Challenges and Controversies to Testing for COVID-19.
Challenges and Controversies to Testing for COVID-19.
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DOI：
10.1128/jcm.01695-20
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发表时间：
2020-10-21
影响因子：
9.4
通讯作者：
Binnicker MJ
中科院分区：
文献类型：
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作者：
Binnicker MJ
冠状病毒病（COVID-19）大流行使SARS-CoV-2的临床实验室和检测成为全球讨论如何结束疫情的前沿和中心。临床实验室通过开发、验证和实施各种分子和血清学检测来应对SARS-CoV-2感染。这在确定病例、通知隔离决定和帮助遏制疾病传播方面发挥了至关重要的作用。然而，随着对COVID-19检测的需求增加，实验室专业人员面临着越来越多的挑战、不确定性，以及在某些情况下的争议，因为他们试图平衡增加检测能力与维持高质量实验室操作的需求。冠状病毒病（COVID-19）大流行使SARS-CoV-2的临床实验室和检测成为全球讨论如何结束疫情的前沿和中心。临床实验室通过开发、验证和实施各种分子和血清学检测来应对SARS-CoV-2感染。这在确定病例、通知隔离决定和帮助遏制疾病传播方面发挥了至关重要的作用。然而，随着对COVID-19检测的需求增加，实验室专业人员面临着越来越多的挑战、不确定性，以及在某些情况下的争议，因为他们试图平衡增加检测能力与维持高质量实验室操作的需求。这种新病毒病原体的出现提出了独特的诊断问题，这些问题并不总是有直接的答案。在这篇评论中，作者讨论了当前争论的几个领域，包括（i）分子检测在定义隔离/检疫持续时间中的作用，（ii）PCR循环阈值是否应包括在患者报告中，（iii）研究人员的样本合并和检测是否代表了扩大筛查的可接受解决方案，以及（iv）对大部分人口进行检测是否可行，是否是结束这一流行病的可行战略。
The coronavirus disease (COVID-19) pandemic has placed the clinical laboratory and testing for SARS-CoV-2 front and center in the worldwide discussion of how to end the outbreak. Clinical laboratories have responded by developing, validating, and implementing a variety of molecular and serologic assays to test for SARS-CoV-2 infection. This has played an essential role in identifying cases, informing isolation decisions, and helping to curb the spread of disease. However, as the demand for COVID-19 testing has increased, laboratory professionals have faced a growing list of challenges, uncertainties, and, in some situations, controversy, as they have attempted to balance the need for increasing test capacity with maintaining a high-quality laboratory operation. The coronavirus disease (COVID-19) pandemic has placed the clinical laboratory and testing for SARS-CoV-2 front and center in the worldwide discussion of how to end the outbreak. Clinical laboratories have responded by developing, validating, and implementing a variety of molecular and serologic assays to test for SARS-CoV-2 infection. This has played an essential role in identifying cases, informing isolation decisions, and helping to curb the spread of disease. However, as the demand for COVID-19 testing has increased, laboratory professionals have faced a growing list of challenges, uncertainties, and, in some situations, controversy, as they have attempted to balance the need for increasing test capacity with maintaining a high-quality laboratory operation. The emergence of this new viral pathogen has raised unique diagnostic questions for which there have not always been straightforward answers. In this commentary, the author addresses several areas of current debate, including (i) the role of molecular assays in defining the duration of isolation/quarantine, (ii) whether the PCR cycle threshold value should be included on patient reports, (iii) if specimen pooling and testing by research staff represent acceptable solutions to expand screening, and (iv) whether testing a large percentage of the population is feasible and represents a viable strategy to end the pandemic.