Journal:Laboratory testing methods for novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Full article title	Laboratory testing methods for novel Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2)
Journal	Frontiers in Cell and Developmental Biology
Author(s)	D'Cruz, Roshan J.; Currier, Arthur W.; Sampson, Valerie B.
Author affiliation(s)	Nemours/Alfred I. duPont Hospital for Children
Primary contact	Email: valerie dot sampson at nemours dot org
Year published	2020
Volume and issue	8
Article #	468
DOI	10.3389/fcell.2020.00468
ISSN	2296-634X
Distribution license	Creative Commons Attribution 4.0 International
Website	https://www.frontiersin.org/articles/10.3389/fcell.2020.00468/full
Download	https://www.frontiersin.org/articles/10.3389/fcell.2020.00468/pdf (PDF)

Abstract

Following the first reports of coronavirus disease 2019 (COVID-19) by China to the World Health Organization (WHO) on December 31, 2019, more than 4,302,774 cases of infection by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus have been reported by authorities in 212 countries and territories as of May 12, 2020. The outbreak and spread of COVID-19 worldwide highlights the critical need for developing rapid and accurate diagnostic testing methods for emerging human coronavirus (CoV) infections. Testing is crucial to tracking the spread of disease during a pandemic, and to swiftly permitting public health interventions, including isolation, quarantine, and appropriate clinical management of afflicted individuals. The key components of viral diagnostic tests are (1) collection of the appropriate sample (blood, nasal swab, and throat swab); (2) availability of the genetic and proteomic sequences of the novel virus for analysis; and (3) rapid and accurate laboratory testing methods. The current gold standard for the molecular diagnosis of SARS-CoV-2 infection is the real-time reverse transcription polymerase chain reaction (qRT-PCR) for the qualitative and quantitative detection of viral nucleic acids. Other relevant laboratory methods include enzyme-linked immunosorbent assays (ELISA) for viral antibody and antigen detection, and serum virus neutralization (SVN) assays for antibody neutralization determination. The challenges faced in developing a diagnostic test for a novel pathogen are the ability to measure low viral loads for early detection, to provide low or no cross-reactivity with other viral strains, and to deliver results rapidly. Several point-of-care molecular devices are currently being integrated for fast and accurate diagnosis of SARS-CoV-2 infections. This review discusses the current laboratory methods available to test for coronaviruses by focusing on the present COVID-19 outbreak.

Keywords: coronavirus, RT-PCR, ELISA, lateral flow diagnostics, convalescent plasma

Introduction

Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus (CoV) that was originally reported in Wuhan, Hubei province, China in December 2019. The International Committee on Taxonomy of Viruses named the virus "severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Infection by SARS-CoV-2 causes a respiratory illness that varies in severity from mild upper respiratory symptoms akin to the seasonal flu, to severe progressive respiratory failure that requires intensive care and can lead to death. Asymptomatic carriers of the virus have also been reported and pose a significant public health threat due to their ability to unknowingly spread the virus. SARS-CoV-2 represents the third coronavirus in this millennium to cross species from animals to humans and cause a severe respiratory disease, after Middle-East respiratory syndrome coronavirus (MERS-CoV) in 2012 (Zaki et al., 2012) and severe acute respiratory syndrome coronavirus (SARS-CoV) in 2003 (Drosten et al., 2003; Ksiazek et al., 2003). This novel CoV has now been identified as the seventh CoV that is transmissible between humans (including HCoV-229E, HCoV-OC43, HCoV-NL63, and HCoV-HKU1) (Salata et al., 2019). On 30th January 2020, the World Health Organization (WHO) declared the SARS-CoV-2 epidemic a public health emergency of international concern and was upgraded to a pandemic on 11th March 2020. At least 4,302,774 confirmed cases and 289,561 deaths worldwide were reported as of 12th May 2020 (worldometers.info/coronavirus/). Diagnostic testing is critical during a pandemic as the ability to track the spread of SARS-CoV-2 is essential for effective disease management and control.

Notes

This presentation is faithful to the original, with only a few minor changes to presentation. In some cases important information was missing from the references, and that information was added. References in this version are listed in order of appearance—by design—rather than alphabetical order as the original was.