Application of nucleic acid amplification tests in managing covid-19 pandemic

Background. COVID-19 pandemic highlighted an importance of sensitive and specific tests that would be cost-efficient, fast and scalable. There are more than 200 COVID-19 detection tests available worldwide, with every country developing own assays. Sample collection, preparation for a test, tests itself and interpretation of results have a strong impact on the clinical value of the testing. Diversity of tests and workflows requires an analysis of their performance in clinics. Methods. Literature review, analysis of clinical reports, online resources, public and commercial reports were used to collect information about the tests. Collected information was processed for extraction of relevant to this review information. Results. Here we review COVID-19 detection tests that are based on amplification of nucleic acids. The tests employ polymerase chain reaction (PCR) or loop-mediated isothermal amplification (LAMP). Clinical value of the tests depends on used technologies that differ for LAMP, real-time and standard PCR methods. Diversity of sample preparation protocols, different designs of the tests, used chemistries and protocols have significant impact on performance of the tests. Tailoring of a testing workflow to available infrastructure and selection of the most efficient combination of tests and protocols for each step in a testing workflow is crucial for the success. Conclusion. Reviewed here strong and weak sides of different tests and protocols can be of help in selection of a testing workflow for achieving maximal clinical utility.