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Updated: Dec 21, 2025
Author Spotlight: Advancing Pathogen Diagnostics with Standardized LAMP
Published on: September 8, 2023
Current laboratory diagnostics of coronavirus disease 2019 (COVID-19)
Giuseppe Lippi1, Camilla Mattiuzzi2, Chiara Bovo3
1Section of Clinical Biochemistry, University of Verona, Verona, Italy. giuseppe.lippi@univr.it.
Insights
Laboratory diagnostics are crucial for managing COVID-19. Viral RNA detection remains key, while antibody tests show promise for surveillance, though accuracy needs further study.
Area of Science:
- Clinical diagnostics
- Infectious disease pathology
- Virology
Background:
- Laboratory medicine is essential for diagnosing and managing human diseases.
- The COVID-19 pandemic caused by SARS-CoV-2 highlights the importance of diagnostic tools.
- Long-term coexistence with SARS-CoV-2 necessitates ongoing vigilance and rapid response capabilities.
Purpose of the Study:
- To review the current and potential diagnostic approaches for COVID-19.
- To assess the role of molecular and serological testing in managing the pandemic.
- To evaluate the utility of rapid antigen and antibody tests for epidemiological surveillance.
Main Methods:
- Review of current diagnostic paradigms for COVID-19.
- Analysis of molecular techniques for detecting SARS-CoV-2 RNA.
- Evaluation of serological markers, including IgG and IgA antibodies, and rapid immunoassay performance.
Main Results:
- Molecular detection of viral RNA in respiratory specimens is the primary etiological diagnostic method.
- Serological studies indicate a sustained immune response with IgG and IgA antibodies appearing 1-2 weeks post-symptom onset.
- Rapid tests for antigens and antibodies offer potential for surveillance, but require further validation for accuracy and reliability.
Conclusions:
- Diagnostic strategies for COVID-19 rely heavily on molecular RNA detection.
- Serological testing reveals immune responses, but the neutralizing capacity and persistence of antibodies require further investigation.
- Rapid diagnostic tests are promising for epidemiological surveillance but need enhanced accuracy and reliability assessments.
Abstract:
Laboratory medicine provides an almost irreplaceable contribution to the diagnostic reasoning and managed care of most human pathologies. The novel coronavirus disease 2019 (COVID-19) is not an exception to this paradigm. Although the relatively recent emergence does not allow to draw definitive conclusions on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostics, some standpoints can be conveyed. First and foremost, it seems now clear that we will be living together with this virus for quite a long time, so that our vigilance and responsiveness against the emergence of new local outbreaks shall be maintained at the highest possible levels. The etiological diagnosis of COVID-19 is, and will remain for the foreseeable future, deeply based on direct identification of viral RNA by means of molecular biology techniques in biological materials, especially upper and lower respiratory tract specimens. Whether other materials, such as blood, urine, stools, saliva and throat washing, will become valid alternatives has not been unequivocally defined so far. As concerns serological testing, promising information can be garnered from preliminary investigations, showing that the vast majority of COVID-19 patients seem to develop a sustained immune response against the virus, characterized especially by emergence of anti-SARS-CoV-2 IgG and IgA, 1 to 2 weeks after the onset of fever and/or respiratory symptoms. Whether these antibodies will have persistent neutralizing activity against the virus is still to be elucidated on individual and general basis. The availability of rapid tests for detecting either viral antigens or anti-SARS-CoV-2 antibodies are a potentially viable opportunity for purposes of epidemiologic surveillance, though more information is needed on accuracy and reliability of these portable immunoassays.
