Coronavirus disease 2019: laboratory diagnosis
![](https://revistas.uptc.edu.co/public/journals/26/cover_issue_663_es_ES.jpg)
Abstract
Coronavirus disease 2019, (Coronavirus Disease 2019, COVID-19), is caused by the Severe Acute Respiratory Syndrome Coronavirus or Severe 2 (SARS-CoV-2). For its diagnosis there are three types of tests: those based on the detection of the virus (RNA or viral antigen), on the detection of antigens and those that detect antibodies. The Real- time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) detects the genetic material (RNA) of the virus, it is the reference standard for diagnostic of COVID-19; tests that detect antigens (virus proteins) may be useful as a criterion to confirm that the virus is present at the time the sample is taken and test that detect antibodies (IgM/IgG) indicate that there has been previous contact with the virus. Laboratory tests are used as help diagnostic and show findings that may lead to suspicion of COVID-19.
Keywords
COVID-19, coronavirus, diagnosis, techniques, examinations
References
- Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterization and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020; 395: 565-574.
- He F, Deng Y, Li W. Coronavirus disease 2019: What we know? J Med Virol. 2020; 1-7. 3. Pal M, Berhanu G, Desalegn C, Ramana k. Severe Acute Respiratory Syndrome Coronavirus2 (SARS-CoV-2): An Update. Cureus 2020; 12 (3): e7423.
- World Health Organization. Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. Who.int. 2020. Available in: https://www.who.int/dg/speeches/detail/whodirector-general-s-opening-remarks-at-themedia-briefing-oncovid-19---11-march-2020. [Access: 17 april 2020].
- Grupo de Nanobiosensores y Aplicaciones Bioanalíticas (NanoB2A) Instituto Catalán de Nanociencia y Nanotecnología (ICN2), CSIC, CIBER-BBN y BIST. Técnicas y sistemas de diagnóstico para COVID-19: clasificación, características, ventajas y limitaciones. Disponible en: http://www.ciencia.gob.es/stfls/MICINN/Ministerio/FICHEROS/ TecnicasDiagnosticoCOVID19-ICN2.pdf. [Consultado: 16 de marzo de 2020].
- Lippi G, Simundica A.M, Plebania M. Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19). [published online ahead of print, 2020 Mar 16]. Clin Chem Lab Med. 2020;/j/cclm.ahead-of-print/cclm-2020- 0285/cclm-2020-0285.xml. doi:10.1515/cclm-2020-0285. [Access: 18 april de 2020].
- Ministerio de Salud y Protección Social Colombia. Lineamientos para el uso de pruebas en el Laboratorio de Salud Pública (LSP) En el marco de la emergencia sanitaria por (COVID19) en Colombia. Abril 13 de 2020. Disponible en: https://www.minsalud.gov.co/RID/lineamientos-pruebas-lspcovid-19.pdf. [Consultado: 20 de abril de 2020].
- Instituto Nacional de Salud. Instructivo para la vigilancia en salud pública intensificada de infección respiratoria aguda asociada al nuevo coronavirus 2019 (COVID-19). 11 de abril de 2020. Disponible en: http://www.ins.gov.co/Paginas/Inicio.aspx. [Consultado: 20 de abril de 2020].
- Zhao J, Yuan Q, Wang H, Liu W, Liao X, Su Y, et al. Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019. MedRxiv. 2020:2020.03.02. Available in: https://doi.org/10.1101/2020.03.02.20030189. [Access: 18 april 2020].
- Loeffelholz MJ, Tang YW. Laboratory diagnosis of emerging human coronavirus infections - The state of the art. Emerg Microb Infect 2020; 9 (1): 747-56.
- Chunbao X, Lingxi J, Guo H, Hong P, Bo G, He L, et al. Comparison of different samples for 2019 novel coronavirus detection by nucleic acid amplification tests. Int J Infect Dis 2020; 93: 264-7.
- Poljak M, Korva M, Knap Gašper N, Fujs Komloš K, Sagadin M, Uršič T, et al. Clinical evaluation of the cobas SARS-CoV-2 test and a diagnostic platform switch during 48 hours in the midst of the COVID-19 pandemic. J Clin Microbiol. 2020 apr 10. Available in: https://jcm.asm.org/content/jcm/early/2020/04/09/JCM.00599- 20.full.pdf. [Access: 17 april 2020].
- Loras C, Sanz J.C. Información preliminar de las características virológicas del nuevo coronavirus SARS-CoV-2. REMASP 2020; 4 (2): 1-10.
- Xiao-Wei Xu, Xiao-Xin Wu, Xian-Gao Jiang, Kai-Jin Xu, Ling-Jun Ying, Chun-Lian Ma, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov2) outside of Wuhan, China: retrospective case series. BMJ. 2020; 368: m606.
- Ministerio de Salud y Protección Social de Colombia. Lineamientos para la gestión de muestras durante la pandemia del SARS- CoV-2 (COVID-19) en Colombia. marzo 30 de 2020. Disponible en: https://www.minsalud.gov.co/RID/lineamientogestion-muestras-covid-19-t.pdf. [Consultado: 20 de abril de 2020].
- World Health Organization. Coronavirus disease (COVID-19) technical guidance: Laboratory testing for 2019-nCoV in humans. Available in: https://www.who.int/emergencies/diseases/novelcoronavirus-2019/technical-guidance/laboratory-guidance. [Access: 18 april 2020].
- Hui D, Zumla A. Severe Acute Respiratory Syndrome: Historical, Epidemiologic, and Clinical Features. Infect Dis Clin N Am 2019; (33): 869-89.
