First Department of Critical Care Medicine & Pulmonary Services, Evangelismos General Hospital, National and Kapodistrian University of Athens, Athens, Greece; European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses, Basel, Switzerland.
Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy; Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Clin Microbiol Infect. 2022 Jun;28(6):812-822. doi: 10.1016/j.cmi.2022.02.011. Epub 2022 Feb 23.
The objective of these guidelines is to identify the most appropriate diagnostic test and/or diagnostic approach for SARS-CoV-2. The recommendations are intended to provide guidance to clinicians, clinical microbiologists, other health care personnel, and decision makers.
An ESCMID COVID-19 guidelines task force was established by the ESCMID Executive Committee. A small group was established, half appointed by the chair and the remaining selected with an open call. Each panel met virtually once a week. For all decisions, a simple majority vote was used. A list of clinical questions using the PICO (population, intervention, comparison, outcome) format was developed at the beginning of the process. For each PICO, two panel members performed a literature search focusing on systematic reviews, with a third panellist involved in case of inconsistent results. Quality of evidence assessment was based on the GRADE-ADOLOPMENT (Grading of Recommendations Assessment, Development and Evaluation - adoption, adaptation, and de novo development of recommendations) approach.
A total of 43 PICO questions were selected that involve the following types of populations: (a) patients with signs and symptoms of COVID-19; (b) travellers, healthcare workers, and other individuals at risk for exposure to SARS-CoV-2; (c) asymptomatic individuals, and (d) close contacts of patients infected with SARS-CoV-2. The type of diagnostic test (commercial rapid nucleic acid amplification tests and rapid antigen detection), biomaterial, time since onset of symptoms/contact with an infectious case, age, disease severity, and risk of developing severe disease are also taken into consideration.
本指南的目的是确定 SARS-CoV-2 最合适的诊断检测和/或诊断方法。本指南旨在为临床医生、临床微生物学家、其他医疗保健人员和决策者提供指导。
ESCMID 执行委员会成立了一个 ESCMID COVID-19 指南工作组。成立了一个小组成员，一半由主席任命，其余成员通过公开招募选定。每个小组每周在线开会一次。所有决定均采用简单多数票。在开始时，使用 PICO（人群、干预、比较、结果）格式列出了一系列临床问题。对于每个 PICO，两名小组成员进行了文献检索，重点是系统评价，如有不一致的结果，则由第三名小组成员参与。证据质量评估基于 GRADE-ADOLOPMENT（推荐评估、制定和评估 - 采用、改编和新制定建议）方法。
共选择了 43 个 PICO 问题，涉及以下类型的人群：（a）有 COVID-19 症状和体征的患者；（b）旅行者、医护人员和其他有接触 SARS-CoV-2 风险的人员；（c）无症状个体，以及（d）感染 SARS-CoV-2 的患者的密切接触者。还考虑了诊断测试类型（商业快速核酸扩增测试和快速抗原检测）、生物材料、症状出现/接触感染病例后的时间、年龄、疾病严重程度以及发展为严重疾病的风险。
