Davis Department of Emergency Medicine, University of California, Sacramento, CA, USA.
Davis Department of Pathology and Laboratory Medicine, University of California, USA.
Expert Rev Mol Diagn. 2021 Dec;21(12):1333-1340. doi: 10.1080/14737159.2021.2005582. Epub 2021 Nov 29.
This expert review outlines current and future point-of-care technologies for the diagnosis of the SARS-CoV-2 virus, which is responsible for causing coronavirus disease COVID-19 in the emergency department. COVID-19 first emerged in late 2019 and is responsible for a range of presentations from minor upper respiratory tract symptoms to severe pneumonia and multisystem organ failure. Among the technologies available include the gold standard of molecular point-of-care tests as well as antigen detection tests.
We discuss point-of-care molecular tests including multiplex, targeted, and single plex panels as well as various antigen testing methodologies in terms of availability and performance characteristics. In addition, we focus on current testing best practices and considerations for point-of-care testing in the emergency department based on a search of the literature available in PubMed to date and a review of FDA and CDC guidance.
While there have been many advances in SARS-CoV-2 point-of-care testing, there remain challenges to implementation in the emergency department setting. A paradigm shift is needed to improve diagnosis and clinical outcomes.
本专家综述概述了当前和未来用于急诊科诊断 SARS-CoV-2 病毒(导致冠状病毒病 COVID-19 的病毒)的即时检测技术。COVID-19 于 2019 年末首次出现,可引起从轻微上呼吸道症状到严重肺炎和多器官功能衰竭等多种表现。现有技术包括分子即时检测的金标准以及抗原检测技术。
我们讨论了即时检测的分子检测,包括多重、靶向和单重检测面板以及各种抗原检测方法,涉及可用性和性能特征。此外,我们还根据在 PubMed 上搜索到的现有文献以及对 FDA 和 CDC 指南的审查,重点关注急诊科即时检测的当前检测最佳实践和注意事项。
尽管 SARS-CoV-2 即时检测技术取得了许多进展,但在急诊科实施仍面临挑战。需要转变观念以改善诊断和临床结果。