A breath of fresh air - the potential for COVID-19 breath diagnostics.
A breath of fresh air - the potential for COVID-19 breath diagnostics.
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DOI：
10.1016/j.ebiom.2020.103183
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发表时间：
2021-01
期刊：
影响因子：
11.1
通讯作者：
Kenyon NJ
中科院分区：
文献类型：
--
作者：
Davis CE;Schivo M;Kenyon NJ
随着世界继续与持续的SARS-CoV-2大流行作斗争，很明显，频繁和广泛的病毒检测是了解疾病传播和指导社区和政府采取公共卫生行动的宝贵工具。迄今为止，大多数传统的诊断测试仍然依赖于已建立的聚合酶链反应（PCR）技术，该技术已被证明是相当强大的大规模筛查工具，并且仍然是现代医学中的金标准。当使用标准化方案时，PCR通常具有高准确性和高特异性（例如，低假阳性和低假阴性）。在大流行早期，面临着快速建立和分发最佳检测方法的挑战。一旦解决，该测试就在世界各地的协议中广泛而成功地推出。然而，在将其作为对抗COVID-19传播的工具时，还出现了其他挑战。首先，鼻咽PCR检测存在已知的采样问题。虽然PCR本身非常强大，但它依赖于收集积极扩增病毒遗传物质的样本。虽然不常见，但有可能“错过”擦拭具有活跃病毒载量的区域，从而导致假阴性测试结果。在这场公共卫生危机中，运营物流和产品供应链出现了更多问题，使检测系统不堪重负。PCR检测所需的液体试剂和鼻拭子需求量很大，因此限制了某些地点的供应，导致计划的检测方案发生改变。最后，尽管PCR非常可靠，但在采样和获得结果之间可能存在明显的时间延迟À小时到天，这取决于测试地点的处理能力。
As the world continues to grapple with the ongoing SARS-CoV-2 pandemic, it remains clear that frequent and widespread virus testing is a valuable tool to understand disease spread and to guide public health actions by communities and governments. To date, most traditional diagnostic tests continue to rely on established polymerase chain reaction (PCR) technologies, which have proven to be quite robust as a tool for mass screening and remain the gold standard within modern medicine. When employed using standardized protocols, PCR typically has a high accuracy and high specificity (eg, low false positives and low false negatives). Early in the pandemic, there were challenges to quickly establish and distribute the best testing methods. Once resolved, the test was widely and successfully rolled out in protocols across the world. However, other challenges have emerged when using this as a tool to combat COVID-19 spread. For one, there are known sampling issues with nasopharyngeal PCR tests. While PCR itself is incredibly robust, it relies on collecting samples of actively amplifying viral genetic material. Though uncommon, it is possible to “miss” swabbing an area with active viral loads, which leads to a false-negative test result. There have been many more issues with the operational logistics and product supply chains that have strained testing systems during this public health crisis. The liquid reagents needed for the PCR test and the nasal swabs are in high demand, thus limiting availability in some locations causing alterations to planned testing protocols. Finally, although PCR is very reliable, there can be a significant time delay between sampling and when the results are available À hours-to-days, depending on processing capabilities of the test site.
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