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국내 중증 급성 호흡기 증후군 코로나 바이러스의 검사실 내 진단: 현재, 한계점 그리고 직면한 과제

Laboratory Diagnosis of Coronavirus Disease 19 (COVID-19) in Korea: Current Status, Limitation, and Challenges

Wontae Kim|전진현|Jaewang Lee|Gi Seon Song|You-Rim Lee|Sungmin Kim|Jungwon Choi|Dahyeon Yoo|Jungyoung Yoo|Kyung-Tae Jang
대한임상검사과학회 (Korean Society for Clinical Laboratory Science)|2020.09|대한임상검사과학회지 (Korean Journal of Clinical Laboratory Science)|제52권 제3호|pp. 284-295|DOI 10.15324/kjcls.2020.52.3.284

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키워드

COVID-19Molecular diagnosisLaboratory diagnosisLaboratory biosafety
주제분류기타자연과학

초록

2019년 12월, 중국 후베이성 우한시에서 COVID-19환자가처음으로 보고되었다. 그 이후 국내에서 신종 코로나 바이러스에 의해 야기된 중증 급성 호흡기 증후군 환자가 급격하게 증가하였다. 이러한 새로운 변종 바이러스는 기침, 인후통, 비루, 호흡곤란, 폐렴 및 기타 폐질환을 유발한다. 중증 급성 호흡기 증후군 코로나 바이러스 2는 RNA바이러스로, 실시간 역전사효소중합효소 연쇄반응을 통한 분자진단 검사가 COVID-19의 진단에 폭 넓게 사용되고 있다. 국내 질병관리본부와 식품의약품안전처의 긴급 사용 허가 승인에 따라, 건강한 사람과 COVID- 19 환자로부터 검체를 채취하여 진단검사의학적인 방법을 통해진단을 수행하고 있다. 기존에 출판된 많은 문헌 고찰을 통해, 본연구에서는 역학, 증상 및 질병관리본부의 승인을 받은 현재의검사실 내 COVID-19 분자 진단 방법, 분자 진단 검사와 혈청학적 진단의 차이, 임상 검체 가이드라인 등을 다시 한 번 확인하고자 하였다. 추가적으로 본 연구를 통해 국내 의료기관 내 의료종사자 및 임상병리사들의 병원 감염을 예방하고자 생물학적 안전에 관한 가이드라인을 확인하였다. 국내 임상병리사들의 경험과 그로부터 얻은 교훈을 통해 국내외 COVID-19 팬데믹 상황으로부터 국민의 안전을 지킬 수 있는 단초를 제공할 수 있을 것이라 사료된다.

Abstract

In December 2019, the first coronavirus disease- 2019 (COVID-19) patient was reported in Wuhan, Hubei Province, China. Since then, the number of patients who suffered severe acute respiratory syndrome caused by the novel Coronavirus (SARS-CoV-2 or 2019-nCoV) has increased dramatically in Korea. This new variant virus induces pulmonary diseases, including cough, sore throat, rhinorrhea, dyspnea, and pneumonia. Because SARS-CoV-2 is an RNA virus, real-time reversetranscriptase PCR has been used widely to diagnose COVID-19. As the Korea Centers for Disease Prevention and Control (KCDC) and Ministry of Food & Drug Safety (MFDS) approved emergency use authorization, clinical specimens collected from COVID-19 patients and even healthy people have been clinically diagnosed by laboratory medicine. Based on a literature search, this paper reviews the epidemiology, symptoms, molecular diagnostics approved by KCDC, a current diagnosis of COVID-19 in the laboratories, the difference between molecular and serological diagnosis, and guidelines for clinical specimens. In addition, the Korean guidelines of biosafety for clinical laboratory scientists are evaluated to prevent healthcare-associated infection. The author’s experience and lessons as clinical laboratory scientists will provide valuable insights to protect the domestic and international health community in this COVID-19 pandemic around the world.

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