Long-Term Health Effects of COVID-19 Disability and Function Following SARS-CoV-2 Infection (2024) / Chapter Skim
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2 Diagnosis of SARS-CoV-2 Infection
Pages 39-54

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From page 39...
... Given the absence of a consensus-based definition and the ongoing evidence-based research on best practices for diagnosing Long COVID, this chapter focuses primarily on the early and current diagnostic measures of acute COVID-19. VIRAL TESTING Over the course of the pandemic, diagnostic tests specific to SARS-CoV-2 were developed and became more readily available, although disparities in 39
From page 40...
... Tests Nucleic acid amplification tests (NAATs) , sometimes called molecular tests, detect nucleic acids (genetic material)
From page 41...
... , antigen testing is particularly helpful for individuals with a recent history of COVID infection who need to test following a new exposure to document active infection (CDC, 2022b; Hayden et al., 2023)
From page 42...
... Individuals with previous infection may also mount a positive serum IgM or IgG spike protein response. Antibodies to the nucleocapsid protein are generated only by infection, so a specific antibody test (IgG or IgM)
From page 43...
... Viral diagnostic tests were limited at the onset of the pandemic until clinical laboratories began to offer viral testing for SARS-CoV-2 in March 2020 (Greninger and Jerome, 2020) , and clinicians therefore had to rely on the presenting symptoms to make a diagnosis of COVID-19.
From page 44...
... Supporting Diagnostic Testing Although the tests described in this section are not specific to COVID-19, the consistent prevalence of certain abnormalities seen in hospitalized COVID-19 patients fostered their use in diagnosing the disease early in the pandemic. Imaging studies, pulmonary function tests, and laboratory tests are among the ancillary tests used in the diagnosis of COVID-19 (Silva et al., 2021)
From page 45...
... Pulmonary Function Tests Abnormal results on pulmonary function tests, called "lung diffusion capacity of carbon monoxide" or DLCO, may also be seen as a result of destruction of the alveolar air sacs or thickening of the alveolar–capillary basement membrane, which then leads to impaired gas exchange. This phenomenon has been well described in cases of COVID-19 pneumonia (Cortes-Telles et al., 2021; Lee et al., 2022; Steinbeis et al., 2022; TorresCastro et al., 2021)
From page 46...
... (CDC, 2023b, 2020 Interim Case Definition, Approved April 5, 2020) Case definitions have incorporated other clinical data, laboratory/ microbiological data, and/or epidemiological linkages or exposure history -- for example, travel to areas with sustained transmission, occupation as a health care worker, or a contact with a positive test.
From page 47...
... . Although neither widely used nor generally recognized presently, specific DNA methylation patterns have been shown to aid in the diagnosis of SARSCoV-2 infection, to predict disease severity, and to establish a history of prior infection (Konigsberg et al., 2021; Pang et al., 2022)
From page 48...
... The introduction of at-home testing means that many people may not have reported their positive results to health care systems. As viral infections fluctuate, as insurance coverage for at-home tests changes, and as society returns to prepandemic activities, some individuals may not even be testing for SARSCoV-2 with at-home tests when ill.
From page 49...
... 2023d. Nucleic acid amplification tests (NAATs)
From page 50...
... 2023. Infectious Diseases Society of America guidelines on the diagnosis of COVID-19: Molecular diagnostic testing.
From page 51...
... 2021. Occurrence and timing of subsequent severe acute respiratory syndrome coronavirus 2 reverse-transcription poly merase chain reaction positivity among initially negative patients.
From page 52...
... 2021. Duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
From page 53...
... The Lancet Infectious Diseases 21(9)


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