Interpretation of diagnostic laboratory tests for severe acute respiratory syndrome: the Toronto experience.

作者：Patrick Tang, Marie Louie, Susan E. Richardson, Marek Smieja, Andrew E. Simor, Frances Jamieson, Margaret A. Fearon, Susan Marie Poutanen, Tony Mazzulli, Raymond Tellier, James B. Mahony, Mark B Loeb, Astrid K. Petrich, Max Chernesky, Allison McGeer, Donald E. Low, Elizabeth W. Phillips, Steven J.M. Jones, Nathalie Bastien, Yan Li, Daryl Dick, Allen Grolla, Lisa Fernando, Timothy F. Booth, Bonnie Henry, Anita Rachlis, Larissa M. Matukas, David B. Rose, Reena Lovinsky, Sharon Lynn Walmsley, Wayne L. Gold, Sigmund Krajden · 发表于：PubMed · 年份：2004 · 被引用次数：77 · 研究领域：SARS-CoV-2 detection and testing、COVID-19 Clinical Research Studies、SARS-CoV-2 and COVID-19 Research

BACKGROUND: An outbreak of severe acute respiratory syndrome (SARS) began in Canada in February 2003. The initial diagnosis of SARS was based on clinical and epidemiological criteria. During the outbreak, molecular and serologic tests for the SARS-associated coronavirus (SARS-CoV) became available. However, without a "gold standard," it was impossible to determine the usefulness of these tests. We describe how these tests were used during the first phase of the SARS outbreak in Toronto and offer some recommendations that may be useful if SARS returns. METHODS: We examined the results of all diagnostic laboratory tests used in 117 patients admitted to hospitals in Toronto who met the Health Canada criteria for suspect or probable SARS. Focusing on tests for SARS-CoV, we attempted to determine the optimal specimen types and timing of specimen collection. RESULTS: Diagnostic test results for SARS-CoV were available for 110 of the 117 patients. SARS-CoV was detected by means of reverse-transcriptase polymerase chain reaction (RT-PCR) in at least one specimen in 59 (54.1%) of 109 patients. Serologic test results of convalescent samples were positive in 50 (96.2%) of 52 patients for whom paired serum samples were collected during the acute and convalescent phases of the illness. Of the 110 patients, 78 (70.9%) had specimens that tested positive by means of RT-PCR, serologic testing or both methods. The proportion of RT-PCR test results that were positive was similar between patient...