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Diagnostic approaches and challenges in COVID-19

Diagnostic approaches

At the beginning of the pandemic, COVID-19 felt like SARS and MERS. In the pre-existing models, the diagnostic approach was included. However, with the severity of the infection and evolution of novel Coronavirus, it was evident that this infection would need a newer and tactical diagnosis. The impact of the disease, paucity of resources, and need for specific tests mounted the crisis to higher levels. As a result, screening by rapid antigen test and confirmation by RT-PCR became the norm.
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Neutralizing Antibodies: among the cocktail of Antibodies?

The severity of the viral infection depends on many factors. Virulence of antigens, the collapse of the immune system, and the production of antibodies are factors. Delay in the production of antibodies due to prolonged antigenic phase can lead to complications. The antibodies are specific to different antigens and bind to particular receptors. Therefore, the antibodies are produced in various stages of infection.

The SARS-CoV-2 virus begins infection as a typical Respiratory disease. As the antigen level drops, antibodies like IgM and IgA take place in the system. The IgM remains in the host system from the eighth day to the twenty-sixth day, along with IgA. After which, it disappears from the system. The secondary antibody in IgG remains in the system for the later part of the convalescent phase until the patient has recovered. Cell-mediated immunity plays a vital role in developing the defense mechanism of the host. After infection with SARS-CoV-2, individuals develop Neutralizing antibodies. The concentrations of these antibodies vary from one individual to the other depending on their immune response. Vaccination against COVID can boost the production of NAbs in the host.

The diagnosis of COVID depends on the detection of antibodies, thereby determining the stage of infection. The Diagnostic kits can screen both asymptomatic and symptomatic individuals. The novel pathogenicity SARS-CoV-2 posed many challenges for the development of antibody detection kits. The window period, the receptors, the antigenic proteins were all unknown for COVID. Hence, previous models of MERS and SARS helped in making the ideal cocktail of the antibodies. In addition, the analysis of local samples obtained in the course of the infection has helped to understand the use of specific antibodies.

Since the pandemic’s start, J Mitra & Co. is catering to the need for Antibody testing for COVID-19 infection. It became the first company to develop and manufacture the COVID-19 (IgM+IgA+IgG) ELISA kit, followed by the COVID-19 Kawach IgG ELISA kit. Both these kits suited well for the early and the late stages of the infection. The second wave of COVID-19 has proved to be more challenging. The use of Neutralizing Antibodies for the diagnosis of COVID addressed this challenge. The company developed the COVID-19 Neutralizing Antibody kit. It has >95% Sensitivity and 100% Specificity.

Antigen Testing in ELISA: A Specific Test At A Precise Time

Antigen Testing in ELISA

Unlike any other viral infection, COVID-19 brought in its own set of challenges. The virulence, pathogenicity of the antigens was unknown. Although a member of the Coronavirus family, SARS-CoV-2 was novel in every form of the infection. The last decade saw pandemics from this family of viruses but never had the severity of the virus comprehended in such a manner.
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Rapid Antigen Test for COVID-19: Evolution and Significance

SARS-CoV-2 uniquely causes infection. It manifests lately in the respiratory system and then brings about a total collapse of the immune response. One strain of the virus caused the first wave of COVID-19 infection. The mortality was although relatively low in the first wave. The overlapping symptoms of COVID-19 with other respiratory diseases posed a challenge for the proper diagnosis of the condition. It was of prime importance to develop a diagnostic mechanism to screen the infected people in the population. The idea was to contain the spread of the infection.
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Why are Neutralizing Antibodies for COVID-19 Diagnosis?

COVID-19

COVID-19 pandemic has opened the frontiers of viral pathogenicity to the next level. In 2020, the first wave of COVID-19 infection carried only one strain. The COVID-19 severity thus is contained timely. The second wave hit hard in February of 2021, with many strains infecting in a whole spree. There were local as well as migratory mutants which had proved to fatal than before. Several factors like dropping the guard early, gathering in public places, and delayed vaccination drive, have lead to the rise in mortality and the slow recovery of patients.
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COVID-19 Neutralization Test

COVID-19 Neutralization Test

Key Highlights :
Scientists discovered Neutralization antibodies in May 2020 and a possible indicator for treatment and diagnostic target. One of the excellent outcomes of the pandemic has been COVID-19 Neutralizing antibodies (NAbs). B cells in the human body produce these NAB.NAB’s primary function is to stop infections by eliminating the invading pathogen.
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Antibody Testing For COVID-19: Evolution And Significance

