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Detection of SARS-CoV-2 in Different Types of Clinical Specimens

Educational Objective
Review efforts to detect SARS-CoV-2 in different types of clinical specimens
1 Credit CME

An epidemic of respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in China and has spread to other countries.1 Real-time reverse transcriptase–polymerase chain reaction (rRT-PCR) of nasopharyngeal swabs typically has been used to confirm the clinical diagnosis.2 However, whether the virus can be detected in specimens from other sites, and therefore potentially transmitted in other ways than by respiratory droplets, is unknown.

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Article Information

Accepted for Publication: March 5, 2020.

Corresponding Author: Wenjie Tan, MD, PhD, National Institute for Viral Disease Control and Prevention, China CDC, 155 Changbai Rd, Changping District, Beijing 102206, China (tanwj@ivdc.chinacdc.cn).

Published Online: March 11, 2020. doi:10.1001/jama.2020.3786

Author Contributions: Drs Wang and Tan had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Wang and Xu contributed equally.

Concept and design: Wang, Xu, Wu, Tan.

Acquisition, analysis, or interpretation of data: Xu, Gao, Lu, Han, Tan.

Drafting of the manuscript: Wang, Xu, Gao, Han, Tan.

Critical revision of the manuscript for important intellectual content: Xu, Lu, Wu, Tan.

Statistical analysis: Wang.

Obtained funding: Wang, Tan.

Administrative, technical, or material support: Xu, Gao, Lu, Han, Wu.

Supervision: Xu, Wu, Tan.

Conflict of Interest Disclosures: None reported.

Funding/Support: This work was supported by grants 2016YFD0500301 and 2020YFC0840900 from the National Key Research and Development Program of China and 2018ZX10101002 from the National Major Project for Control and Prevention of Infectious Disease in China.

Role of the Funder/Sponsor: The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank Gary Wong, PhD (CAS Key Laboratory of Molecular Virology & Immunology, Institute Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China) for English revision of the manuscript, and clinical staff members in hospitals in Hubei Province, Shandong Province, and Beijing for collection of specimens. None of these individuals received compensation for their contributions.

References
1.
Tan  W , Zhao  X , Ma  X ,  et al.  Notes from the field: a novel coronavirus genome identified in a cluster of pneumonia cases—Wuhan, China 2019-2020.   China CDC Weekly. 2020;2(4):61-62.Google Scholar
2.
Wang  D , Hu  B , Hu  C ,  et al.  Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China.   JAMA. Published February 7, 2020. doi:10.1001/jama.2020.1585PubMedGoogle Scholar
3.
Zhang  W , Du  RH , Li  B ,  et al.  Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes.   Emerg Microbes Infect. 2020;9(1):386-389. doi:10.1080/22221751.2020.1729071PubMedGoogle ScholarCrossref
4.
Pan  Y , Zhang  D , Yang  P , Poon  LLM , Wang  Q .  Viral load of SARS-CoV-2 in clinical samples.   Lancet Infect Dis. Published online February 24, 2020. doi:10.1016/S1473-3099(20)30113-4PubMedGoogle Scholar
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