Background
Sensitive molecular diagnostics and correct test interpretation are crucial for accurate COVID-19 diagnosis and thereby essential for good clinical practice. Furthermore, they are a key factor in outbreak phases where active case finding in combination with isolation and contact tracing are crucial for outbreak control.
Aim
As more countries are on the brink to enter new phases in the COVID-19 outbreak response, we reviewed current published knowledge on the kinetics of SARS-CoV-2 RNA molecular detection in a wide range of clinical samples to support the laboratory response and to inform Public Health control.
Methods
We performed an extensive search on studies published between 1 December 2019 and 15 May 2020, reporting on SARS-CoV-2 molecular detection and/or virus isolation in any laboratory specimens of COVID-19 cases.
Results
We compiled a dataset of 264 studies including 32515 COVID-19 cases, and additionally aggregated data points sampling (n=2777) from 217 adults with known infection timeline. We summarised data on SARS-CoV-2 detection in the respiratory and gastrointestinal tract, blood, oral fluid, tears, cerebrospinal fluid, peritoneal fluid, semen, vaginal fluid; where provided, we also summarised specific observations on SARS-CoV-2 detection in pregnancy, infancy, children, adolescents and immunocompromised individuals.
Conclusion
Optimal SARS-CoV-2 molecular testing relies on choosing the most appropriate sample type, collected with adequate sampling technique, and with the infection timeline in mind. We outlined knowledge gaps and directions for future well-documented systematic studies.
Keywords
SARS-CoV-2, COVID-19, Laboratory Diagnosis, Polymerase Chain Reaction