Laboratorio clínico y COVID-19. Diagnóstico y biomarcadores asociados con la progresión de la enfermedad

Autores/as

  • Adriana Beatriz Pedreañez Santana Universidad del Zulia, Facultad de Medicina, Maracaibo, Venezuela
  • Jorge Robalino Instituto INGINOST, Riobamba, Ecuador http://orcid.org/0000-0002-2254-2498
  • Nelson Muñoz Universidad Nacional del Chimborazo, Facultad de Ciencias de la Salud, Riobamba, Ecuador http://orcid.org/0000-0002-6873-0021
  • Diego Tene Laboratorio Clínico del Hospital General IESS, Riobamba, Ecuador

DOI:

https://doi.org/10.33936/qkrcs.v5i3.3572

Palabras clave:

SARS-CoV-2, Covid-19, diagnóstico de laboratorio, serología, PCR en tiempo real

Resumen

El mundo se encuentra en medio de una pandemia causada por la enfermedad coronavirus 2019 (COVID-19), asociada al virus SARS-CoV-2, reportado por primera vez en diciembre de 2019 en la provincia de Wuhan, China. Debido a su rápida propagación, existe la necesidad de diagnósticos rápidos y precisos que permitan monitorear mejor la enfermedad. El objetivo de esta revisión fue describir y analizar los principales métodos de laboratorio empleados para el diagnóstico de la COVID-19, así como los marcadores bioquímicos asociados con la progresión de la enfermedad. Para ello, se realizó una búsqueda minuciosa en PubMed utilizando las siguientes palabras clave: (COVID-19; SARS-CoV-2; serología, PCR en tiempo real; métodos; Pruebas rápidas; biomarcadores). Esta revisión ofrece un enfoque de la enfermedad desde el punto de vista del laboratorio clínico, y aporta claridad al creciente conjunto de pruebas de diagnóstico disponibles y en desarrollo; así como la comprensión de los parámetros bioquímicos que se alteran durante la misma. La identificación de biomarcadores de laboratorio eficaces capaces de clasificar a los pacientes en función de su riesgo es imprescindible para poder garantizar un tratamiento oportuno y sirve como guía para científicos, médicos, estudiantes y el público en general.

