Infectious Disease

IDSA Updates Tips for COVID-19 Molecular Testing

January 06, 2021

2 min read

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Caliendo and Hanson do not report any relevant financial information.

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The Infectious Disease Society of America has updated its guidelines for molecular diagnostic COVID-19 testing.

In a press conference Angela M. Caliendo, MD, PhD, FIDSA, and Kimberly E. Hanson, MD, MHS, Both the members of the IDSA Board of Directors and the Chairs of the IDSA Panel of Experts on COVID-19 Diagnostic Guidelines discussed revisions to recommendations regarding specimen types, types of molecular tests, and screening for asymptomatic individuals.

Regarding specimen collection, IDSA now recommends “a nasopharyngeal swab, mid-turbinate swab, anterior nasal swab, saliva, or a combined anterior nasal / oropharyngeal swab instead of an oropharyngeal swab alone for SARS-CoV-2 RNA testing in suspected symptomatic individuals Collect COVID -19. “Hanson said labs should make sure they can test saliva for the virus because it requires special equipment.

The panel now also recommends “using either rapid RT-PCR or standard laboratory PCR [nucleic acid amplification tests (NAATs)] via rapid isothermal NAAT in symptomatic individuals suspected of having COVID-19. “Caliendo said it was important that a backup test be provided if a person tests negative on a rapid isothermal test. However, the test administrator makes a strong suspicion that the person has COVID-19 or has a range of symptoms for the virus.

In two additional updates, the panel recommends “RNA testing (vs. no testing) in asymptomatic individuals prior to hematopoietic stem cells or solid organ transplant regardless of known exposure to COVID-19” and “against RNA testing in asymptomatic individuals without a known Exposure to COVID-19 who are undergoing a time-sensitive aerosol generating procedure (e.g., bronchoscopy) if [personal protective equipment] is available. “Hanson said that screening for the virus in cancer patients or those with autoimmune diseases is at the provider’s discretion.

Caliendo said there is a lack of information on recently approved COVID-19 home tests, and that cost could be an obstacle later. However, she also said the tests can potentially be useful if used properly.

“It will be very interesting to see how easy it is for people to do it at home and how well the whole process works,” said Caliendo. “They are out there but I don’t know how available the tests are at this point as both tests recently received theirs [emergency use authorization]. It’s something to look out for. “

Hanson discussed the potential impact of COVID-19 variants on testing.

“We learned that there are many different variants, some of which have mutations in the spike region that differ from the original classical sequences used to design the tests,” she said. “We did not find the UK variant in our collection and we do not believe that these polymorphisms or small mutations in the spike regions affect the accuracy of the molecular tests.”

Hanson emphasized the importance of test diversification.

“Diversifying not only in the types of samples you will accept in your laboratory, but also the variety in offering different tests for different situations has helped us in our supply chain,” said Hanson. “We are not completely dependent on just one supply chain. Opening up additional options for sample and test types can help laboratories if they are able to validate several different iterations and combinations of different approaches. “

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