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SARS-CoV-2 감염의 진단에 이용되는 검사실 테스트의 비교

Comparison of Laboratory Tests Applied for Diagnosing the SARS-CoV-2 Infection

이창근|Dongsup Lee
대한임상검사과학회 (Korean Society for Clinical Laboratory Science)|2022.06|대한임상검사과학회지 (Korean Journal of Clinical Laboratory Science)|제54권 제2호|pp. 79-94|DOI 10.15324/kjcls.2022.54.2.79

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키워드

SARS-CoV-2Laboratory testsRT-qPCRMolecular diagnostics testsSerological assays
주제분류기타자연과학

초록

COVID-19로 인한 높은 전염성과 호흡기 질환의 심각성 때문에, 전염의 확산을 더 잘 모니터링하고 예방하기 위해 경제적이고 정확한 검사가 필요하다. COVID-19 대유행의 초기 단계에서 SARS-CoV-2의 구조적 및 분자적 특성이 밝혀짐에 따라, 많은 COVID-19 진단 키트 제조업체들은 진단 테스트의 설계, 개발, 검증 및 구현에 적극적으로 투자했다. 현재, SARS-CoV-2 에 대한 진단검사로써 신속한 항원, 특정 IgG 및 IgM 항체검사를 위한 면역 혈청학적 검사 그리고 분자 진단 검사가 가장 널리 사용되고 검증된 기술이다. 분자 진단 분석법은 SARS-CoV-2 에 감염된 것으로 의심되는 개인에서 바이러스 RNA를 직접 검출하기 위한 gold standard이다. 항체 기반 혈청 검사는 지역사회에서 COVID-19 유병률을 결정하고 면역력을 획득한 개인을 식별하는 데 사용되는 간접 검사이다. 본 논문에서는 시판되고 FDA가 승인한 분자 및 면역학적 진단 측정을 평가하여 성능 특성을 분석하였다.

Abstract

Due to the highly contagious nature and severity of the respiratory diseases caused by COVID-19, economical and accurate tests are required to better monitor and prevent the spread of this contagion. As the structural and molecular properties of SARS-CoV-2 were being revealed during the early stage of the COVID-19 pandemic, many manufacturers of COVID-19 diagnostic kits actively invested in the design, development, validation, verification, and implementation of diagnostic tests. Currently, diagnostic tests for SARS-CoV-2 are the most widely used and validated techniques for rapid antigen, and immuno-serological assays for specific IgG and IgM antibody tests and molecular diagnostic tests. Molecular diagnostic assays are the gold standard for direct detection of viral RNA in individuals suspected to be infected with SARS-CoV-2. Antibody-based serological tests are indirect tests applied to determine COVID-19 prevalence in the community and identify individuals who have obtained immunity. In the future, it is necessary to explore technical problems encountered in the early stages of global or regional outbreaks of pandemics and provide future directions for better diagnostic tests. This article evaluates the commercially available and FDA-approved molecular and immunological diagnostic assays and analyzes their performance characteristics.

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