COVID-19 diagnostic study of choice: Difference between revisions

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==Diagnostic Study of Choice==
==Diagnostic Study of Choice==
===Study of Choice===
===Study of Choice===
*The Nucleic acid amplification test by the reverse transcriptase-polymerase chain reaction (RT-PCR) is the gold standard test for detecting coronavirus illness. These tests are highly specific for detecting coronavirus illness.<ref name="pmid32269100">{{cite journal| author=Nalla AK, Casto AM, Huang MW, Perchetti GA, Sampoleo R, Shrestha L | display-authors=etal| title=Comparative Performance of SARS-CoV-2 Detection Assays Using Seven Different Primer-Probe Sets and One Assay Kit. | journal=J Clin Microbiol | year= 2020 | volume= 58 | issue= 6 | pages=  | pmid=32269100 | doi=10.1128/JCM.00557-20 | pmc=7269385 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32269100  }} </ref>
*The Nucleic acid amplification test by the reverse transcriptase-polymerase chain reaction (RT-PCR) is the gold standard test for detecting coronavirus illness. These tests are highly specific for detecting coronavirus illness.<ref name="pmid32269100">{{cite journal| author=Nalla AK, Casto AM, Huang MW, Perchetti GA, Sampoleo R, Shrestha L | display-authors=etal| title=Comparative Performance of SARS-CoV-2 Detection Assays Using Seven Different Primer-Probe Sets and One Assay Kit. | journal=J Clin Microbiol | year= 2020 | volume= 58 | issue= 6 | pages=  | pmid=32269100 | doi=10.1128/JCM.00557-20 | pmc=7269385 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32269100  }} </ref>
 
===Diagnostic Results===
===Diagnostic Results===
*The NAAT detects viral gene sequence specific for coronavirus. The genes detected by NAAT includes nucleocapsid(N), envelope(E), spike(S), and RNA dependent RNA polymerase (RdRP) in the open reading frame. <ref name="pmid32245835">{{cite journal| author=Tang YW, Schmitz JE, Persing DH, Stratton CW| title=Laboratory Diagnosis of COVID-19: Current Issues and Challenges. | journal=J Clin Microbiol | year= 2020 | volume= 58 | issue= 6 | pages=  | pmid=32245835 | doi=10.1128/JCM.00512-20 | pmc=7269383 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32245835  }} </ref>
*The NAAT detects viral gene sequence specific for coronavirus. The genes detected by NAAT include nucleocapsid(N), envelope(E), spike(S), and RNA dependent RNA polymerase (RdRP) in the open reading frame. <ref name="pmid32245835">{{cite journal| author=Tang YW, Schmitz JE, Persing DH, Stratton CW| title=Laboratory Diagnosis of COVID-19: Current Issues and Challenges. | journal=J Clin Microbiol | year= 2020 | volume= 58 | issue= 6 | pages=  | pmid=32245835 | doi=10.1128/JCM.00512-20 | pmc=7269383 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32245835  }} </ref>
*The turnaround time for these tests is variable depending upon the specific testing kit and laboratory performing it.<ref name="pmid32350048">{{cite journal| author=Lieberman JA, Pepper G, Naccache SN, Huang ML, Jerome KR, Greninger AL| title=Comparison of Commercially Available and Laboratory Developed Assays for in vitro Detection of SARS-CoV-2 in Clinical Laboratories. | journal=J Clin Microbiol | year= 2020 | volume=  | issue=  | pages=  | pmid=32350048 | doi=10.1128/JCM.00821-20 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32350048  }} </ref>  
*The turnaround time for these tests is variable depending upon the specific testing kit and laboratory performing it.<ref name="pmid32350048">{{cite journal| author=Lieberman JA, Pepper G, Naccache SN, Huang ML, Jerome KR, Greninger AL| title=Comparison of Commercially Available and Laboratory Developed Assays for in vitro Detection of SARS-CoV-2 in Clinical Laboratories. | journal=J Clin Microbiol | year= 2020 | volume=  | issue=  | pages=  | pmid=32350048 | doi=10.1128/JCM.00821-20 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32350048  }} </ref>
 
