ABSTRACT
Reverse transcription-polymerase chain reaction (RT-PCR) tests for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), are approved for qualitative use. The cycle threshold (Ct) value reflects the concentration of viral RNA in the sample, with lower Ct values indicating higher levels of RNA. Caregivers may wish to use the Ct value to determine the progression of infection, how severe the infection will be, and whether the patient can transmit the virus. Variability of Ct values and the data supporting these uses should be considered when deciding whether and how to use Ct values in clinical care.
Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/diagnosis , Humans , RNA, Viral/analysis , RNA, Viral/genetics , Reverse Transcriptase Polymerase Chain Reaction , Reverse Transcription , SARS-CoV-2/geneticsABSTRACT
Frequent, low-cost, universal testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with quarantine of those with a positive result has been suggested as a strategy to address the coronavirus disease 2019 (COVID-19) pandemic in the United States. Specifically, home or community use of tests that use paper strip detection devices, which may have reduced sensitivity for SARS-CoV-2, has been advocated. There are several potential challenges or problems with this strategy, including the limited availability of such tests, consequences of incorrect test results, difficulties with adherence to testing, and the questionable accuracy of such tests for detection of infectious people. Because of these, we think it is premature to strongly advocate for such a testing strategy, as the adverse consequences may outweigh any benefits. High-quality outcome data demonstrating the efficacy of this testing strategy are needed before widespread implementation.
Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques , Coronavirus Infections/prevention & control , Humans , Mass Screening , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Reagent Kits, Diagnostic/standards , Reagent Kits, Diagnostic/supply & distribution , SARS-CoV-2 , Sensitivity and Specificity , United States/epidemiologySubject(s)
Black or African American , Microbiology/standards , Periodicals as Topic/standards , Racism/prevention & control , Healthcare Disparities/statistics & numerical data , Healthcare Disparities/trends , Humans , Periodicals as Topic/trends , Racism/statistics & numerical data , Racism/trendsSubject(s)
Betacoronavirus/isolation & purification , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , COVID-19 , COVID-19 Testing , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Humans , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2Subject(s)
Clinical Laboratory Techniques/methods , Clinical Laboratory Techniques/trends , Communicable Disease Control/methods , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Point-of-Care Testing/trends , Public Health Administration/methods , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques/economics , Communicable Disease Control/economics , Communicable Disease Control/trends , Coronavirus Infections/economics , Coronavirus Infections/epidemiology , Health Policy , Humans , Pandemics , Pneumonia, Viral/epidemiology , Point-of-Care Testing/economics , Public Health Administration/economics , Public Health Administration/trendsABSTRACT
Understanding of coronavirus disease 2019 is rapidly evolving with new articles on the subject daily. This flood of articles can be overwhelming for busy practicing clinicians looking for key pieces of information that can be applied in daily practice. This review article synthesizes the reported imaging findings in pediatric Coronavirus disease 2019 (COVID-19) across the literature, offers imaging differential diagnostic considerations and useful radiographic features to help differentiate these entities from COVID-19, and provides recommendations for requesting imaging studies to evaluate suspected cases of pediatric COVID-19.