Diagnostic approaches in COVID-19: clinical updates

Expert Rev Respir Med. 2021 Feb;15(2):197-212. doi: 10.1080/17476348.2021.1823833. Epub 2020 Sep 30.

Abstract

Introduction: COVID-19 is a recent emerging pandemic whose prognosis is still unclear. Diagnostic tools are the main players that not only indicate a possible infection but can further restrict the transmission and can determine the extent to which disease progression would occur.

Areas covered: In this paper, we have performed a narrative and critical review on different technology-based diagnostic strategies such as molecular approaches including real-time reverse transcriptase PCR, serological testing through enzyme-linked immunosorbent assay, laboratory and point of care devices, radiology-based detection through computed tomography and chest X-ray, and viral cell cultures on Vero E6 cell lines are discussed in detail to address COVID-19. This review further provides an overview of emergency use authorized immunodiagnostic and molecular diagnostic kits and POC devices by FDA for timely and efficient conduction of diagnostic tests. The majority of the literature cited in this paper is collected from guidelines on protocols and other considerations on diagnostic strategies of COVID-19 issued by WHO, CDC, and FDA under emergency authorization.

Expert opinion: Such information holds importance to the health professionals in conducting error-free diagnostic tests and researches in producing better clinical strategies by addressing the limitations associated with the available methods.

Keywords: COVID-19; SARS-CoV-2; immunodiagnostics; point of care; rRT-PCR; radiology; serological testing; viral cell culture.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Animals
  • Antibodies, Viral / blood
  • COVID-19 / diagnosis*
  • COVID-19 Testing
  • Chlorocebus aethiops
  • Colorimetry
  • Cytopathogenic Effect, Viral
  • Enzyme-Linked Immunosorbent Assay
  • Humans
  • Immunoglobulin A / blood
  • Immunoglobulin G / blood
  • Luminescent Measurements
  • Lung / diagnostic imaging
  • Lung / pathology
  • Molecular Diagnostic Techniques
  • Nucleic Acid Amplification Techniques
  • Point-of-Care Testing
  • Quarantine / psychology
  • Radiography
  • Reverse Transcriptase Polymerase Chain Reaction
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / immunology
  • Tomography, X-Ray Computed
  • Vero Cells
  • Virus Replication

Substances

  • Antibodies, Viral
  • Immunoglobulin A
  • Immunoglobulin G

Supplementary concepts

  • LAMP assay