=== Diagnostic Criteria ===
=== Diagnostic Criteria ===
The diagnostic criteria for suspected and confirmed cases of [[coronavirus]] disease 2019 ([[COVID-19]]) is tabulated below:<ref name="ChenZhou2020">{{cite journal|last1=Chen|first1=Nanshan|last2=Zhou|first2=Min|last3=Dong|first3=Xuan|last4=Qu|first4=Jieming|last5=Gong|first5=Fengyun|last6=Han|first6=Yang|last7=Qiu|first7=Yang|last8=Wang|first8=Jingli|last9=Liu|first9=Ying|last10=Wei|first10=Yuan|last11=Xia|first11=Jia'an|last12=Yu|first12=Ting|last13=Zhang|first13=Xinxin|last14=Zhang|first14=Li|title=Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study|journal=The Lancet|volume=395|issue=10223|year=2020|pages=507–513|issn=01406736|doi=10.1016/S0140-6736(20)30211-7}}</ref><ref>{{Cite web|url=http://www.nhc.gov.cn/xcs/zhengcwj/202002/de2d62a5711c41ef9b2c4b6f4d1f2136.shtml|title=C.N.H. Commission
The diagnostic criteria for suspected and confirmed cases of [[coronavirus]] disease 2019 ([[COVID-19]]) is tabulated below:<ref name="ChenZhou2020">{{cite journal|last1=Chen|first1=Nanshan|last2=Zhou|first2=Min|last3=Dong|first3=Xuan|last4=Qu|first4=Jieming|last5=Gong|first5=Fengyun|last6=Han|first6=Yang|last7=Qiu|first7=Yang|last8=Wang|first8=Jingli|last9=Liu|first9=Ying|last10=Wei|first10=Yuan|last11=Xia|first11=Jia'an|last12=Yu|first12=Ting|last13=Zhang|first13=Xinxin|last14=Zhang|first14=Li|title=Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study|journal=The Lancet|volume=395|issue=10223|year=2020|pages=507–513|issn=01406736|doi=10.1016/S0140-6736(20)30211-7}}</ref><ref>{{Cite web|url=http://www.nhc.gov.cn/xcs/zhengcwj/202002/de2d62a5711c41ef9b2c4b6f4d1f2136.shtml|title=C.N.H. Commission

Revision as of 20:34, 11 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]

Overview

The diagnostic criteria for suspected and confirmed cases of coronavirus disease 2019 (COVID-19) are tabulated in the section below.

Diagnostic Study of Choice

Study of Choice

  • The Nucleic acid amplification test by the reverse transcriptase-polymerase chain reaction (RT-PCR) is the gold standard test for detecting coronavirus illness. These tests are highly specific for detecting coronavirus illness.[1]

Diagnostic Results

  • The NAAT detects viral gene sequence specific for coronavirus. The genes detected by NAAT include nucleocapsid(N), envelope(E), spike(S), and RNA dependent RNA polymerase (RdRP) in the open reading frame. [2]
  • The turnaround time for these tests is variable depending upon the specific testing kit and laboratory performing it.[3]

Diagnostic Criteria

The diagnostic criteria for suspected and confirmed cases of coronavirus disease 2019 (COVID-19) is tabulated below:[4][5][6][7][8][9]

Case Diagnostic Criteria
Suspected Case Anyone with a history of epidemiology and any two of the clinical manifestations or anyone without epidemiological history and three of the clinical manifestations is considered to be a suspected case:

1) Epidemiological history:

  • Within 14 days before the disease onset, there is a travel history or living history in Wuhan or other areas with local cases
  • Within 14 days before the disease onset, there is contact with patients who had a fever or respiratory symptoms from Wuhan or other areas with local cases
  • Clustering of patients or contact with patients infected with the SARS-CoV-2


2) Clinical manifestations:

  • Fever and/or respiratory symptoms
  • With the above-mentioned imaging characteristics of pneumonia
  • The total number of leukocytes in the early stage of the disease is normal or decreased, or the lymphocyte count is decreased
Confirmed Case Any suspected case with one of the following pathogenic features is reclassified as a confirmed case:

Ongoing diagnostic Trials

  • A researcher at Israel’s Ben-Gurion University of the Negev (BGU) has developed a test that identifies those carrying the COVID-19 virus in less than a minute. And it is both affordable and works with greater than 90% accuracy to boot[10]

Antibody response

  • Most recovering from #COVID19 do not have high levels of neutralizing antibodies BUT antibodies to the receptor binding domain (RBD) of the spike protein with potent antiviral activity were found in all individuals tested & may be tx target[11]
  • 8 weeks after hospital discharge, 40% of asymptomatic patients have no antibodies, and 12.9% of those who were symptomatic had no #COVID19 antibodies[12]