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Citas

1. Hosseini ES, Kashani NR, Nikzad H, Azadbakht J, Bafrani HH, Kashani HH. The novel coronavirus Disease-2019 (COVID-19): Mechanism of action, detection and recent therapeutic strategies. Virology Internet. 2020;551:1-9. Disponible en: https://doi.org/10.1016/j.virol.2020.08.011
2. Alocución de apertura del Director General de la OMS en la rueda de prensa sobre la COVID-19 celebrada el 11 de marzo de 2020 Internet. Disponible en: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
3. Tu H, Tu S, Gao S, Shao A, Sheng J. Current epidemiological and clinical features of COVID-19; a global perspective from China. J Infect Internet 2020;81(1):1-9. Disponible en: https://doi.org/10.1016/j.jinf.2020.04.011
4. Li X, Geng M, Peng Y, Meng L, Lu S. Molecular immune pathogenesis and diagnosis of COVID-19. J Pharm Anal Internet. 2020;10(2):102-108. Disponible en: https://doi.org/10.1016/j.jpha.2020.03.001
5. Tang S, Mao Y, Jones RM, Tan Q, Ji JS, Li N, et al. Aerosol transmission of SARS-CoV-2? Evidence, prevention and control. Environ Int Internet. 2020;144:106039. Disponible en: https://doi.org/10.1016/j.envint.2020.106039
6. Lee S, Meyler P, Mozel M, Tauh T, Merchant R. Asymptomatic carriage and transmission of SARS-CoV-2: What do we know? Can J Anaesth Internet. 2020;67(10):1424-1430. Disponible en: https://doi.org/10.1007/s12630-020-01729-x
7. Pan X, Chen D, Xia Y, Wu X, Li T, Ou X, et al. Asymptomatic cases in a family cluster with SARS-CoV-2 infection. Lancet Infect Dis Internet. 2020;20(4):410-411. Disponible en: https://doi.org/10.1016/S1473-3099(20)30114-6
8. Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med Internet. 2020;382(12):1177-1179. Disponible en: https://doi.org/10.1056/NEJMc2001737
9. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet Internet. 2020;395(10223):497-506. Disponible en: https://doi.org/10.1016/S0140-6736(20)30183-5
10. Machhi J, Herskovitz J, Senan AM, Dutta D, Nath B, Oleynikov MD, et al. The Natural History, Pathobiology, and Clinical Manifestations of SARS-CoV-2 Infections. J Neuroimmune Pharmacol Internet. 2020;15(3):359-386. Disponible en: https://doi.org/10.1007/s11481-020-09944-5
11. Liu R, Yi S, Zhang J, Lv Z, Zhu C, Zhang Y. Viral Load Dynamics in Sputum and Nasopharyngeal Swab in Patients with COVID-19. J Dent Res Internet. 2020;99(11):1239-1244. Disponible en: https://doi.org/10.1177/0022034520946251
12. Yongchen Z, Shen H, Wang X, Shi X, Li Y, Yan J, et al. Different longitudinal patterns of nucleic acid and serology testing results based on disease severity of COVID-19 patients. Emerg Microbes Infect Internet. 2020;9(1):833-836. Disponible en: https://doi.org/10.1080/22221751.2020.1756699
13. He Y, Luo J, Yang J, Song J, Wei L, Ma W. Value of Viral Nucleic Acid in Sputum and Feces and Specific IgM/IgG in Serum for the Diagnosis of Coronavirus Disease 2019. Front Cell Infect Microbiol Internet. 2020;10:445. Disponible en: https://doi.org/10.3389/fcimb.2020.00445
14. Charlton CL, Babady E, Ginocchio CC, Hatchette TF, Jerris RC, Li Y, et al. Practical Guidance for Clinical Microbiology Laboratories: Viruses Causing Acute Respiratory Tract Infections. Clin Microbiol Rev Internet. 2018;32(1):e00042-18. Disponible en: https://doi.org/10.1128/CMR.00042-18
15. Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA Internet. 2020;323(18):1843-1844. Disponible en: https://doi.org/10.1001/jama.2020.3786
16. Interim Guidelines for Collecting and Handling of Clinical Specimens for COVID-19 Testing. Centros para el control y la prevención de enfermedades (CDC). Disponible en: https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html. [consultado 2021.03.16]
17. Erensoy S. COVID-19 Pandemisinde SARS-CoV-2 ve Mikrobiyolojik Tanı Dinamikler [SARS-CoV-2 and Microbiological Diagnostic Dynamics in COVID-19 Pandemic]. Mikrobiyol Bul Internet. 2020;54(3):497-509. Disponible en: https://doi.org/10.5578/mb.69839
