The Appropriate Use of Testing for COVID-19

West J Emerg Med. 2020 Apr 13;21(3):470-472. doi: 10.5811/westjem.2020.4.47370.

Abstract

Many public officials are calling for increased testing for the 2019 novel coronavirus disease (COVID-19), and some governments have taken extraordinary measures to increase the availability of testing. However, little has been published about the sensitivity and specificity of the reverse transcriptase-polymerase chain reaction (RT-PCR) nasopharyngeal swabs that are commonly used for testing. This narrative review evaluates the literature regarding the accuracy of these tests, and makes recommendations based on this literature. In brief, a negative RT-PCR nasopharyngeal swab test is insufficient to rule out COVID-19. Thus, over-reliance on the results of the test may be dangerous, and the push for widespread testing may be overstated.

Publication types

  • Review

MeSH terms

  • Betacoronavirus* / genetics
  • Betacoronavirus* / isolation & purification
  • COVID-19
  • COVID-19 Testing
  • Clinical Laboratory Techniques / standards*
  • Coronavirus
  • Coronavirus Infections / diagnosis*
  • Diagnostic Tests, Routine
  • False Negative Reactions
  • Humans
  • Nasal Cavity
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • Real-Time Polymerase Chain Reaction* / standards
  • SARS-CoV-2
  • Sensitivity and Specificity
  • Specimen Handling