Department of Engineering, University of Massachusetts Boston, Boston, MA, USA.
Little Devices Lab, Massachusetts Institute of Technology, Cambridge, MA, USA.
J Mater Chem B. 2021 Oct 13;9(39):8157-8173. doi: 10.1039/d1tb00674f.
The COVID-19 pandemic has led to an unprecedented global health challenge, creating sudden, massive demands for diagnostic testing, treatment, therapies, and vaccines. In particular, the development of diagnostic assays for SARS-CoV-2 has been pursued as they are needed for quarantine, disease surveillance, and patient treatment. One of the major lessons the pandemic highlighted was the need for fast, cheap, scalable and reliable diagnostic methods, such as paper-based assays. Furthermore, it has previously been suggested that paper-based tests may be more suitable for settings with lower resource availability and may help alleviate some supply chain challenges which arose during the COVID-19 pandemic. Therefore, we explore how such devices may fit in a comprehensive diagnostic strategy and how some of the challenges to the technology, low sensitivity, may be addressed. We discuss the properties of the SARS-CoV-2 virus itself, the COVID-19 disease pathway, and the immune response. We then describe the different diagnostic strategies that have been pursued, focusing on molecular strategies for viral genetic material, antigen tests, and serological assays, and innovations for improving the diagnostic sensitivity and capabilities. Finally, we discuss pressing issues for the future, and what needs to be addressed for the ongoing pandemic and future outbreaks.
新冠疫情带来了前所未有的全球健康挑战,对诊断检测、治疗、疗法和疫苗产生了突然的、大规模的需求。特别是,人们迫切需要针对 SARS-CoV-2 的诊断检测方法,因为它们对于隔离、疾病监测和患者治疗都非常重要。疫情凸显出的主要教训之一是需要快速、廉价、可扩展和可靠的诊断方法,例如基于纸张的检测方法。此外,此前曾有人提出,基于纸张的检测可能更适合资源较少的环境,并且可能有助于缓解在新冠疫情期间出现的一些供应链挑战。因此,我们探讨了这些设备如何适应综合诊断策略,以及如何解决该技术面临的一些挑战,例如低灵敏度问题。我们讨论了 SARS-CoV-2 病毒本身、新冠疾病途径和免疫反应的特性。然后,我们描述了所采用的不同诊断策略,重点介绍了针对病毒遗传物质的分子策略、抗原检测和血清学检测,以及提高诊断灵敏度和能力的创新。最后,我们讨论了未来的紧迫问题,以及为应对当前的大流行和未来的疫情爆发需要解决的问题。
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