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Approximately 10 to 15 percent of cases of what we call the "common cold" are associated with an endemic coronavirus, of which are two distinct groups: HCoV-229E and HCoV-OC43.<ref name="WatTheCommon04">{{cite journal |title=The common cold: A review of the literature |journal=European Journal of Internal Medicine |author=Wat, D. |volume=15 |issue=2 |pages=79–88 |year=2004 |doi=10.1016/j.ejim.2004.01.006 |pmid=15172021}}</ref> Disease symptoms associated with these coronaviruses—typically in the form of respiratory infection and the symptoms that come with it—by themselves are typically mild<ref name="LoeffelholzLab20" />, and laboratory testing isn't necessarily indicated for those immunocompetent individuals capable of self-limiting.<ref name="BabadyMulti18">{{cite journal |title=Multicenter Evaluation of the ePlex Respiratory Pathogen Panel for the Detection of Viral and Bacterial Respiratory Tract Pathogens in Nasopharyngeal Swabs |journal=Journal of Clinical Microbiology |author=Babady, N.E.; England, M.R.; Jurcic Smith, K.L. et al. |volume=56 |issue=2 |at=e01658-17 |year=2018 |doi=10.1128/JCM.01658-17 |pmid=29212701 |pmc=PMC5786739}}</ref> However, symptom overlap with pharyngitis and bronchitis, as well as the complication of pharyngitis and sinusitis also potentially having bacterial origin, can complicate clinical diagnosis. Additionally, as more antivirals that target a specific virus are created, and as concerns of unnecessarily using antibiotics to treat viral diseases grows<ref name="JenisonRapid16">{{cite web |url=https://www.statnews.com/2016/11/30/antibiotic-resistance-molecular-diagnostics/ |title=Rapid lab tests can help reduce antibiotic resistance |author=Jenison, R. |work=STAT |date=30 November 2016 |accessdate=03 April 2020}}</ref><ref name="RoyRapid18">{{cite web |url=https://www.healio.com/news/infectious-disease/20180926/rapid-test-for-viral-infections-reduces-unnecessary-antibiotic-prescribing |title=Rapid test for viral infections reduces unnecessary antibiotic prescribing |author=Roy, K. |work=Healio |date=26 September 2018 |accessdate=06 September 2021}}</ref>, laboratory methods of respiratory virus diagnosis—particularly for those who are immunocompromised—have value.<ref name="WatTheCommon04" /><ref name="BabadyMulti18" />  
Approximately 10 to 15 percent of cases of what we call the "common cold" are associated with an endemic coronavirus, of which are two distinct groups: HCoV-229E and HCoV-OC43.<ref name="WatTheCommon04">{{cite journal |title=The common cold: A review of the literature |journal=European Journal of Internal Medicine |author=Wat, D. |volume=15 |issue=2 |pages=79–88 |year=2004 |doi=10.1016/j.ejim.2004.01.006 |pmid=15172021}}</ref> Disease symptoms associated with these coronaviruses—typically in the form of respiratory infection and the symptoms that come with it—by themselves are typically mild<ref name="LoeffelholzLab20">{{cite journal |title=Laboratory diagnosis of emerging human coronavirus infections – The state of the art |journal=Emerging Microbes & Infections |author=Loeffelholz, M.J.; Tang, T.-W. |volume=9 |issue=1 |pages=747–56 |year=2020 |doi=10.1080/22221751.2020.1745095 |pmid=32196430}}</ref>, and laboratory testing isn't necessarily indicated for those immunocompetent individuals capable of self-limiting.<ref name="BabadyMulti18">{{cite journal |title=Multicenter Evaluation of the ePlex Respiratory Pathogen Panel for the Detection of Viral and Bacterial Respiratory Tract Pathogens in Nasopharyngeal Swabs |journal=Journal of Clinical Microbiology |author=Babady, N.E.; England, M.R.; Jurcic Smith, K.L. et al. |volume=56 |issue=2 |at=e01658-17 |year=2018 |doi=10.1128/JCM.01658-17 |pmid=29212701 |pmc=PMC5786739}}</ref> However, symptom overlap with pharyngitis and bronchitis, as well as the complication of pharyngitis and sinusitis also potentially having bacterial origin, can complicate clinical diagnosis. Additionally, as more antivirals that target a specific virus are created, and as concerns of unnecessarily using antibiotics to treat viral diseases grows<ref name="JenisonRapid16">{{cite web |url=https://www.statnews.com/2016/11/30/antibiotic-resistance-molecular-diagnostics/ |title=Rapid lab tests can help reduce antibiotic resistance |author=Jenison, R. |work=STAT |date=30 November 2016 |accessdate=03 April 2020}}</ref><ref name="RoyRapid18">{{cite web |url=https://www.healio.com/news/infectious-disease/20180926/rapid-test-for-viral-infections-reduces-unnecessary-antibiotic-prescribing |title=Rapid test for viral infections reduces unnecessary antibiotic prescribing |author=Roy, K. |work=Healio |date=26 September 2018 |accessdate=06 September 2021}}</ref>, laboratory methods of respiratory virus diagnosis—particularly for those who are immunocompromised—have value.<ref name="WatTheCommon04" /><ref name="BabadyMulti18" />  


