Navigating the Diagnostics of COVID-19

Abstract

Introduction/Objective The recent outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in Hubei province, China in December 2019 and has spread worldwide at an alarming rate. With millions of individuals infected and over two hundred thousand deaths, the necessity to develop fast and efficient diagnostic methods is of high importance. Diagnostic modalities rely on a combination of epidemiology, clinical presentation, laboratory examination, and appropriate imaging to diagnose and distinguish SARS-CoV-2 from other pulmonary infections. The purpose of this paper is to report on currently available diagnostic screening methods for patients infected with SARS-CoV-2 to guide frontline healthcare workers involved with COVID-19 patient care. Methods An electronic literature search was performed for peer-reviewed articles published from January 1, 2020, until April 26, 2020. Articles were then reviewed and included based on the applicability to the topic. Results The preferred diagnostic approach is reverse transcription of the virus’ RNA followed by PCR amplification (RT-PCR). This method recognizes the gene-specific primers to target various viral protein genes, such as the envelope protein gene or the nucleocapsid protein gene, which enables this test to be both sensitive and specific toward SARS-CoV-2. However, this method has been proven to be time-consuming taking hours-to-days for the results. In order to improve the speed and efficiency of diagnostics, newer rapid diagnostic serological tests are being developed for testing SARS-CoV-2, each with its own unique advantages and disadvantages. They could potentially be used as triage tests to rapidly identify patients who are very likely to have COVID-19 in combination with other accurate diagnostic methods. Conclusion Therefore, a combination of diagnostic testing used in a timely manner may be beneficial for the rapid and accurate detection of SARS-CoV-2. This was evident in cases where despite initial negative RT-PCR tests for various patients, who later demonstrate chest CT scans with various degrees of consolidation and ground-glass opacity. Thus establishing the need for radiology diagnosis to be complementary to RT-PCR for COVID-19 patients. Hopefully, the continuous development and use of rapid diagnostic tests and the implementation of public health measures will help control the spread of the disease.

Lexical modeling and weighted matrices for analyses of COVID-19 outbreak

“…Worldwide, government agencies have authorized numerous diagnostic procedures; nevertheless, the right policies are still unclear, dependent on the health status or the objectives of the research of the patient ( Sanyaolu et al, 2020 ). For example, in Europe, the CE-IVD and FDA authorized or utilized for data analysis 365 different commercialized tools.…”

Maturing pharmacogenomic factors deliver improvements and cost efficiencies

“…Repurposing the infrastructure centered around viral testing to address other pressing public health concerns represents a major opportunity that should not be overlooked. Molecular diagnostic platform manufacturers and laboratories demonstrated their real-time ability to answer the call by quickly increasing the volumes and speeds at which samples could be collected, coordinated, and processed by increasing capacity and adopting new, more efficient testing procedures (Sanyaolu et al 2020;Kriegova et al 2020;La Marca et al 2020;Zhang et al 2020; Johns Hopkins Center for Health Security 2022). Tapping this latent potential in other areas, securing adequate funding, and publicizing the existing documentation of critical returns-on-investment are all necessary to demonstrating the future of all sorts of testing strategies, including those related to PGx.…”

Candida auris: Multidrug resistance and new treatment strategies

“…yeast is a mighty skin colonizer, which increases its transmission within hospitalized patients. The infection can spread to internal organs via bloodstream causing candidemia resulting in almost 70% mortality rate [5]. In addition to this, C. auris can also be detected in hospital surfaces and indwelling medical devices leading to its persistence in hospital settings remaining viable in dry surfaces for up to 4 weeks [6,3].…”

“…Also shown as a risk factor is the use of antibiotic therapy by hospitalized patients, as most of the fungal infections are considered as opportunistic. Diabetic and organ transplantation patients are also on the verge of the risk [5]. The considerable challenge of this infection is its multidrug resistance ability alarmingly being reported as resistant to at least two of the three classes of current antifungal therapy, such as azoles, echinocandins, and polyenes, at an extremely high rate reaching up to 93% [5,7].…”

“…Diabetic and organ transplantation patients are also on the verge of the risk [5]. The considerable challenge of this infection is its multidrug resistance ability alarmingly being reported as resistant to at least two of the three classes of current antifungal therapy, such as azoles, echinocandins, and polyenes, at an extremely high rate reaching up to 93% [5,7]. As an alternative, echinocandins are now becoming the first choice in treating this infection.…”