Diagnostics for SARS-CoV-2 detection: A comprehensive review of the FDA-EUA COVID-19 testing landscape

• Published in: Biosensors & bioelectronics Vol. 165; p. 112454
• Main Authors: Ravi, Neeraja, Cortade, Dana L., Ng, Elaine, Wang, Shan X.
• Format: Journal Article
• Language: English
• Published: England Elsevier B.V 01-10-2020
• Subjects: Betacoronavirus - isolation & purification; Biosensing Techniques - instrumentation; Biosensing Techniques - methods; Coronavirus Infections - blood; Coronavirus Infections - diagnosis; COVID-19; Diagnostic testing; FDA-EUA; Humans; Immunoassay; Immunoassay - instrumentation; Immunoassay - methods; Immunoglobulin G - analysis; Immunoglobulin G - blood; Immunoglobulin M - analysis; Immunoglobulin M - blood; Pandemics; Pneumonia, Viral - blood; Pneumonia, Viral - diagnosis; Point-of-care; Point-of-Care Testing; Reverse Transcriptase Polymerase Chain Reaction - instrumentation; Reverse Transcriptase Polymerase Chain Reaction - methods; RNA, Viral - analysis; RT-PCR; SARS-CoV-2; Specimen Handling - instrumentation; Specimen Handling - methods; United States; United States Food and Drug Administration; United States; COVID-19; FDA-EUA; Diagnostic testing; Immunoassay; SARS-CoV-2; RT-PCR; Point-of-care
• ISSN: 0956-5663; 1873-4235
• DOI: 10.1016/j.bios.2020.112454

The rapidly spreading outbreak of COVID-19 disease is caused by the SARS-CoV-2 virus, first reported in December 2019 in Wuhan, China. As of June 17, 2020, this virus has infected over 8.2 million people but ranges in symptom severity, making it difficult to assess its overall infection rate. There is a need for rapid and accurate diagnostics to better monitor and prevent the spread of COVID-19. In this review, we present and evaluate two main types of diagnostics with FDA-EUA status for COVID-19: nucleic acid testing for detection of SARS-CoV-2 RNA, and serological assays for detection of SARS-CoV-2 specific IgG and IgM patient antibodies, along with the necessary sample preparation for accurate diagnoses. In particular, we cover and compare tests such as the CDC 2019-nCoV RT-PCR Diagnostic Panel, Cellex's qSARS-CoV-2 IgG/IgM Rapid Test, and point-of-care tests such as Abbott's ID NOW COVID-19 Test. Antibody testing is especially important in understanding the prevalence of the virus in the community and to identify those who have gained immunity. We conclude by highlighting the future of COVID-19 diagnostics, which include the need for quantitative testing and the development of emerging biosensors as point-of-care tests.
•Current standard-of-care for COVID-19 diagnosis is RT-PCR, used to detect SARS-CoV-2 viral RNA.•Serological assays for detection of SARS-CoV-2 specific IgG and IgM antibodies are useful to assess virus prevalence.•Point-of-care tests for COVID-19 diagnoses can expedite results and alleviate the burden placed on healthcare providers.•Future testing strategies include developing quantitative COVID-19 diagnostic tools.