新型冠状病毒肺炎的实验室诊断:当前的问题和挑战。
Laboratory Diagnosis of COVID-19: Current Issues and Challenges.
机构信息
Cepheid, Danaher Diagnostic Platform, Shanghai, China
Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
出版信息
J Clin Microbiol. 2020 May 26;58(6). doi: 10.1128/JCM.00512-20.
The COVID-19 outbreak has had a major impact on clinical microbiology laboratories in the past several months. This commentary covers current issues and challenges for the laboratory diagnosis of infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the preanalytical stage, collecting the proper respiratory tract specimen at the right time from the right anatomic site is essential for a prompt and accurate molecular diagnosis of COVID-19. Appropriate measures are required to keep laboratory staff safe while producing reliable test results. In the analytic stage, real-time reverse transcription-PCR (RT-PCR) assays remain the molecular test of choice for the etiologic diagnosis of SARS-CoV-2 infection while antibody-based techniques are being introduced as supplemental tools. In the postanalytical stage, testing results should be carefully interpreted using both molecular and serological findings. Finally, random-access, integrated devices available at the point of care with scalable capacities will facilitate the rapid and accurate diagnosis and monitoring of SARS-CoV-2 infections and greatly assist in the control of this outbreak.
在过去的几个月里,COVID-19 疫情对临床微生物学实验室产生了重大影响。本评论涵盖了严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染的实验室诊断当前面临的问题和挑战。在分析前阶段,从正确的解剖部位采集适当的呼吸道标本,对于 COVID-19 的快速、准确分子诊断至关重要。需要采取适当的措施来保护实验室工作人员的安全,同时获得可靠的检测结果。在分析阶段,实时逆转录聚合酶链反应(RT-PCR)检测仍然是 SARS-CoV-2 感染病因诊断的首选分子检测方法,而基于抗体的技术正在被引入作为辅助工具。在分析后阶段,应综合使用分子和血清学检测结果来仔细解释检测结果。最后,即时、集成、可扩展的床边检测设备将有助于快速、准确地诊断和监测 SARS-CoV-2 感染,并极大地有助于控制此次疫情。
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