Ravaging SARS-CoV-2: rudimentary diagnosis and puzzling immunological responses

Abstract

Introduction

In December 2019, the first COVID-19 case, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was reported in Wuhan, China. The SARS-CoV-2 rapidly disseminated throughout the world via community spread, acquiring pandemic status with significant fatality.

Observations

Rapid SARS-CoV-2 diagnosis was soon perceived critical for arresting community spread and effective therapy development. Human SARS-CoV-2 infection can be diagnosed either by nucleic acid identification or specific antibody detection. Contrary to nucleic acid identification confirmed active SARS-CoV-2 infection; antibody detection confirms a past infection, even in asymptomatic subjects. SARS-CoV-2 specific antibodies augment the ability to effectively counter the virus. A crucial hurdle limiting the steadfast implementation of antibody detection is the time required for threshold B lymphocyte population generation. This process is dependent on precise antigen recognition and MHC class I molecules presentation.

Conclusions

Thus, nucleic acid and antibody dependent tests complement each other in identifying human SARS-CoV-2 infection and shaping up subsequent immunological responses. This article discusses the complimentary association of nucleic acid identification (corresponding to an active infection) and antibody testing (the yester CoV-2 infection vulnerability) as the diagnostic and screening measures of SARS-CoV-2 infection.

Highlights

• Nucleic acid (RNA) identification and specific antibody detection against SARS-CoV-2 are the noted diagnostic mechanisms for screening human SARS-CoV-2 infection.

• While nucleic acid identification screens prevailing SARS-CoV-2 infection, detection of SARS-CoV-2 specific antibodies signifies a past infection, even in asymptomatic subjects.

• Antibodies against SARS-CoV-2 provide a potential therapeutic option via transfer from antibody rich plasma of a recovered subject to an infected individual.

• Nucleic acid identification may not absolutely confirm the infection because of frequent SARS-CoV-2 genome mutations and possible technical errors, while specific antibody detection also needs at least (8–14) days for detectable screening of B-cell generated antibodies.

• Nucleic acid and antibody tests are complementary to each other as an early stage diagnostic assay for SARS-CoV-2 infection and possible therapy (antibodies).

• Sufferers with a high clinical suspicion but negative RT-PCR screening could be examined via combined imaging and repeated swab test.

Keywords:

• Severe acute respiratory syndrome Coronavirus 2: real-time reverse transcriptase polymerase chain reaction: antibody
• specific high sensitivity enzymatic reporter unlocking technique: Rapid Diagnostic Test
• Enzyme Linked Immunosorbent Assay
• neutralization assay
• chemiluminescent immunoassay

Transparency

Declaration of funding

The study was not funded.

Declaration of financial/other relationships

The authors declare no financial or other relationships that may cause any conflict of interest.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors unanimously accept the responsibility for description and discussion covered in this manuscript and approval of its final version.

Acknowledgements

Authors wish to oblige the uninterrupted internet facilities accorded hereby from Central University of Gujarat, (Gandhinagar), India and University of Utah, Salt Lake City, Utah, USA.