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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 PREPUBLICATION COPY -- Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Ch02.indd 39 5/21/24 10:49 AM
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 help ful 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...
... tests, or serology, are an indirect method of demonstrating recent exposure to SARS-CoV-2. Early in the pandemic, prior to the availability of at-home antigen tests and the facility of molecu lar testing, antibody tests were used to help diagnose SARS-CoV-2 infection.
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; Torres Castro et al., 2021)
From page 46...
... OR at least one of the following symptoms: cough, shortness of breath, or difficulty breathing OR Severe respiratory illness with at least one of the following: • Clinical or radiographic evidence of pneumonia, OR • Acute respiratory distress syndrome (ARDS)
From page 47...
... Host DNA methylation patterns have been studied to differentiate between COVID-19–infected and –uninfected persons, and these patterns may help predict disease progression and outcomes even before the onset of symptoms (Konigsberg et al., 2021)
From page 48...
... The intro duction 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 change, and as society returns to prepandemic activities, some individuals may not even be testing for SARS CoV-2 with at-home tests when ill.
From page 49...
... 2023a. Considerations for SARS-CoV-2 antigen testing for healthcare providers testing individuals in the community.
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...
... 2022. Severity of respiratory failure and computed chest tomography in acute COVID-19 correlates with pulmonary function and respiratory symptoms after infection with SARS-CoV-2: An obser vational longitudinal study over 12 months.
From page 53...
... The Lancet Infectious Diseases 21(9)
From page 54...
... PREPUBLICATION COPY -- Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Ch02.indd 54 5/21/24 10:49 AM


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