Towards a sensitive and accurate interpretation of molecular testing for SARS-CoV-2: a rapid review of 264 studies

Kamelia R. Stanoeva, Annemiek A. van der Eijk, Adam Meijer, Laetitia M. Kortbeek, Marion P.G. Koopmans, Chantal B.E.M. Reusken*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

6 Citations (Scopus)
51 Downloads (Pure)


Background: Sensitive molecular diagnostics and correct test interpretation are crucial for accurate COVID-19 diagnosis and thereby essential for good clinical practice. Furthermore, they are a key factor in outbreak control where active case finding in combination with isolation and contact tracing are crucial. Aim: With the objective to inform the public health and laboratory responses to the pandemic, we reviewed current published knowledge on the kinetics of SARS-CoV-2 infection as assessed by RNA molecular detection in a wide range of clinical samples. Methods: We performed an extensive search on studies published between 1 December 2019 and 15 May 2020, reporting on molecular detection and/ or isolation of SARS-CoV-2 in any human laboratory specimen. Results: We compiled a dataset of 264 studies including 32,515 COVID-19 cases, and additionally aggregated data points (n = 2,777) from sampling of 217 adults with known infection timeline. We summarised data on SARS-CoV-2 detection in the respirat y and gastrointestinal tract, blood, oral fluid, tears, cerebrospinal fluid, peritoneal fluid, semen, vaginal fluid; where provided, we also summarised specific observations on SARS-CoV-2 detection in pregnancy, infancy, children, adolescents and immunocompromised individuals. Conclusion: Optimal SARS-CoV-2 molecular testing relies on choosing the most appropriate sample type, collected with adequate sampling technique, and with the infection timeline in mind. We outlined knowledge gaps and directions for future well-documented systematic studies.

Original languageEnglish
Pages (from-to)1-21
Number of pages21
Issue number10
Publication statusPublished - 1 Mar 2021

Bibliographical note

Funding Information:
KRS received fellowship funding by the European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control (ECDC). An ECDC representative formally approved the manuscript before submission. MPGK received funding from the H2020 COVID-19 project RECOVER (grant agreement nr 101003589). The funders had no role in the collection, analysis, and interpretation of data, nor the writing of the review.

Publisher Copyright:
© 2021 European Centre for Disease Prevention and Control (ECDC). All rights reserved.


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