Optimizing testing regimes for the detection of COVID-19 in children and older adults

ABSTRACT

Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection is a major pandemic and continuously emerging due to unclear prognosis and unavailability of reliable detection tools. Older adults are more susceptible to COVID-19 than children showing mature Angiotensin-Converting Enzyme 2 (ACE2), low concentration of immune targets, and comorbid conditions. Several detection platforms have been commercialized to date and more are in pipeline, however, the rate of false-positive results and rapid mutation of SARS-CoV-2 is increasing. Additionally, physiological, and geographical variations of affected individuals are also calling for diagnostic methods optimization.

Areas Covered: Extensive information related to the optimization and usefulness of SARS-CoV-2 diagnostic methods based on sensitivity and specificity as definitive and feasible investigative tools is discussed. Moreover, an option of combining laboratory diagnostic methods to improve diagnostic strategies is also proposed and discussed in the comparative section of optimization studies.

Expert Opinion: The review article explains the importance of optimization strategies for SARS-CoV-2 detection in children and older adults. There are advancements in COVID-19 detection including CRISPR-based, electrochemical, and optical-based sensing systems. However, the lack of sufficient studies on a comparative evaluation of standardized SARS-CoV-2 diagnostic methods among children and older adults, limit the authentication of commercialized kits.

KEYWORDS:

• SARS-CoV-2
• molecular diagnostics
• immunodiagnostic
• nanotechnology
• sensors
• point-of-care (POC) kits
• children and older adults

Article highlights

• Focused on the limitations of laboratory-based SARS-CoV-2 diagnostic techniques in children and older adults.

• Optimization of COVID-19 detection assays and commercialized kits are highly recommended.

• Proposed strategies of optimized diagnostic methods for active COVID-19 cases in children and older adults.

• Promoted next-generation sensors and involvement of CRISPR-Cas-like techniques for differential detection mechanism for SARS-CoV-2 identification.

Acknowledgments

The authors acknowledge the assistance of Dr. Tessy Iype and Dr. C.N. Ramchand, from MagGenome Technologies Pvt. Ltd., India for their valuable technical input.

Reviewer disclosures

One peer reviewer received personnal fees and travel accomodation from BioMérieux, Qiagen, Hologic and Gilead; and received grants for medical research from Qiagen. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents received or pending, or royalties.

Additional information

Funding

The work is financially supported by Extramural Research grant (File No. EMR/2016/007564) and Young Scientist Scheme (File No. YSS/2015/000023) by Science and Engineering Research Board (SERB), Government of India; Technology Development Program (TDP) (TDP/BDTD/33/2019), Department of Science and Technology (DST), Government of India; and Biotechnology Industry Research Assistance Council (BIRAC) (File No. BT/IIPME0211/02/16).