Application of nucleic acid amplification tests in managing COVID-19 pandemic

Abstract

Background. COVID-19 pandemic highlighted the importance of sensitive and specific tests that would be cost-efficient, fast and scalable. There are more than 200 COVID-19 detection tests available worldwide, with every country developing its own assays. Sample collection, preparing for a test, the test itself and interpretation of results have a strong impact on the clinical value of testing. The diversity of tests and workflows requires the analysis of their performance in clinics. Methods. Literature review, analysis of clinical reports, online resources, public and commercial reports were used to collect information about tests. The collected information was processed to obtain information relevant to this review. Results. COVID-19 tests based on the amplification of nucleic acids are reviewed. Tests employ polymerase chain reaction (PCR) or loop-mediated isothermal amplification (LAMP). The clinical value of these tests depends on the technologies used, as they differ for LAMP, real-time and standard PCR methods. The diversity of sample preparation protocols, different designs of the tests, used chemicals and protocols have a significant impact on tests. Tailoring a testing workflow to available infrastructure and selecting the most efficient combination of tests and protocols for each step in a testing workflow is crucial for the success. Conclusion. Strengths and weaknesses of different test systems and protocols that were reviewed herein can be helpful in selecting a testing workflow to achieve maximum clinical utility.