of Care ◽  
Serological Testing ◽  
Serological Tests ◽  
Actual Performance ◽  
Mortality And Morbidity ◽  
Global Pandemic ◽  
Initial Discovery ◽  
Significant Mortality

In only a few months after initial discovery in Wuhan, China, SARS-CoV-2 and the associated coronavirus disease 2019 (COVID-19) have become a global pandemic causing significant mortality and morbidity and implementation of strict isolation measures. In the absence of vaccines and effective therapeutics, reliable serological testing must be a key element of public health policy to control further spread of the disease and gradually remove quarantine measures. Serological diagnostic tests are being increasingly used to provide a broader understanding of COVID-19 incidence and to assess immunity status in the population. However, there are discrepancies between claimed and actual performance data for serological diagnostic tests on the market. In this study, we conducted a review of independent studies evaluating the performance of SARS-CoV-2 serological tests. We found significant variability in the accuracy of marketed tests and highlight several lab-based and point-of-care rapid serological tests with high levels of performance. The findings of this review highlight the need for ongoing independent evaluations of commercialized COVID-19 diagnostic tests.

scholarly journals A Study of Universal Severe Acute Respiratory Syndrome Coronavirus 2 RNA Testing Among Residents and Staff in a Large Group of Care Homes in South London

2020 ◽  
Author(s):  
Agnes Marossy ◽  
Stefan Rakowicz ◽  
Angela Bhan ◽  
Sarah Noon ◽  
Amanda Rees ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Care Home ◽  
Asymptomatic Infection ◽  
Care Homes ◽  
Infection Prevention And Control ◽  
Accurate Identification ◽  
Care Home Staff ◽  
Lack Of Information ◽  
And Control ◽  
Nose And Throat

Abstract Background Care homes have experienced a high number of coronavirus disease 2019 (COVID-19)–related deaths among residents since the onset of the pandemic. However, up to May 2020, there has been a lack of information about the extent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among residents and staff in care homes and limited testing in this setting. Methods Combined nose and throat swab testing for SARS-CoV-2 RNA was carried out in 2455 residents and staff across 37 care homes in the London Borough of Bromley across a 3-week period. Results were reported within 24 hours of sample delivery, and data were collected on the presence or absence of symptoms. Results Overall, the point prevalence of SARS-CoV-2 infection was 6.5%, with a higher rate in residents (9.0%) than in staff (4.7%). A key finding was the high proportion of asymptomatic infection detected in staff (69%) and residents (51%), with evidence of underdetection of symptoms by care home staff. Conclusions The high proportion of asymptomatic infection combined with underdetection of symptoms by care home staff indicates that offering a test to all residents and staff in care homes with rapid reporting of results would assist accurate identification of infected individuals, facilitating prompt infection prevention and control action.

scholarly journals SARS-CoV-2 serological testing changes disease management in a PCR-negative patient

2020 ◽  
Vol 13 (8) ◽  
pp. e237239
Author(s):  
Dacre Knight ◽  
Joan Irizarry-Alvarado
Keyword(s):  
Disease Management ◽  
Severe Acute Respiratory Syndrome ◽  
Statistical Inference ◽  
Healthcare Providers ◽  
Bayes Theorem ◽  
Diagnostic Evaluation ◽  
Serological Testing ◽  
Testing Methods ◽  
Negative Patient

Since the beginning of the COVID-19 pandemic, healthcare providers worldwide have faced many obstacles in the diagnostic evaluation of patients for severe acute respiratory syndrome coronavirus 2, the causative virus. Even with the application of statistical inference by Bayes’ theorem to estimate the probability of a diagnosis, with and without testing capabilities, some cases may still carry a degree of uncertainty. This has important implications for limiting the spread of disease. The basis for isolation and quarantine is a known diagnosis. This case is an example of a diagnostic conundrum that required more thorough use of testing methods, particularly serological testing, to guide the isolation recommendations for a patient with COVID-19. This will be helpful to other diagnosticians by providing an example of how serological findings may be effectively applied in the course of individual COVID-19 management.

Four cats with fungal rhinitis

2005 ◽  
Vol 7 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Beth L Whitney ◽  
John Broussard ◽  
Joseph D Stefanacci
Keyword(s):  
Diagnostic Tests ◽  
False Negative ◽  
Clinical Signs ◽  
Nasal Discharge ◽  
Fungal Culture ◽  
Serological Testing ◽  
Increased Risk ◽  
Oral Itraconazole ◽  
Diagnostic Samples ◽  
Positive Results

Fungal rhinitis is uncommon in the cat and cases of nasal aspergillosis–penicilliosis have been rarely reported. Signs of fungal rhinitis include epistaxis, sneezing, mucopurulent nasal discharge and exophthalmous. Brachycephalic feline breeds seem to be at increased risk for development of nasal aspergillosis–penicilliosis. Computed tomography (CT) imaging and rhinoscopy are useful in assessing the extent of the disease and in obtaining diagnostic samples. Fungal culture may lead to false negative or positive results and must be used in conjunction with other diagnostic tests. Serological testing was not useful in two cats tested. The cats in this study were treated with oral itraconazole therapy. When itraconazole therapy was discontinued prematurely, clinical signs recurred. Hepatotoxicosis is a possible sequel to itraconazole therapy.

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