References

  1. Nalla AK, Casto AM, Huang MW, Perchetti GA, Sampoleo R, Shrestha L; et al. (2020). "Comparative Performance of SARS-CoV-2 Detection Assays Using Seven Different Primer-Probe Sets and One Assay Kit". J Clin Microbiol. 58 (6). doi:10.1128/JCM.00557-20. PMC 7269385 Check |pmc= value (help). PMID 32269100 Check |pmid= value (help).
  2. Tang YW, Schmitz JE, Persing DH, Stratton CW (2020). "Laboratory Diagnosis of COVID-19: Current Issues and Challenges". J Clin Microbiol. 58 (6). doi:10.1128/JCM.00512-20. PMC 7269383 Check |pmc= value (help). PMID 32245835 Check |pmid= value (help).
  3. Lieberman JA, Pepper G, Naccache SN, Huang ML, Jerome KR, Greninger AL (2020). "Comparison of Commercially Available and Laboratory Developed Assays for in vitro Detection of SARS-CoV-2 in Clinical Laboratories". J Clin Microbiol. doi:10.1128/JCM.00821-20. PMID 32350048 Check |pmid= value (help).
  4. Chen, Nanshan; Zhou, Min; Dong, Xuan; Qu, Jieming; Gong, Fengyun; Han, Yang; Qiu, Yang; Wang, Jingli; Liu, Ying; Wei, Yuan; Xia, Jia'an; Yu, Ting; Zhang, Xinxin; Zhang, Li (2020). "Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study". The Lancet. 395 (10223): 507–513. doi:10.1016/S0140-6736(20)30211-7. ISSN 0140-6736.
  5. "C.N.H. Commission Notice on prevention and control of pneumonia in children and pregnant women with new coronavirus infection China National Health Commission, Beijing (2020) (in Chinese)". line feed character in |title= at position 18 (help)
  6. "Technology, M.e.g.o.T.h.a.t.T.M.C.o.H.U.o.S.a. A rapid guideline for the diagnosis and treatment of pneumonia with new coronavirus infection (Third edition)".
  7. "Union Hospital T.M.C., Huazhong University of Science and Technology., Wuhan union hospital manage the 2019 new coronavirus infection strategies and instructions (in Chinese)". line feed character in |title= at position 15 (help)
  8. "[Diagnosis and clinical management of 2019 novel coronavirus infection: an operational recommendation of Peking Union Medical College Hospital (V2.0)]". Zhonghua Nei Ke Za Zhi (in Chinese). 59 (3): 186–188. February 2020. doi:10.3760/cma.j.issn.0578-1426.2020.03.003. PMID 32023681 Check |pmid= value (help).
  9. "Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected".
  10. https://www.bioworld.com/articles/435285-Israels-ben-Gurion-university-develops-one-minute-coronavirus-test.html. Missing or empty |title= (help)
  11. Robbiani, Davide F.; Gaebler, Christian; Muecksch, Frauke; Lorenzi, Julio C. C.; Wang, Zijun; Cho, Alice; Agudelo, Marianna; Barnes, Christopher O.; Gazumyan, Anna; Finkin, Shlomo; Hägglöf, Thomas; Oliveira, Thiago Y.; Viant, Charlotte; Hurley, Arlene; Hoffmann, Hans-Heinrich; Millard, Katrina G.; Kost, Rhonda G.; Cipolla, Melissa; Gordon, Kristie; Bianchini, Filippo; Chen, Spencer T.; Ramos, Victor; Patel, Roshni; Dizon, Juan; Shimeliovich, Irina; Mendoza, Pilar; Hartweger, Harald; Nogueira, Lilian; Pack, Maggi; Horowitz, Jill; Schmidt, Fabian; Weisblum, Yiska; Michailidis, Eleftherios; Ashbrook, Alison W.; Waltari, Eric; Pak, John E.; Huey-Tubman, Kathryn E.; Koranda, Nicholas; Hoffman, Pauline R.; West, Anthony P.; Rice, Charles M.; Hatziioannou, Theodora; Bjorkman, Pamela J.; Bieniasz, Paul D.; Caskey, Marina; Nussenzweig, Michel C. (2020). "Convergent antibody responses to SARS-CoV-2 in convalescent individuals". Nature. doi:10.1038/s41586-020-2456-9. ISSN 0028-0836.
  12. Long, Quan-Xin; Tang, Xiao-Jun; Shi, Qiu-Lin; Li, Qin; Deng, Hai-Jun; Yuan, Jun; Hu, Jie-Li; Xu, Wei; Zhang, Yong; Lv, Fa-Jin; Su, Kun; Zhang, Fan; Gong, Jiang; Wu, Bo; Liu, Xia-Mao; Li, Jin-Jing; Qiu, Jing-Fu; Chen, Juan; Huang, Ai-Long (2020). "Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections". Nature Medicine. doi:10.1038/s41591-020-0965-6. ISSN 1078-8956.