Integrative Biology Laboratory, Salk Institute for Biological Studies, La Jolla, CA, 92037 USA.
Departments of Laboratory Medicine and Immunobiology, Yale University School of Medicine, New Haven, CT 06520 USA.
Med. 2020 Dec 18;1(1):78-89. doi: 10.1016/j.medj.2020.08.001. Epub 2020 Aug 21.
Testing for SARS-CoV-2 has attracted a tremendous amount of attention as a tool to manage the ongoing COVID-19 pandemic. Although diagnostic laboratory testing is used ubiquitously by physicians and encountered regularly by individuals receiving medical care, several aspects of test interpretation are incompletely understood by medical communities and the general population, creating a significant challenge in minimizing the damage caused by disease spread through informed decision making and proper testing utilization. Here, general principles of test interpretation are reviewed and applied to specific examples, such as whether asymptomatic individuals should be tested, what it means to test positive (or negative), and how to interpret tests for "immunity passports." Unexpectedly, the answers seem to run contrary to many of the popular narratives about testing as a tool for managing COVID-19. Although testing is an important and essential part of managing diseases such as COVID-19, improper utilization can have unintended negative consequences.
作为管理持续的 COVID-19 大流行的工具,SARS-CoV-2 的检测引起了极大的关注。尽管诊断性实验室检测已被医生广泛使用,接受医疗服务的个体也经常接触,但医学专业人员和普通人群对检测解释的几个方面并不完全了解,这给通过知情决策和适当检测利用来最小化疾病传播造成的损害带来了巨大的挑战。在此,我们回顾了检测解释的一般原则,并将其应用于特定示例,例如无症状个体是否应进行检测、检测结果阳性(或阴性)意味着什么,以及如何解释“免疫护照”检测。出人意料的是,答案似乎与将检测作为管理 COVID-19 工具的许多流行说法相悖。尽管检测是管理 COVID-19 等疾病的重要和必不可少的部分,但不当使用可能会带来意想不到的负面后果。