Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinicgrid.66875.3a, Rochester, Minnesota, USA.
J Clin Microbiol. 2021 Oct 19;59(11):e0046921. doi: 10.1128/JCM.00469-21. Epub 2021 Aug 4.
Since the beginning of the COVID-19 pandemic, molecular methods (e.g., real-time PCR) have been the primary means of diagnosing the disease. It is now well established that molecular tests can continue to detect SARS-CoV-2 genomic RNA for weeks or months following the resolution of clinical illness. This has prompted public health agencies to recommend a symptom- and/or time-based strategy for discontinuation of isolation precautions, which, for hospitalized patients, results in significant use of personal protective equipment. Due to the inability of current molecular diagnostic assays to differentiate between the presence of remnant viral RNA (i.e., noninfectious) and replication-competent (i.e., infectious) virus, there has been interest in determining whether laboratory tests can be used to predict an individual's likelihood of transmitting the virus to others. This review will highlight what is currently known about the potential for existing assays, such as real-time PCR and antigen tests, to predict active viral infection. In addition, data on the performance of new methods, such as molecular tests targeting viral RNA intermediates (e.g., subgenomic RNA), will be discussed.
自 COVID-19 大流行开始以来,分子方法(例如实时 PCR)一直是诊断该病的主要手段。现在已经证实,在临床疾病缓解后数周或数月内,分子检测仍可继续检测到 SARS-CoV-2 基因组 RNA。这促使公共卫生机构建议根据症状和/或时间制定隔离预防措施的停止策略,这会导致住院患者大量使用个人防护设备。由于当前的分子诊断检测方法无法区分残余病毒 RNA(即无传染性)和具有复制能力的(即传染性)病毒的存在,因此人们一直有兴趣确定实验室检测是否可用于预测个体将病毒传播给他人的可能性。这篇综述将重点介绍目前已知的现有检测方法(例如实时 PCR 和抗原检测)预测活跃病毒感染的潜力。此外,还将讨论针对病毒 RNA 中间体(例如亚基因组 RNA)的新方法(例如分子检测)的性能数据。
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