18. Sharfstein JM, Becker SJ, Mello MM. Diagnostic Testing for the Novel Coronavirus. JAMA Internet. 2020;323(15):1437-1438. Disponible en: https://doi.org/10.1001/jama.2020.3864
19. Sethuraman N, Jeremiah SS, Ryo A. Interpreting Diagnostic Tests for SARS-CoV-2. JAMA Internet. 2020;323(22):2249-2251. Disponible en: https://doi.org/10.1001/jama.2020.8259
20. Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DK, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill Internet. 2020;25(3):2000045. Disponible en: https://doi.org/10.2807/1560-7917.ES.2020.25.3.2000045
21. Smyrlaki I, Ekman M, Lentini A, Rufino de Sousa N, Papanicolaou N, Vondracek M, et al. Massive and rapid COVID-19 testing is feasible by extraction-free SARS-CoV-2 RT-PCR. Nat Commun Internet. 2020;11(1):4812. Disponible en: https://doi.org/10.1038/s41467-020-18611-5
22. Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses. J Adv Res Internet. 2020;24:91-98. Disponible en: https://doi.org/10.1016/j.jare.2020.03.005
23. Zapor M. Persistent Detection and Infectious Potential of SARS-CoV-2 Virus in Clinical Specimens from COVID-19 Patients. Viruses Internet. 2020;12(12):1384. Disponible en: https://doi.org/10.3390/v12121384
24. Nguyen NNT, McCarthy C, Lantigua D, Camci-Unal G. Development of Diagnostic Tests for Detection of SARS-CoV-2. Diagnostics (Basel) Internet. 2020;10(11):905. Disponible en: https://doi.org/10.3390/diagnostics10110905
25. Lan L, Xu D, Ye G, Xia C, Wang S, Li Y, et al. Positive RT-PCR Test Results in Patients Recovered From COVID-19. JAMA Internet. 2020;323(15):1502-1503. Disponible en: https://doi.org/10.1001/jama.2020.2783
26. Oliveira BA, Oliveira LC, Sabino EC, Okay TS. SARS-CoV-2 and the COVID-19 disease: a mini review on diagnostic methods. Rev Inst Med Trop Sao Paulo Internet. 2020;62:e44. Disponible en: https://doi.org/10.1590/S1678-9946202062044
27. Kucirka LM, Lauer SA, Laeyendecker O, Boon D, Lessler J. Variation in False-Negative Rate of Reverse Transcriptase Polymerase Chain Reaction-Based SARS-CoV-2 Tests by Time Since Exposure. Ann Intern Med Internet. 2020;173(4):262-267. Disponible en: https://doi.org/10.7326/M20-1495
28. To KK, Tsang OT, Leung WS, Tam AR, Wu TC, Lung DC, et al. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: An observational cohort study. Lancet Infect Dis Internet. 2020;20:565-574. Disponible en: https://doi.org/10.1016/S1473-3099(20)30196-1
29. Wolfel R, Corman VM, Guggemos W, Seilmaier M, Zange S, Muller MA, Niemeyer D, Jones TC, Vollmar P, Rothe C, Hoelscher M, Bleicker T, Brünink S, Schneider J, Ehmann R, Zwirglmaier K, Drosten Ch, Wendtner C. Virological assessment of hospitalized patients with COVID-2019. Nature Internet. 2020;581:465-469 Disponible en: https://doi.org/10.1038/s41586-020-2196-x
30. Guo L, Ren L, Yang S, Xiao M, Chang D, Yang F, De la Cruz ChS, Wang Y, Wu C, Xiao Y, Zhang L, Han L, Dang S, Xu Y, Yang QW, Xu SY, Zhu HD, Xu YC, Jin Q, Sharma L, Wang L, Wang J. Profiling Early Humoral Response to Diagnose Novel Coronavirus Disease (COVID-19). Clin Infect Internet. 2020;71(15):778-785. Disponible en: https://doi.org/10.1093/cid/ciaa310
31. Yu HQ, Sun BQ, Fang ZF, Zhao JC, Liu XY, Li YM, Sun XZ, Liang HF, Zhong B, Huang ZF, Zheng PY, Tian LF, Qu HQ, Liu DC, Wang EY, Xiao XJ, Li SY, Ye F, Guan L, Hu DS, Hakonarson H, Liu ZG, Zhon NS. Distinct features of SARS-CoV-2-specific IgA response in COVID-19 patients. Eur Respir J Internet. 2020;56:2001526. Disponible en: https://doi.org/10.1183/13993003.01526-2020
32. Chvatal-Medina M, Mendez-Cortina Y, Patiño PJ, Velilla PA, Rugeles MT. Antibody Responses in COVID-19: A Review. Front Immunol Internet. 2021;12:633184. Disponible en: https://doi.org/10.3389/fimmu.2021.633184
33. Ong DSY, Fragkou PC, Schweitzer VA, Chemaly RF, Moschopoulos CD, Skevaki C; European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV). How to interpret and use COVID-19 serology and immunology tests. Clin Microbiol Infect Internet. 2021;27(7):981-6. Disponible en: https://doi.org/10.1016/j.cmi.2021.05.001
