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. 2020 Jun 5;54(2):164–174. doi: 10.1016/j.jmii.2020.05.016

Table 4.

Summary of reality and pitfalls of virological and serological methods for the diagnosis of COVID-19.

Modality Benefits Pitfalls False negative Uncertain
rRT-PCR (SARS-CoV-2 RNA)
  • 1

    Confirmatory test
  • 1

    Long turnaround (3–4 h)

  • 2

    Cannot confirm viral viability

  • 3

    Technique-dependent

  • 4

    Specimen source-dependent

  • 5

    Equipment-dependent

  • 6

    Expensive
  • 1

    Low viral load

  • 2

    Improper sampling procedure

  • 3

    Inappropriate sampling site

  • 4

    Unqualified reagent

  • 5

    Errors in storage and processing specimens and interpretation
  • 1

    Number of negative results required to confirm absence of COVID-19.

  • 2

    Whether sputum is more appropriate than other upper respiratory tract specimens at any degree of severity or disease stage.

  • 3

    Useful for mass screening
Serology (anti-SARS-CoV-2 IgA, IgM, or IgG antibodies)
  • 1

    Rapid

  • 2

    User friendly

  • 3

    Inexpensive
  • 1

    Unknown clinical significance

  • 2

    Repeat tests needed

  • 3

    Time lags between viral infection, illness onset, and IgM, IgG, IgA antibody development.
  • 1

    Low antibody concentration

  • 2

    Early stage of disease

  • 3

    Immunocompromised patients
  • 1

    Unknown performance in immunocompromised patients

  • 2

    Appropriate timing of tests

  • 3

    Cross-reactivity

  • 4

    Correlation between severity of diseases and serological response
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