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用于检测严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的分子诊断方法及其病理生理后果。

Molecular diagnostic approaches for SARS-CoV-2 detection and pathophysiological consequences.

作者信息

Salazar-Ardiles Camila, Asserella-Rebollo Leyla, Cornejo Carlos, Arias Dayana, Vasquez-Muñoz Manuel, Toledo Camilo, Andrade David C

机构信息

Exercise Applied Physiology Laboratory, Centro de Investigación en Fisiología y Medicina de Altura (FIMEDALT), Biomedical Department, Faculty of Health Sciences, Universidad de Antofagasta, Av. Universidad de Antofagasta #02800, Antofagasta, Chile.

Medical Technology School, Faculty of Health, University Santo Tomás, Iquique, Chile.

出版信息

Mol Biol Rep. 2023 Dec;50(12):10367-10382. doi: 10.1007/s11033-023-08844-0. Epub 2023 Oct 10.

Abstract

SARS-CoV-2, a novel coronavirus within the Coronaviridae family, is the causative agent behind the respiratory ailment referred to as COVID-19. Operating on a global scale, COVID-19 has led to a substantial number of fatalities, exerting profound effects on both public health and the global economy. The most frequently reported symptoms encompass fever, cough, muscle or body aches, loss of taste or smell, headaches, and fatigue. Furthermore, a subset of individuals may manifest more severe symptoms, including those consistent with viral pneumonitis, which can be so profound as to result in fatalities. Consequently, this situation has spurred the rapid advancement of disease diagnostic technologies worldwide. Predominantly employed in diagnosing COVID-19, the real-time quantitative reverse transcription PCR has been the foremost diagnostic method, effectively detecting SARS-CoV-2 viral RNA. As the pandemic has evolved, antigen and serological tests have emerged as valuable diagnostic tools. Antigen tests pinpoint specific viral proteins of SARS-CoV-2, offering swift results, while serological tests identify the presence of antibodies in blood samples. Additionally, there have been notable strides in sample collection methods, notably with the introduction of saliva-based tests, presenting a non-invasive substitute to nasopharyngeal swabs. Given the ongoing mutations in SARS-CoV-2, there has been a continuous need for genomic surveillance, encompassing full genome sequencing and the identification of new variants through Illumina technology and, more recently, nanopore metagenomic sequencing (SMTN). Consequently, while diagnostic testing methods for COVID-19 have experienced remarkable progress, no test is flawless, and there exist limitations with each technique, including sensitivity, specificity, sample collection, and the minimum viral load necessary for accurate detection. These aspects are comprehensively addressed within this current review.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是冠状病毒科的一种新型冠状病毒,是被称为COVID-19的呼吸系统疾病的病原体。COVID-19在全球范围内传播,已导致大量死亡,对公共卫生和全球经济都产生了深远影响。最常报告的症状包括发热、咳嗽、肌肉或身体疼痛、味觉或嗅觉丧失、头痛和疲劳。此外,一部分人可能会出现更严重的症状,包括与病毒性肺炎一致的症状,严重时可能导致死亡。因此,这种情况促使全球疾病诊断技术迅速发展。实时定量逆转录聚合酶链反应主要用于诊断COVID-19,一直是首要的诊断方法,能有效检测SARS-CoV-2病毒RNA。随着疫情的发展,抗原和血清学检测已成为有价值的诊断工具。抗原检测可精确识别SARS-CoV-2的特定病毒蛋白,结果快速,而血清学检测则可确定血样中抗体的存在。此外,样本采集方法也有显著进展,特别是引入了基于唾液的检测,为鼻咽拭子提供了一种非侵入性替代方法。鉴于SARS-CoV-2不断发生变异,持续需要进行基因组监测,包括全基因组测序以及通过Illumina技术和最近的纳米孔宏基因组测序(SMTN)识别新变种。因此,虽然COVID-19的诊断检测方法取得了显著进展,但没有一种检测是完美无缺的,每种技术都存在局限性,包括敏感性、特异性、样本采集以及准确检测所需的最低病毒载量。本综述全面探讨了这些方面。

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