Open AccessTesting for Severe Acute Respiratory Syndrome–Coronavirus 2: Challenges in Getting Good Specimens, Choosing the Right Test, and Interpreting the Results
Author(s) -
Yuan-Po Tu,
Timothy J. O'Leary
Publication year - 2020
Publication title -
critical care medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.002
H-Index - 271
eISSN - 1530-0293
pISSN - 0090-3493
DOI - 10.1097/ccm.0000000000004594
Subject(s) - medicine , covid-19 , test (biology) , coronavirus , betacoronavirus , respiratory system , intensive care medicine , emergency medicine , virology , disease , outbreak , infectious disease (medical specialty) , paleontology , biology
We explore ways to reduce errors in laboratory diagnosis of severe acute respiratory syndrome-coronavirus 2 infection by considering preanalytic, analytic, and postanalytic sources. To address preanalytic challenges, we first consider alternative anatomic sites for specimen collection, then discuss self-collection, alternative sampling devices, and transport media. Strengths and limitations of various analytic test systems are considered in the context of postanalytic challenges associated with making test results meaningful, specifically considering the complex relationship between "positive" test results and reproduction and shedding of intact virus. Finally, we provide recommendations regarding healthcare worker surveillance and release of patients with coronavirus disease 2019 from isolation.