Top SARS-CoV-2 / COVID-19 Questions Answered by Robin Patel, M.D.

Top SARS-CoV-2 / COVID-19 Questions Answered by Robin Patel, M.D.

Terms like social distancing, self-quarantine and pandemic are punctuating household conversations and raising pertinent questions. Robin Patel, M.D., President of ASM, Chair of the Division of Clinical Microbiology and Director of the Infectious Diseases Laboratory at Mayo Clinic, in Rochester, MN answers in an open interview about the novel coronavirus, SARS-CoV-2.

From the Q&A:

Can you briefly explain what this novel coronavirus is?

Coronaviruses are a large family of viruses. They’re pretty common in people, and they usually cause just the common cold. They’re also found in many different species of animals. Very rarely, animal coronaviruses can infect and spread between people. Examples of animal coronaviruses that infect humans include: Middle East respiratory syndrome coronavirus (MERS-CoV), Severe acute respiratory syndrome coronavirus (SARS-CoV) and the one we’re dealing with now, called SARS Coronavirus-2 (SARS-CoV-2).

The disease caused by SARS-CoV-2 has been named Coronavirus Disease 2019 and abbreviated COVID-19. We first saw this virus in late 2019 in Wuhan, China. SARS-CoV-2 is a Betacoronavirus, like MERS coronavirus and SARS coronavirus. And all 3 have their origin in bats. [MERS-CoV likely jumped from bats to dromedary camels in the distant past before appearing in humans.]

What is the testing process for COVID-19?

First,we must collect a specimen. This is a respiratory virus. So if we’re going to test for it, we need a sample that comes from the respiratory tract. Most often this is called a nasopharyngeal swab. It can also be tested for using a throat swab. And for patients who have pneumonia or involvement in their lungs, we’ll test lower respiratory secretions, like sputum.

I’ve noted confusion amongst the general public about what testing means. I’d like to clarify that there is much more to testing than just collecting a specimen. The actual testing for this virus, and for many other infectious diseases, is done in clinical microbiology laboratories. Testing in a laboratory is a complicated process. The virus is an RNA virus, so tests are designed to pick up the specific RNA of this virus, and not another virus or other coronaviruses.

Before this outbreak, we had no test for this virus. So clinical microbiology and public health laboratories had to develop their own tests. Today, we also have tests made by companies and sold to clinical microbiology or public health laboratories to perform.

In all of these tests there is a first step where RNA of the virus is extracted from the patient specimen, a second step where the RNA is converted to DNA and a third step where the DNA is amplified with DNA primers that are specific to SARS-CoV-2. This is not a trivial type of test. It needs to be performed by trained laboratorians to make sure it’s done correctly.

Once the laboratory test is complete, the results are sent through a computer to the patient’s electronic medical record and are available for viewing by healthcare providers, and in many cases for patients to see as well.

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