Current Status and Future Developments of Laboratory Diagnosis for SARS-CoV-2 infection

新型冠狀病毒感染的實驗室檢驗：目前的狀況與未來的發展

自2019年開始造成世界大流行的冠狀病毒疾病，是由新型冠狀病毒引起的。針對此病毒正確且即時的實驗室檢測，有助於控制病毒的散播，特別是在早期階段。目前，於鼻咽拭子中，常用定量逆轉錄-聚合酶連鎖反應，偵測病毒核醣核酸，來檢測新型冠狀病毒。也有定量逆轉錄-聚合酶連鎖的自動化設備處理檢體，以應付大量的檢體需求。在無法用定量逆轉錄－－聚合酶連鎖檢測時，簡易、不貴的定點照護檢驗方法，常檢測病毒的抗原。如果需要，可以用細胞培養病毒或定序病毒的基因體，以鑑定病毒變異株。檢測人群中，是否有此病毒感染引起的抗體，可做為流行病的研究。如果需要，中和試驗可用於分析抗體是否可以阻止病毒入侵細胞。除了定量逆轉錄-聚合酶連鎖反應，還有很多分子檢測的方法，可用於檢測新型冠狀病毒。幾種比鼻咽拭子更方便取得的檢體，正在研究中。自新型冠狀病毒爆發以來，出現很多的變異株。對付這些變異株，創新的檢測方法是必須的。此綜論對於新型冠狀病毒感染的實驗室檢驗，做整理性的回顧，包括目前的狀況與未來的發展。

The ongoing COVID-19 pandemic was caused by SARS-CoV-2 infection. Accurate and timely laboratory tests for SARS-CoV-2 infection, especially in early stages, will help to control the spread of the virus. At present, real-time RT-PCR (or RT-qPCR) detecting viral RNA genomes is widely used to diagnose SARS-CoV-2 infection from nasopharyngeal swabs. Automated devices for sample processing are available for the large-scale samples for RT-qPCR. Point of care testing detecting viral antigen(s) is used as a simple and inexpensive screening tool for SARS-CoV-2 in settings where RT-qPCR is not available. If necessary, SARS-CoV-2 will be isolated in cultured cells and/or viral genomes will be sequenced to identify the viral variants. Tests for detecting antibodies induced by SARS-CoV-2 infection are performed to identify infected individuals in the population for the epidemiological studies. If needed, neutralization test was conducted to analyze the ability of the antibodies counteracting the virus. More molecular diagnostic tests other than RT-qPCR are also available. Several types of easy-to-obtain specimens other than nasopharyngeal swabs are under investigation. Numerous SARS-CoV-2 variants have emerged since the SARS-CoV-2 outbreak. To combat this mutable virus, innovative diagnostic methods are required. This mini-review article summarized the current status and future developments of laboratory diagnosis for SARS-CoV-2 infection.