Multi-tiered screening and diagnosis strategy for COVID-19: a model for sustainable testing capacity in response to pandemic.
Multi-tiered screening and diagnosis strategy for COVID-19: a model for sustainable testing capacity in response to pandemic.
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DOI：
10.1080/07853890.2020.1763449
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发表时间：
2020-08
影响因子：
4.4
通讯作者：
Sambursky R
中科院分区：
文献类型：
--
作者：
Pulia MS;O'Brien TP;Hou PC;Schuman A;Sambursky R
测试部署的延迟导致了围绕总体疾病负担和社区传播的不确定性，严重阻碍了公共卫生遏制和医疗保健系统准备工作。现在可以使用包含快速宿主免疫护理点检测的多层次检测策略，通过有效地识别有疾病风险的患者，从而促进在疾病暴发期间更早地进行隔离，从而在可能需要几周和几个月才能开发、验证和生产足够数量的病原体特定确认检测期间，用于未来的大流行规划。在护理时对患者进行分类并支持医疗和治疗决策的指导、病毒分离或确证测试或适当治疗新冠肺炎和/或细菌感染的能力，是我国应对大流行的关键组成部分，迫切需要实施拟议的战略来抗击当前的疫情。2019年冠状病毒病(新冠肺炎)是由新型被膜单链核糖核酸冠状病毒(SARS-CoV-2)引起的，是一种持续的全球大流行。当其他国家将广泛的测试作为早期缓解战略部署时，美国在生物识别测试的开发和部署方面遇到了拖延。因此，围绕疾病负担和社区传播存在不确定性，严重阻碍了遏制努力。新冠肺炎阐明了分层诊断方法的必要性，以快速识别临床上重要的感染并减少疾病传播。如果没有能力有效地筛查患者，医院就会不堪重负，可能会延误其他紧急情况的治疗。将快速宿主免疫反应分析作为筛查试验、分子确证试验和快速免疫球蛋白M/Ig G试验相结合的多层次诊断策略将有效地评估潜在的新冠肺炎患者，以评估隔离/进一步检测的益处并提供人群暴露/群体免疫的信息。由于对现有策略的依赖受到分析准确性、结果时间和检测能力的限制，因此在几分钟内用指棒对患者进行分诊，而不是在侵入性拭子后几小时/天对患者进行分诊对于应对大流行至关重要。从大流行一开始就可以进行早期筛查和分类，通过护理点宿主免疫反应测试，这将缩短对临床和公共卫生行动的反应时间。
Delayed testing deployment has led to uncertainty surrounding overall disease burden and community spread, severely hampering public health containment and healthcare system preparation efforts. A multi-tiered testing strategy incorporating rapid, host immune point-of-care tests can be used now and for future pandemic planning by effectively identifying patients at risk of disease thereby facilitating quarantine earlier in the progression of the outbreak during the weeks and months it can take for pathogen specific confirmatory tests to be developed, validated and manufactured in sufficient quantities. The ability to triage patients at the point of care and support the guidance of medical and therapeutic decisions, for viral isolation or confirmatory testing or for appropriate treatment of COVID-19 and/or bacterial infections, is a critical component to our national pandemic response and there is an urgent need to implement the proposed strategy to combat the current outbreak. Coronavirus disease 2019 (COVID-19), caused by novel enveloped single stranded RNA coronavirus (SARS-CoV-2), is responsible for an ongoing global pandemic. While other countries deployed widespread testing as an early mitigation strategy, the U.S. experienced delays in development and deployment of organism identification assays. As such, there is uncertainty surrounding disease burden and community spread, severely hampering containment efforts. COVID-19 illuminates the need for a tiered diagnostic approach to rapidly identify clinically significant infections and reduce disease spread. Without the ability to efficiently screen patients, hospitals are overwhelmed, potentially delaying treatment for other emergencies. A multi-tiered, diagnostic strategy incorporating a rapid host immune response assay as a screening test, molecular confirmatory testing and rapid IgM/IgG testing to assess benefit from quarantine/further testing and provide information on population exposure/herd immunity would efficiently evaluate potential COVID-19 patients. Triaging patients within minutes with a fingerstick rather than hours/days after an invasive swab is critical to pandemic response as reliance on the existing strategy is limited by assay accuracy, time to results, and testing capacity. Early screening and triage is achievable from the outset of a pandemic with point-of-care host immune response testing which will improve response time to clinical and public health actions.
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DOI：
10.1016/s0140-6736(03)13967-0
发表时间：
2003-07-26
期刊：
Lancet (London, England)
影响因子：
--
作者：
Kuiken T;Fouchier RA;Schutten M;Rimmelzwaan GF;van Amerongen G;van Riel D;Laman JD;de Jong T;van Doornum G;Lim W;Ling AE;Chan PK;Tam JS;Zambon MC;Gopal R;Drosten C;van der Werf S;Escriou N;Manuguerra JC;Stöhr K;Peiris JS;Osterhaus AD
通讯作者：
Osterhaus AD
影响因子：
168.9
作者：
Huang, Chaolin;Wang, Yeming;Cao, Bin
通讯作者：
Cao, Bin
影响因子：
6.1
作者：
Liu Wei;Tao Zhao-Wu;Hu Yi
通讯作者：
Hu Yi
影响因子：
39.2
作者：
Harris, Aaron M.;Hicks, Lauri A.;Qaseem, Amir
通讯作者：
Qaseem, Amir
影响因子：
3.6
作者：
Halminen, M;Ilonen, J;Makela, MJ
通讯作者：
Makela, MJ