Navigating the Pandemic Response Life Cycle: Molecular Diagnostics and Immunoassays in the Context of COVID-19 Management
Navigating the Pandemic Response Life Cycle: Molecular Diagnostics and Immunoassays in the Context of COVID-19 Management
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DOI：
10.1109/rbme.2020.2991444
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发表时间：
2021-01-01
影响因子：
17.6
通讯作者：
Zhang, Jingwei
中科院分区：
文献类型：
--
作者：
Gharizadeh, Baback;Yue, Junqiu;Zhang, Jingwei
2019年冠状病毒病(新冠肺炎)是由严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)引起的传染病。为了应对新冠肺炎的传播，提供快速和彻底的分子诊断和血清学检测的基础设施是疫情和大流行管理的基石。我们在此回顾在新冠肺炎管理生命周期中使用分子测试和免疫分析的临床见解：预防阶段、准备阶段、反应阶段和恢复阶段。总结了人类感染过程中病毒RNA、抗原和抗体的时空分布，为准确检测该病提供了生物学基础。我们分享了在现实世界大容量筛选节目中学到的教训和遇到的障碍。讨论了临床需求，以确定这些测试中存在的技术差距。利用工程聚合酶、等温扩增和复杂基质直接扩增等技术可能会提高当前基础设施的生产率，而CRISPR诊断、视觉终点检测和核酸检测的无聚合酶链式反应方法等新兴技术可能会导致家庭测试。新冠肺炎大流行带来的经验教训和创新可以升级我们的全球公共卫生基础设施，以更好地抗击未来可能爆发的疫情。
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To counter COVID-19 spreading, an infrastructure to provide rapid and thorough molecular diagnostics and serology testing is the cornerstone of outbreak and pandemic management. We hereby review the clinical insights with regard to using molecular tests and immunoassays in the context of COVID-19 management life cycle: the preventive phase, the preparedness phase, the response phase and the recovery phase. The spatial and temporal distribution of viral RNA, antigens and antibodies during human infection is summarized to provide a biological foundation for accurate detection of the disease. We shared the lessons learned and the obstacles encountered during real world high-volume screening programs. Clinical needs are discussed to identify existing technology gaps in these tests. Leverage technologies, such as engineered polymerases, isothermal amplification, and direct amplification from complex matrices may improve the productivity of current infrastructure, while emerging technologies like CRISPR diagnostics, visual end point detection, and PCR free methods for nucleic acid sensing may lead to at-home tests. The lessons learned, and innovations spurred from the COVID-19 pandemic could upgrade our global public health infrastructure to better combat potential outbreaks in the future.