Antibody Testing For COVID-19

In India, the first reported case of COVID-19 was in February 2020. Subsequently, in the next month, the lockdown was introduced for the entire country. The primary objective of the lockdown was to contain the infection, isolate the infected people and start with the early detection of SARS-CoV-2 disease. RT-PCR is the gold standard for confirming COVID-19. Preliminary screening of COVID-19 is by Rapid Antigen test.
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Coexistence of Dengue and Chikungunya: Challenges in Diagnos

Dengue and Chikungunya: Challenges in Diagnos

The Indian subcontinent is synonymous with tropical diseases, and the prevalence of Vector-Borne diseases, although seasonal, is most catastrophic. Mosquitoes have been on this planet for thousands of years, and to date, they are responsible for wreaking havoc among large spats of the Indian Population. The major viral diseases Dengue and Chikungunya are the ones that fall in this category. The discreet pattern of monsoons has disturbed the normal cycle of the mosquito. Also, as a result, it has altered epidemiology too. The diseases do arrive with the ascent of the rains. It does last until the end of December in the winter season. The symptoms for both illnesses are pretty similar, and they often mimic each other with an exception in the late stages and hence they pose a massive challenge for clinicians to detect the same in the early stages. As per the consensus of the medicos, simultaneous screening for both Dengue and Chikungunya should be conducted initially for the NS1 antigens and gradually to the Antibodies.
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Blood Grouping and Transfusion: Significance and Challenges

Blood Grouping and Transfusion

It would be hard to imagine any test or Diagnosis of any ailment done in today’s world without knowing the Blood group of the patient. Blood typing has become an integral part of the current diagnostic protocol and forms the backbone of any pre-surgical tests. Today, the human blood group system comprises 38 distinct blood groups listed in the International Society of Blood Transfusion. They are classified based on cell surface antigens and their combinations. They are controlled by specific genes which do not recombine with each other. It rarely changes in lifetime, and if it occurs, it could be due to suppression of blood group antigen, mutation, or autoimmune disease. The blood group is unique to each individual.
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Leptospirosis in India: epidemiology and diagnosis

Leptospirosis is a zoonotic disease more prevalent in countries associated with poor sanitation and hygiene. It is a highly communicable disease of the tropical world passing on from the animals (primarily rodents and bovines), which are the reservoirs of the pathogen, to humans. The disease is caused by bacteria, specifically a Spirochaete, which was later named Leptospira. The etiological organism for the disease is Leptospira interrogans, a tiny (0.1µm x 6 -20µm) and highly motile organism with hooks. Due to its bending coil-like structure, the name Leptospirosis was conceived (in Greek leptos, meaning “fine,” and speira, meaning “a coil”). Since Adolf Weil first reported it, hence also called Weil’s Disease. Currently, 23 serogroups and more than 200 serovars of Leptospira are known to cause the disease globally.
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The World of Antibodies: shape up Diagnosis for COVID?

The last decade exposed humankind to various viral infections like SARS, MERS, Ebola, and now COVID-19. While some of them developed antibodies against the infections, there are still many people who have not been exposed to these infections and are potentially at high risk of getting infected. Not only that, the biggest concern lies if the immune response has already developed the memory cells to counter future interaction with these viruses. By virtue, the production of antibodies to infection is a standalone mechanism to fight the viral attack in a primitive response. Still, long-term protection can only be provided by a proper vaccine which can develop humoral immunity in the host body.
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Diagnosis Of COVID-19: Mutations And Post-Vaccination Review

Diagnosis Of COVID-19

Humanity has never been brought to a standstill as the COVID-19 pandemic has done. What started as a pandemic from a small market in Wuhan in China spread in no time to the entire world, barely leaving any pocket non-infected. Since the pandemic started, the race was to understand the pathogenicity of the proteins and submolecular entities of the SARS-CoV-2 virus, which has now been sequenced, and now the quest is to develop a targeted therapy and immunization mechanism to check the infection. The cases subsided with the strict lockdown imposed in 2020, and the country was recuperating back to normal when the second wave hit in late January 2021, and by mid-February 2021 it was evident that the second wave has started wreaking havoc as it has done in other countries like US, Brazil, and Italy.
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