Munne Kiran, Bhanothu Venkanna, Bhor Vikrant, Patel Vainav, Mahale Smita D, Pande Shailesh
Department of Clinical Research, ICMR-National Institute for Research in Reproductive Health, Jehangir Merwanji Street, Parel, Mumbai, 400012 India.
Genetic Research Centre, ICMR-National Institute for Research in Reproductive Health, Jehangir Merwanji Street, Parel, Mumbai, 400012 India.
Virusdisease. 2021 Jun;32(2):187-189. doi: 10.1007/s13337-021-00692-5. Epub 2021 May 3.
In this current pandemic of coronavirus disease 2019 (COVID-19), prompt interventions in terms of early detection and clinical management along with isolation of positive cases is of utmost importance. This helps to limit not only the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections but also the morbidity and mortality associated with it. Different strategies for screening of COVID-19 in containment zones and non-containment areas include testing of symptomatic patients and their contacts in fever clinics, hospital-based testing, testing on demand and population-based screening. The choice of tests like reverse-transcription polymerase chain reaction (RT-PCR), rapid antigen testing (RAT) or antibody test depends upon these strategies and also the turnaround time. Currently, RT-PCR is considered the gold standard for COVID-19 detection. This commentary provides the insights and experiences on COVID-19 diagnosis by RT-PCR. The utility of this test is limited by several false positive, false negative and inconclusive results at early stages of infection, scarcity of reagents and lack of well-equipped labs including trained staff. Moreover, appropriate sample collection and transport, standard laboratory protocols, stringent quality control norms, good quality RNA extraction kits, PCR kits with suitable primers can help in improving accuracy of the test results. A careful assessment of clinical, radiological and molecular findings is required for identifying potential cases of COVID-19.
在当前这场2019冠状病毒病(COVID-19)大流行中,在早期检测、临床管理以及隔离阳性病例方面迅速采取干预措施至关重要。这不仅有助于限制严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染的传播,还能降低与之相关的发病率和死亡率。在防控区和非防控区筛查COVID-19的不同策略包括在发热门诊对有症状患者及其接触者进行检测、基于医院的检测、按需检测和基于人群的筛查。像逆转录聚合酶链反应(RT-PCR)、快速抗原检测(RAT)或抗体检测等检测方法的选择取决于这些策略以及周转时间。目前,RT-PCR被认为是COVID-19检测的金标准。本评论提供了关于通过RT-PCR进行COVID-19诊断的见解和经验。该检测方法的效用受到感染早期的一些假阳性、假阴性和不确定结果、试剂短缺以及包括缺乏训练有素的工作人员在内的设备不完善实验室的限制。此外,适当的样本采集和运输、标准实验室操作规程、严格的质量控制规范、优质的RNA提取试剂盒、带有合适引物的PCR试剂盒有助于提高检测结果的准确性。识别COVID-19潜在病例需要对临床、放射学和分子学检查结果进行仔细评估。