34. Ejazi SA, Ghosh S, Ali N. Antibody detection assays for COVID-19 diagnosis: an early overview. Immunol Cell Biol Internet. 2021;99(1):21-33. Disponible en: https://doi.org/10.1111/imcb.12397
35. Carter LJ, Garner LV, Smoot JW, Li Y, Zhou Q, Saveson CJ. Assay Techniques and Test Development for COVID-19 Diagnosis. ACS Cent Sci Internet. 2020;6:591-605. Disponible en: https://doi.org/10.1021/acscentsci.0c00501
36. O Murchu E, Byrne P, Walsh KA, Carty PG, Connolly M, De Gascun C, et al. Immune response following infection with SARS-CoV-2 and other coronaviruses: A rapid review. Rev Med Virol Internet. 2021;31(2):e2162. Disponible en: https://doi.org/10.1002/rmv.2162
37. Cinquanta L., Fontana D.E., Bizzaro N. Chemiluminescent immunoassay technology: what does it change in autoantibody detection? Auto Immun Highlights Internet. 2017;8(1):9. Disponible en: https://doi.org/10.1007/s13317-017-0097-2
38. Jarrom D, Elston L, Washington J, Prettyjohns M, Cann K, Myles S, et al. Effectiveness of tests to detect the presence of SARS-CoV-2 virus, and antibodies to SARS-CoV-2, to inform COVID-19 diagnosis: a rapid systematic review. BMJ Evid Based Med Internet. 2020. Disponible en: https://doi.org/10.1136/bmjebm-2020-111511
39. Mekonnen D, Mengist HM, Derbie A, Nibret E, Munshea A, He H, et al. Diagnostic accuracy of serological tests and kinetics of severe acute respiratory syndrome coronavirus 2 antibody: A systematic review and meta-analysis. Rev Med Virol Internet. 2021;31(3):e2181. Disponible en: https://doi.org/10.1002/rmv.2181
40. Theel ES, Slev P, Wheeler S, Couturier MR, Wong SJ, Kadkhoda K. The Role of Antibody Testing for SARS-CoV-2: Is There One? J Clin Microbiol Internet. 2020;58(8):e00797-20. Disponible en. https://doi.org/10.1128/JCM.00797-20
41. Asesoramiento sobre el uso de pruebas de inmunodiagnóstico en el punto de atención para COVID-19 (Organización Mundial de la Salud, 2020. Disponible en: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/media-resources/science-in-5/episode-14---covid-19---tests?gclid=Cj0KCQjwwLKFBhDPARIsAPzPi-K4S3WUAEEZ_G_6Mdg7Nbeaaw3m4QRprvysvyO60J5IKSbE1yhFdXwaAldxEALw_wcB [consultado 2021.03.16]
42. Mak GC, Cheng PK, Lau SS, Wong KK, Lau CS, Lam ET, et al. Evaluation of rapid antigen test for detection of SARS-CoV-2 virus. J Clin Virol Internet. 2020;129:104500. Disponible en: https://doi.org/10.1016/j.jcv.2020.104500
43. Porte L, Legarraga P, Vollrath V, Aguilera X, Munita JM, Araos R, et al. Evaluation of a novel antigen-based rapid detection test for the diagnosis of SARS-CoV-2 in respiratory samples. Int J Infect Dis Internet. 2020;99:328-333. Disponible en: https://doi.org/10.1016/j.ijid.2020.05.098
44. Wang T, Du Z, Zhu F, Cao Z, An Y, Gao Y, et al. Comorbidities and multi-organ injuries in the treatment of COVID-19. Lancet Internet. 2020;395(10228):e52. Disponible en: https://doi.org/10.1016/S0140-6736(20)30558-4
45. Pourbagheri-Sigaroodi A, Bashash D, Fateh F, Abolghasemi H. Laboratory findings in COVID-19 diagnosis and prognosis. Clin Chim Acta [Internet]. 2020;510:475-482. Disponible en: https://doi.org/10.1016/j.cca.2020.08.019
46. Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med Internet. 2020;8(5):475-481. Disponible en: https://doi.org/10.1016/S2213-2600(20)30079-5
47. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet Internet. 2020;395(10223):507-513. Disponible en: https://doi.org/10.1016/S0140-6736(20)30211-7
48. Liu Y, Du X, Chen J, Jin Y, Peng L, Wang HHX, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect Internet. 2020;81(1):e6-e12. Disponible en: https://doi.org/10.1016/j.jinf.2020.04.002
49. Zahorec R, Hulin I, Zahorec P. Rationale Use of Neutrophil-to-lymphocyte ratio for early diagnosis and stratification of COVID-19. Bratisl Lek Listy Internet. 2020;121(7):466-470. Disponible en: https://doi.org/10.4149/BLL_2020_077