- Tang Y, Persing D.H, Stratton C.W. The Laboratory Diagnosis of COVID-19 Infection: Current Issues and Challenges. J clin microbiol 2020 Article in Press. Available in: https://jcm.asm.org/content/early/2020/04/03/JCM.00512-20. [Access: 17 may 2020].
- Corman V, Bleicker T, Brünink S, Drosten Charité C. Diagnostic detection of 2019-nCoV by real-time RT-PCR. Protocol and preliminary evaluation as of Jan 17, 2020. Available in: https://www.who.int/docs/defaultsource/coronaviruse/protocol-v2-1.pdf?sfvrsn=a9ef618c_2. [Access: 17 september 2020].
- Organización Panamericana de la Salud. Directrices de Laboratorio para la Detección y Diagnóstico de la Infección con el virus COVID-19. 30 de marzo de 2020. Disponible en: https://www.paho.org/es/documentos/directrices-laboratoriopara-deteccion-diagnostico-infeccion-con-virus-covid-19. [Consultado: 20 de abril de 2020].
- World Health Organization. Advice on the use of point-of-care immunodiagnostic tests for COVID-19 Scientific brief 8 April 2020. Available in: https://www.who.int/docs/defaultsource/coronaviruse/sb-2020-1-poc immunodiagnostics-2020-04- 08.pdf?sfvrsn=5b6820_2. [Access: 17 april 2020].
- Trujillo H, Gutiérrez A, Rodríguez A, Mejía J, Peña A, García M, et al. Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS CoV-2/COVID 19 en establecimientos de atención en salud. Infectio 2020; 24 (3): 1-102.
- World Health Organization. Antigen-detection in the diagnosis of SARS-CoV-2 infection using rapid immunoassays. Interim guidance, 11 september 2020. Available in: https://www.who.int/publications/i/item/antigen-detection-in-thediagnosis-of-sars-cov-2infection-using-rapid-immunoassays.
- Yunb H, Suna Z, Wua J, Tanga A, Hua M, Xianga Z, et al. Laboratory data analysis of novel coronavirus (COVID-19) screening in 2510 patients. Clinic Chim Ac 2020; 507: 94-7.
- Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia. Mil Med Res 2020; 7 (4): 233-6.
- Tan L, Wang Q, Zhang D, Ding J, Huang O, Tang Y, et al Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Sig Transduct Target Ther 2020; 5: 33.
- Barnes BJ, Adrover JM, Baxter-Stoltzfus A, Borczuk A, Cools-Lartigue J, Crawford J, et al. potential drivers of COVID-19: Neutrophil extracellular traps. J Exp Med 2020; 217 (6): e20200652.
- Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with COVID-19 in Wuhan, China [published online ahead of print, 2020 Mar 12]. Clin Infect Dis 2020; 1-24.
- Liu J, Liu Y, Xiang P, Pu L, Xiong H, Li C, et al. Neutrophilto-lymphocyte ratio predicts severe illness patients with 2019 novel Coronavirus in the early stage. MedRxiv preprint feb 12, 2020. Available in: https://www.medrxiv.org/content/10.1101/2020.02.10.20021584v 1.full.pdf. [Access: 29 april 2020].
- Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood. American Society of Hematology. April 27, 2020.Available in: https://ashpublications.org/blood/article/doi/10.1182/blood.20200 06000/454646/COVID-19-and-its-implications-for-thrombosisand. [Access: 15 may 2020]. 12
- Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507-13.
- Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054-62.
- Páramo J. Coagulación, Dímero D y COVID-19 [sede web]. España; Sociedad Española de trombosis y hemostasia. 2020. Disponible en: https://www.covid-19.seth.es. [Consultado: 29 de abril de 2020].
- Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol 2020; 17 (5): 259‐60.
- Guan WJ, Ni ZY, Hu Y. Liang W, Ou C, He J, et al. Clinical characteristics of Coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1708-20.
- Adams DH, Hubscher SG. Systemic viral infections and collateral damage in the liver. Am J Pathol 2006; 168: 1057-9.
- Han Y, Zhang H. Lactate dehydrogenase, a Risk Factor of Severe COVID-19 Patients: A Retrospective and Observational Study. MedRxiv preprint 27 de marzo de 2020. Available in: https://www.medrxiv.org/content/10.1101/2020.03.24. 20040162v1. [Access: 29 april 2020].
- Sharma Y. The potential use of albumin in COVID-19 patients [sede web]. London, United Kingdom; BMJ; 24 april 2020. Available in: https://www.bmj.com/content/368/bmj.m810/rr-57. [Access: 29 april 2020].
- Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China [published correction appears in Intensive Care Med. 2020 Apr 6]. Intensive Care Med 2020; 46 (5): 846‐8.
- Lippi G, Plebani M. Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. Clin Chim Acta 2020; 505: 190‐1.
- Wang L. C-reactive protein levels in the early stage of COVID19. Med Mal Infect 2020; 50 (4): 332‐4.
- Fadoi. COVID-19: Guida clinico-pratica a cura del Gruppo Giovani [sede web]. Italy; Societa´scientifica di medicina interna; 2020. Aggiornata il 16 aprile 2020. Disponible su: https://www.fadoi.org/news/covid-19-guida-clinico-pratica-acura-del-gruppo-giovani-fadoi/. [Consultare: 29 aprile 2020].
- Coomes EA, Haghbayan H. Interleukin-6 in COVID-19: A Systematic Review and Meta-Analysis. MedRxiv preprint 03 april 2020.