RT-PCR, a molecular method, has been used for well over a decade for detecting coronaviruses.<ref name="WatTheCommon04" /><ref name="MahonyDetect08">{{cite journal |title=Detection of Respiratory Viruses by Molecular Methods |journal=Clinical Microbiology Reviews |author=Mahoney, J.B. |volume=21 |issue=4 |pages=716–47 |year=2008 |doi=10.1128/CMR.00037-07 |pmid=18854489 |pmc=PMC2570148}}</ref> However, as molecular methods of analysis have expanded over the years, more rapid solutions for testing have been developed. For example, the GenMark ePlex rapid multiplex molecular diagnostics instrument and the ePlex Respiratory Pathogen Panel were evaluated in a multicenter trial by Babady ''et al.'' in 2017.<ref name="BabadyMulti18" /> The panel is capable of testing for the presence of 15 viral types—including the -229E, -OC43, and two other coronaviruses—and two bacterial types in nasopharyngeal swab specimens, with results in typically less than two hours.<ref name="BabadyMulti18" /> The cost associated with these sorts of tests, compared to their benefits, likely limits ubiquitous use at the first sign of a cold<ref name="BabadyMulti18" />, but as molecular diagnostic technologies become more compact and easy-to-use, testing for infection by endemic human coronaviruses may become slightly more commonplace. However, as the authors point out, with no treatment for these endemic coronaviruses, any additional utility beyond diagnosing an illness as viral rather than bacterial would primarily be found in epidemiological studies of the associated genotyping data.<ref name="BabadyMulti18" />
RT-PCR, a molecular method, has been used for well over a decade for detecting coronaviruses.<ref name="WatTheCommon04" /><ref name="MahonyDetect08">{{cite journal |title=Detection of Respiratory Viruses by Molecular Methods |journal=Clinical Microbiology Reviews |author=Mahoney, J.B. |volume=21 |issue=4 |pages=716–47 |year=2008 |doi=10.1128/CMR.00037-07 |pmid=18854489 |pmc=PMC2570148}}</ref> However, as molecular methods of analysis have expanded over the years, more rapid solutions for testing have been developed. For example, the GenMark ePlex rapid multiplex molecular diagnostics instrument and the ePlex Respiratory Pathogen Panel were evaluated in a multicenter trial by Babady ''et al.'' in 2017.<ref name="BabadyMulti18" /> The panel is capable of testing for the presence of 15 viral types—including the -229E, -OC43, and two other coronaviruses—and two bacterial types in nasopharyngeal swab specimens, with results in typically less than two hours.<ref name="BabadyMulti18" /> The cost associated with these sorts of tests, compared to their benefits, likely limits ubiquitous use at the first sign of a cold<ref name="BabadyMulti18" />, but as molecular diagnostic technologies become more compact and easy-to-use, testing for infection by endemic human coronaviruses may become slightly more commonplace. However, as the authors point out, with no treatment for these endemic coronaviruses, any additional utility beyond diagnosing an illness as viral rather than bacterial would primarily be found in epidemiological studies of the associated genotyping data.<ref name="BabadyMulti18" />

