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关于 COVID-19 诊断工具新发现的局限性及其后果的指南。

Guidelines on newly identified limitations of diagnostic tools for COVID-19 and consequences.

机构信息

Department of Biological Sciences, BITS-Pilani, Telangana, India.

出版信息

J Med Virol. 2021 Apr;93(4):1837-1842. doi: 10.1002/jmv.26673. Epub 2020 Dec 17.

Abstract

Coronavirus disease 2019 (COVID-19) caused by coronavirus has spread worldwide and has become the deadliest pandemic of the 21st century. Such rapid spread is predominantly attributed to the poor diagnosis and its asymptomatic transmission. In the absence of treatment regime, timely diagnosis is the best available remedy that can restrict its spread. An early diagnosis of COVID-19 is critical for determining the line of treatment and preventing long term complications in the infected subject. Unfortunately, available rapid antigen and antibody kits are known to be erroneous whereas reverse transcription polymerase chain reaction based tests are expensive, viral load dependent and at times inconclusive. In current scenario, the false-negative results imposed a major risk to the individual patient care and also to the efforts for containing the spread at the population level, where as false positives are traumatic for families and can lead to improper treatment resulting in severe complications. In this article, the limitations of available diagnostic procedures have been elaborated and plausible combination approach has been advised.

摘要

由冠状病毒引起的 2019 年冠状病毒病(COVID-19)已在全球范围内传播,成为 21 世纪最致命的大流行。这种快速传播主要归因于诊断不佳和无症状传播。在没有治疗方案的情况下,及时诊断是最好的治疗方法,可以限制其传播。COVID-19 的早期诊断对于确定治疗方案和预防感染患者的长期并发症至关重要。不幸的是,已知现有的快速抗原和抗体试剂盒存在错误,而基于逆转录聚合酶链反应的检测方法则昂贵、依赖病毒载量,有时还不确定。在当前情况下,假阴性结果对个体患者护理构成了重大风险,也对在人群层面上控制传播的努力构成了重大风险,而假阳性结果对家庭来说是创伤性的,并可能导致不当治疗,从而导致严重并发症。本文详细阐述了现有诊断程序的局限性,并提出了合理的组合方法。

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