50. Ciccullo A, Borghetti A, Zileri Dal Verme L, Tosoni A, Lombardi F, Garcovich M, et al. Neutrophil-to-lymphocyte ratio and clinical outcome in COVID-19: a report from the Italian front line. Int J Antimicrob Agents Internet 2020 Aug;56(2):106017. Disponible en: https://doi.org/10.1016/j.ijantimicag.2020.106017
51. Durmus E, Kivrak T, Gerin F, Sunbul M, Sari I, Erdogan O. Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio are Predictors of Heart Failure. Arq Bras Cardiol Internet. 2015;105(6):606-13. Disponible en: https://doi.org/10.5935/abc.20150126
52. Khurana D, Deoke SA. Thrombocytopenia in Critically Ill Patients: Clinical and Laboratorial Behavior and Its Correlation with Short-term Outcome during Hospitalization. Indian J Crit Care Med Internet. 2017;21(12):861-864. Disponible en: https://doi.org/10.4103/ijccm.IJCCM_279_17
53. Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost Internet 2020;18(5):1094-1099. Disponible en: https://doi.org/10.1111/jth.14817
54. Jiang F, Deng L, Zhang L, Cai Y, Cheung CW, Xia Z. Review of the Clinical Characteristics of Coronavirus Disease 2019 (COVID-19). J Gen Intern Med [Internet]. 2020;35(5):1545-1549. Disponible en: https://doi.org/10.1007/s11606-020-05762-w
55. Chang D, Lin M, Wei L, Xie L, Zhu G, Dela Cruz CS, Sharma L. Epidemiologic and Clinical Characteristics of Novel Coronavirus Infections Involving 13 Patients Outside Wuhan, China. JAMA [Internet]. 2020;323(11):1092-1093. Disponible en: https://doi.org/10.1001/jama.2020.1623
56. Xu P, Zhou Q, Xu J. Mechanism of thrombocytopenia in COVID-19 patients. Ann Hematol [Internet]. 2020;99(6):1205-1208. Disponible en: https://doi.org/10.1007/s00277-020-04019-0
57. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med Internet. 2020;46(5):846-848. Disponible en: https://doi.org/10.1007/s00134-020-05991-x
58. Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med Internet 2020;58(7):1021-1028. Disponible en: https://doi.org/10.1515/cclm-2020-0369
59. Tan C, Huang Y, Shi F, Tan K, Ma Q, Chen Y, et al. C-reactive protein correlates with computed tomographic findings and predicts severe COVID-19 early. J Med Virol Internet. 2020;92(7):856-862. Disponible en: https://doi.org/10.1002/jmv.25871
60. Khodeir MM, Shabana HA, Alkhamiss AS, Rasheed Z, Alsoghair M, Alsagaby SA, et al. Early prediction keys for COVID-19 cases progression: A meta-analysis. J Infect Public Health Internet. 2021;14(5):561-569. Disponible en: https://doi.org/10.1016/j.jiph.2021.03.001
61. Zhang JJY, Lee KS, Ang LW, Leo YS, Young BE. Risk Factors for Severe Disease and Efficacy of Treatment in Patients Infected With COVID-19: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis. Clin Infect Dis Internet 2020;71(16):2199-2206. Disponible en: https://doi.org/10.1093/cid/ciaa576
62. Karzai W, Oberhoffer M, Meier-Hellmann A, Reinhart K. Procalcitonin--a new indicator of the systemic response to severe infections. Infection Internet. 1997;25(6):329-34. Disponible en: https://doi.org/10.1007/BF01740811
63. Russwurm S, Wiederhold M, Oberhoffer M, Stonans I, Zipfel PF, Reinhart K. Molecular aspects and natural source of procalcitonin. Clin Chem Lab Med Internet. 1999;37(8):789-97. Disponible en: https://doi.org/10.1515/CCLM.1999.119
64. Zhang G, Hu C, Luo L, Fang F, Chen Y, Li J, et al. Clinical features and short-term outcomes of 221 patients with COVID-19 in Wuhan, China. J Clin Virol Internet. 2020;127:104364. Disponible en: https://doi.org/10.1016/j.jcv.2020.104364
65. Lippi G, Plebani M. Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. Clin Chim Acta Internet 2020;505:190-191. Disponible en: https://doi.org/10.1016/j.cca.2020.03.004
66. Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ Internet 2020;368:m1091. Disponible en: https://doi.org/10.1136/bmj.m1091

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2021-09-15

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Laboratorio Clínico