Revision as of 17:57, 3 February 2022

Approximately 10 to 15 percent of cases of what we call the "common cold" are associated with an endemic coronavirus, of which are two distinct groups: HCoV-229E and HCoV-OC43.[1] Disease symptoms associated with these coronaviruses—typically in the form of respiratory infection and the symptoms that come with it—by themselves are typically mild[2], and laboratory testing isn't necessarily indicated for those immunocompetent individuals capable of self-limiting.[3] However, symptom overlap with pharyngitis and bronchitis, as well as the complication of pharyngitis and sinusitis also potentially having bacterial origin, can complicate clinical diagnosis. Additionally, as more antivirals that target a specific virus are created, and as concerns of unnecessarily using antibiotics to treat viral diseases grows[4][5], laboratory methods of respiratory virus diagnosis—particularly for those who are immunocompromised—have value.[1][3]

RT-PCR, a molecular method, has been used for well over a decade for detecting coronaviruses.[1][6] However, as molecular methods of analysis have expanded over the years, more rapid solutions for testing have been developed. For example, the GenMark ePlex rapid multiplex molecular diagnostics instrument and the ePlex Respiratory Pathogen Panel were evaluated in a multicenter trial by Babady et al. in 2017.[3] The panel is capable of testing for the presence of 15 viral types—including the -229E, -OC43, and two other coronaviruses—and two bacterial types in nasopharyngeal swab specimens, with results in typically less than two hours.[3] The cost associated with these sorts of tests, compared to their benefits, likely limits ubiquitous use at the first sign of a cold[3], but as molecular diagnostic technologies become more compact and easy-to-use, testing for infection by endemic human coronaviruses may become slightly more commonplace. However, as the authors point out, with no treatment for these endemic coronaviruses, any additional utility beyond diagnosing an illness as viral rather than bacterial would primarily be found in epidemiological studies of the associated genotyping data.[3]

References

  1. ↑ 1.0 1.1 1.2 Wat, D. (2004). "The common cold: A review of the literature". European Journal of Internal Medicine 15 (2): 79–88. doi:10.1016/j.ejim.2004.01.006. PMID 15172021. 
  2. ↑ Loeffelholz, M.J.; Tang, T.-W. (2020). "Laboratory diagnosis of emerging human coronavirus infections – The state of the art". Emerging Microbes & Infections 9 (1): 747–56. doi:10.1080/22221751.2020.1745095. PMID 32196430. 
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Babady, N.E.; England, M.R.; Jurcic Smith, K.L. et al. (2018). "Multicenter Evaluation of the ePlex Respiratory Pathogen Panel for the Detection of Viral and Bacterial Respiratory Tract Pathogens in Nasopharyngeal Swabs". Journal of Clinical Microbiology 56 (2): e01658-17. doi:10.1128/JCM.01658-17. PMC PMC5786739. PMID 29212701. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786739. 
  4. ↑ Jenison, R. (30 November 2016). "Rapid lab tests can help reduce antibiotic resistance". STAT. https://www.statnews.com/2016/11/30/antibiotic-resistance-molecular-diagnostics/. Retrieved 03 April 2020. 
  5. ↑ Roy, K. (26 September 2018). "Rapid test for viral infections reduces unnecessary antibiotic prescribing". Healio. https://www.healio.com/news/infectious-disease/20180926/rapid-test-for-viral-infections-reduces-unnecessary-antibiotic-prescribing. Retrieved 06 September 2021. 
  6. ↑ Mahoney, J.B. (2008). "Detection of Respiratory Viruses by Molecular Methods". Clinical Microbiology Reviews 21 (4): 716–47. doi:10.1128/CMR.00037-07. PMC PMC2570148. PMID 18854489. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2570148. 
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