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Updates on laboratory investigations in coronavirus disease 2019 (COVID-19)
Giuseppe Lippi1, Brandon M Henry2, Fabian Sanchis-Gomar3
1Section of Clinical Biochemistry, University of Verona, Verona, Italy. giuseppe.lippi@univr.it.
Insights
Laboratory medicine is crucial for diagnosing COVID-19, assessing immune response, and predicting disease severity. It guides treatment and offers updates on viral RNA detection and serological testing strategies.
Area of Science:
- Medical diagnostics
- Infectious diseases
- Clinical pathology
Background:
- COVID-19 pandemic continues to spread globally, causing significant mortality.
- Unlike previous coronaviruses, COVID-19 leads to severe respiratory and multi-organ failure.
- Laboratory medicine plays a vital role in managing the pandemic.
Purpose of the Study:
- To provide recent updates on laboratory investigations for COVID-19.
- To highlight the value of molecular and serological testing.
- To discuss strategies for improving testing throughput and quality.
Main Methods:
- Review of molecular testing for SARS-CoV-2 RNA detection.
- Analysis of serological testing for immune response assessment.
- Evaluation of conventional laboratory tests for disease progression prediction.
- Discussion of strategies for enhancing testing efficiency and reliability.
Main Results:
- Molecular testing is key for diagnosing SARS-CoV-2 infection.
- Serological testing establishes immune response presence and extent.
- Conventional lab tests aid in predicting unfavorable disease progression.
- Optimized testing strategies can enhance diagnostic throughput and quality.
Conclusions:
- Laboratory medicine is indispensable for COVID-19 diagnosis, prognosis, and therapeutic guidance.
- Continuous updates and strategic improvements in testing are essential for pandemic management.
- Further research into rapid testing and monitoring is warranted.
Abstract:
The coronavirus disease 2019 (COVID-19) pandemic is still spreading worldwide, affecting several million people. Unlike the previous two coronavirus outbreaks, COVID-19 has caused several thousand deaths for respiratory and multiple organ failure. As specifically concerns this latest infectious pathology, laboratory medicine can provide a substantial contribution to diagnosing an acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection through molecular testing, establishing the presence and extent of an immune response against the virus, mostly through serological testing. However, it can also help to predict the risk of unfavorable disease progression by measuring some conventional laboratory tests and, last but not least, can provide reliable therapeutic guidance. This article is hence aimed at offering recent updates on the important role and value of laboratory investigations in COVID-19, also providing information on some hot topics such as virus RNA detection in different biological samples, causes of recurrent positivity of reverse-transcription polymerase chain reaction (RT-PCR), potential strategies for enhancing the throughput of molecular testing (i.e., pre-test probability assessment, sample pooling, use of rapid tests), as well as pragmatic indications for enhancing the quality and value of serological testing and laboratory-based monitoring.
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