Rethinking COVID-19 test sensitivity-a strategy for improving the detection limit

Pan Afr Med J. 2021 Aug 16:39:244. doi: 10.11604/pamj.2021.39.244.30131. eCollection 2021.

Abstract

Numerous genetic tests for the detection of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, including those based on the ever-popular real-time polymerase chain reaction (RT-qPCR) technique, have been reported. These diagnostic tests give false negatives particularly during the early and late stages of COVID-19 clearly indicating inadequate test sensitivity. The entire COVID-19 diagnostic workflow is often overlooked and given very little attention. Herein, we propose that volumetric modifications to COVID-19 workflows would significantly improve detection limits. We would therefore encourage researchers to adopt a holistic approach, in which all the steps of a COVID-19 diagnostic workflow, are carefully scrutinised, particularly those upstream factors at the viral sampling and pre-analytical stages.

Keywords: SARS-CoV-2; diagnostic workflow; false negatives; real-time polymerase chain reaction.

MeSH terms

  • COVID-19 / diagnosis*
  • COVID-19 Testing / methods*
  • COVID-19 Testing / standards
  • False Negative Reactions
  • Humans
  • Limit of Detection
  • Real-Time Polymerase Chain Reaction / methods*
  • Real-Time Polymerase Chain Reaction / standards
  • Sensitivity and Specificity
  • Specimen Handling