Department of Biological Sciences, Munster Technological University, Bishopstown, T12 P928 Cork, Ireland.
Department of Biopharmaceutical and Medical Science, Galway-Mayo Institute of Technology, Old Dublin Road, H91 DCH9 Galway, Ireland.
Med Sci (Basel). 2021 May 25;9(2):36. doi: 10.3390/medsci9020036.
SARS-CoV-2 infection has generated the biggest pandemic since the influenza outbreak of 1918-1919. One clear difference between these pandemics has been the ability to test for the presence of the virus or for evidence of infection. This review examined the performance characteristics of sample types PCR detection of the virus, of antibody testing, of rapid viral antigen detection kits and computerised tomography (CT) scanning. It was found that combined detection approaches, such as the incorporation of CT scans, may reduce the levels of false negatives obtained by PCR detection in both symptomatic and asymptomatic patients, while sputum and oral throat washing sample types should take precedence over swabbing when available. Rt-PCR assays for detection of the virus remain the gold-standard method for SARS-CoV-2 diagnosis and can be used effectively on pooled samples for widespread screening. The novel Oxford antibody assay was found to have the highest sensitivity and specificity of four currently available commercial antibody kits but should only be used during a specific timeframe post-symptom onset. Further research into transmission modes between symptomatic and asymptomatic patients is needed. Analysis of the performance characteristics of different sampling and detection methods for SARS-CoV-2 showed that timing of sampling and testing methods used can greatly influence the rate of false-positive and false-negative test results, thereby influencing viral spread.
SARS-CoV-2 感染引发了自 1918-1919 年流感大流行以来最大的一次大流行。这两次大流行的一个明显区别是检测病毒存在或感染证据的能力。本综述检查了病毒的 PCR 检测、抗体检测、快速病毒抗原检测试剂盒和计算机断层扫描（CT）扫描等样本类型的性能特征。研究发现，将 CT 扫描等联合检测方法纳入其中，可能会降低 PCR 检测在有症状和无症状患者中获得的假阴性率，而在有条件时，痰液和口腔咽喉冲洗样本类型应优先于拭子。用于检测病毒的实时聚合酶链反应（RT-PCR）检测仍然是 SARS-CoV-2 诊断的金标准方法，并且可以有效地用于广泛筛查的混合样本中。新型牛津抗体检测试剂盒在四种目前可用的商业抗体试剂盒中具有最高的敏感性和特异性，但仅应在症状出现后特定时间内使用。需要进一步研究有症状和无症状患者之间的传播模式。对 SARS-CoV-2 不同采样和检测方法的性能特征进行分析表明，采样和检测方法的时间选择会极大地影响假阳性和假阴性检测结果的比率，从而影响病毒的传播。
