The Coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), seems to have spared no single community. Rapid and accurate identification of COVID-19 patients are the mainstay for breaking the chain of community infection and controlling the pandemic. There are now a bewildering array of diagnostic tests available to detect COVID-19 at various stages of infection. In this, the fourth article in the COVID-19 Commentary series, we describe the basics of current clinical diagnostics, including molecular and serological testing approaches, and summarize their advantages and limitations.
Article
The current pandemic of COVID-19 is an infectious disease caused by SARS-CoV-2 which originated in Wuhan, China in late 2019. It is now known that the median incubation period of COVID-19 is approximately 5 days (range: 2 to 14 days), and a large proportion of those infected become symptomatic within two weeks or so (range: 8 to 16 days).1 The recovery period for mild infection is 2 weeks, although in severe cases this may last up to 6 weeks. In the most severe infections, the time from symptom onset to death may range between 2 to 8 weeks, depending on various co-factors, such as the extant co-morbidities.
In the early pre-symptomatic phase, the index case unknowingly transmits the infection to others prior to symptom development and, on the contrary, a small proportion of infected individuals never develop symptoms (so called ‘asymptomatics’) and may act as ‘silent spreaders’ of the infection in the community. These two elements of the disease development have made the spread of COVID-19 virtually uncontrollable, leading to the current pandemic.
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