Navigating the Diagnostics of COVID-19

Abstract

The recent outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in Hubei province, China, in December 2019 and has spread worldwide at an alarming rate. With over eight million individuals infected and exceeding 400,000 deaths globally, the necessity to develop fast and efficient diagnostic methods is of high importance. This paper reports on currently available diagnostic screening methods for patients infected with SARS-CoV-2 to guide frontline healthcare workers involved with the diagnosis of 2019 novel coronavirus disease (COVID-19) patient. An electronic literature search was performed for peer-reviewed articles published from January 1, 2020, until June 19, 2020. Published articles were then reviewed and included based on the applicability to the topic. The preferred diagnostic approach is the reverse transcription (RT) of the virus' ribonucleic acid (RNA) followed by polymerase chain reaction (PCR) amplification (RT-PCR). However, this method has been proven to be time-consuming. In improving the speed and efficiency of diagnostics, newer rapid diagnostic serological tests are in development for testing SARS-CoV-2, each with its unique advantages and disadvantages. They could potentially be used as triage tests to rapidly identify patients who are very likely to have COVID-19 in combination with other accurate diagnostic methods, such as diagnostic imaging. A combination of the disease history, clinical manifestations, laboratory diagnostic testing, and diagnostic imaging is crucial for making an accurate and useful diagnosis for COVID-19. Hopefully, the continuous development and use of rapid diagnostic tests and the implementation of public health measures will help control the spread of the disease.

Keywords: COVID-19; Diagnostic test; RT-PCR; SARS-CoV-2; Serology.

Fig. 1

Chest radiograph image from a confirmed COVID-19 case demonstrating severe pneumonia with bilateral ground-glass opacities. Note: Radiograph image from COVID-19 case (10), courtesy of Dr. Edgar Lorente, Radiopaedia.org, rID: 75187 [21]

Fig. 2

CT image from a confirmed COVID-19 case showing multiple patchy and light consolidations in both lungs and grid-like thickness of interlobular septae. Note: Radiograph image of confirmed COVID-19 case (36), courtesy of Dr. Mohammad Taghi Niknejad, Radiopaedia.org, rID: 75607 [21]