Negar Deldadeh,1Flora Forouzesh,2Mohammad Amin Javidi,3,*
1. Department of Genetics, Faculty of Advanced Science, and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran 2. Department of Genetics, Faculty of Advanced Science, and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran 3. Department of Integrative Oncology, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
Introduction: The efficient methods for Corona Virus Disease 2019 (COVID-19) diagnosis can be considered a key tool to manage this disease. The gold standard in this area is real-time quantitative reverse transcription-polymerase chain reaction (qRT-PCR), a sensitive and specific method to detect SARS-CoV-2. Other methods for the diagnosis of this virus include other RNA-based techniques, CRISPR, serological testing of antibodies, ELISA, imaging technologies, and artificial intelligence. The main aim of this article is to review different diagnostic approaches and discuss their advantages and disadvantages.
Methods: Articles from the authenticated database such as Google scholar, PubMed, Science Direct, Scopus, and Web of Science were collected and refined according to the subject.
Results: Methods that are used for COVID-19 diagnosis can be divided into 4 distinct categories according to their detecting targets:
The RNA-based methods: The technologies used for the detection of nucleic acid in COVID-19 include RNA sequencing (RNA-seq), real-time quantitative reverse transcription-polymerase chain reaction (qRT-PCR), droplet digital reverse transcription-polymerase chain reaction (ddRT-PCR), reverse transcription loop-mediated isothermal amplification (RT-LAMP), and clustered regularly interspaced short palindromic repeats (CRISPR). Their advantages include high sensitivity, specificity, and accuracy; their disadvantages are long testing times, and high equipment/personnel requirements.
The immunologic-based methods: The immunologic methods for diagnosis of COVID-19 include the detection of antigens and antibodies and can detect recovered patients with COVID-19. Four kinds of methods including rapid antigen detection, antibody detection, nanoparticle-based lateral-flow assay, and enzyme-linked immunosorbent assay (ELISA) are widely used in the diagnosis of COVID-19. Their advantages include high sensitivity, specificity, and can detect recovered people; their disadvantages are slow detection speed, and cumbersome steps.
The imaging methods: Different types of diagnosing COVID-19 imaging technologies include chest computed tomography (CT), chest radiography and lung ultrasound are utilized to different degrees. Patients suffering from fever and cough, chest discomfort, and difficulty in breathing are usually diagnosed by imaging examinations. Their advantages include low risk of infection, and low equipment requirements; their disadvantages are the need for professional analysis, and difficulty to detect mild symptoms.
The assistive technology methods: The primary purpose of assistive technology is to maintain or improve an individual's functioning and independence. Different types of diagnosing COVID-19 assistive technologies include blood testing, pooling test, artificial intelligence, and omics analysis. Their advantages include expense reduction, low equipment requirements, reduce the need for professionals, and can study disease mechanisms; their disadvantages are low sensitivity and specificity and need to be utilized in combination with other detection methods.
Conclusion: The gold standard for diagnosing COVID-19 is the real-time quantitative reverse transcription-polymerase chain reaction (qRT-PCR), which is a sensitive and specific method to detect SARS-CoV-2. Other methods for the diagnosis of this virus include other RNA-based methods, CRISPR, serological testing of antibodies, ELISA, imaging technologies, and artificial intelligence. Concerning the type of samples and stages of the disease, a combination of information on patient demographics and histories, clinical symptoms, outcomes of molecular and serological diagnostic tests, and imaging information is highly recommended to achieve an adequate diagnosis of patients with COVID-19.