Point-of-Care Testing-The Key in the Battle against SARS-CoV-2 Pandemic.

Ana Maria Ionescu,Mariana Carmen Chifiriuc,Monica Simion,Larisa Gogianu,Florina Silvia Iliescu,Gratiela Gradisteanu Pircalabioru,Ciprian Iliescu,Violeta Dediu

doi:10.3390/mi12121464

Abstract

The deleterious effects of the coronavirus disease 2019 (COVID-19) pandemic urged the development of diagnostic tools to manage the spread of disease. Currently, the “gold standard” involves the use of quantitative real-time polymerase chain reaction (qRT-PCR) for SARS-CoV-2 detection. Even though it is sensitive, specific and applicable for large batches of samples, qRT-PCR is labour-intensive, time-consuming, requires trained personnel and is not available in remote settings. This review summarizes and compares the available strategies for COVID-19: serological testing, Point-of-Care Testing, nanotechnology-based approaches and biosensors. Last but not least, we address the advantages and limitations of these methods as well as perspectives in COVID-19 diagnostics. The effort is constantly focused on understanding the quickly changing landscape of available diagnostic testing of COVID-19 at the clinical levels and introducing reliable and rapid screening point of care testing. The last approach is key to aid the clinical decision-making process for infection control, enhancing an appropriate treatment strategy and prompt isolation of asymptomatic/mild cases. As a viable alternative, Point-of-Care Testing (POCT) is typically low-cost and user-friendly, hence harbouring tremendous potential for rapid COVID-19 diagnosis.

Highlights

At the end of November 2021, there have been more than 250 million confirmed cases of coronavirus disease 2019 (COVID-19), including five million deaths, reported to World Health Organisation (WHO)
Aptima SARS-CoV-2/Flu assay, Hologic, Inc. is the first FDA-issued Emergency Use Authorization (EUA) automated multiplexed target nucleic acid amplification test intended for simultaneous in vitro qualitative detection and differentiation of Ribonucleic acid (RNA) from SARS-CoV-2 virus, influenza A virus (Flu A) and influenza B virus (Flu B), isolated and purified from nasopharyngeal (NP), nasal and mid-turbinate swab specimens obtained from individuals suspected of respiratory viral infection consistent with COVID-19 by their healthcare provider
Since the economic and psychological consequences of the COVID-19 pandemic are measurable at society and individual levels, the availability of specific and sensitive assays for at-home detection of this viral infection is essential

Summary

Introduction

At the end of November 2021, there have been more than 250 million confirmed cases of coronavirus disease 2019 (COVID-19), including five million deaths, reported to WHO. The research community worldwide responded and gathered to consolidate the scientific findings and knowledge on SARS-CoV-2 infection to control the pandemic and prepare for future outbreaks. Clinical diagnosis of COVID-19 is possible when pathognomonic symptoms [7], coupled with epidemiologic data, are apparent. Micromachines 2021, 12, 1464 specific [8], and the history of contact with other possible infected persons is not always readily available [9,10], a rapid ascertainable clinical/epidemiological diagnosis is difficult. Laboratory procedures and data collected via effective screening and confirmatory diagnosis are crucial to identify COVID-19 asymptomatic/symptomatic cases, active or not. We will firstly present the main challenges in SARS-CoV-2 detection and a brief description of the virus biology. Point-of-Care Testing (POCT) systems as rapid human and environmental testing methods

Challenges in SARS-CoV-2 Detection

SARS-CoV-2—Structure and Characteristics

Specimen Collection and Sample Preparation

Nucleic Acids

Viral Antigens

Detection Methods

PCR Mediated Detection

Isothermal Amplification

Sequencing-Based Tests

CRISPR-Mediated Detection

Combined Methods

Serologic Tests