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Point-of-Care (POC) diagnostics for coronavirus disease 2019 (COVID-19) and their potential impact on dentistry

From Volume 48, Issue 7, July 2021 | Pages 585-590

Authors

Lakshman Samaranayake

DSc, DDS, FRCPath, FHKCPath, FDS RCS(Edin), FRACDS, FDS RCPS

Professor Emeritus, and Immediate-past Dean, Faculty of Dentistry, University of Hong Kong

Articles by Lakshman Samaranayake

Email Lakshman Samaranayake

Niraj Kinariwala

BDS, MDS

MDS, PhD, Associate Professor, Karnavati School of Dentistry, Karnavati University, Gujarat, India;

Articles by Niraj Kinariwala

Abstract

It is clear that the coronavirus disease 2019 (COVID-19) pandemic, due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) will be with us for the foreseeable future, possibly entrenched as an endemic infection. This poses a grave threat for clinical dental practice as asymptomatic (viral) carriers unknowing of their status, may attend for treatment with the possibility of resultant disease spread to non-immune individuals in the clinic. Even if one is immune through vaccination, the temporal waning of protective antibodies may lead to mild–moderate variant-induced infection, as shown in a number of recent studies. Hence, it is likely that rapid and accurate identification of COVID-19 patients at the point-of-care (POC), that is in the clinic or during the pre-attendance period, will be a critical imperative in the foreseeable future, as a secondary safeguard, in addition to successful vaccination. There are now an array of POC diagnostic tests to detect SARS-CoV-2, and here we summarize their salient features, and the potential utility as an infection control measure in dentistry.

CPD/Clinical Relevance: To describe the currently available POC diagnostic tests for COVID-19, and their utility as a critical infection control measure during dental care delivery in the immediate post-pandemic period.

Article

The COVID-19 pandemic, due to SARS-CoV-2, which began in late 2019, has virtually engulfed the whole world while incessantly spreading in some regions, and gradually receding in others. The morbidity and the mortality of the disease is breathtaking, and makes for grim reading with 179 million infections and 3.88 million deaths worldwide at the time of writing (July 2021).1 The miraculous production of effective and efficacious COVID-19 vaccines within the relatively short span of 1 year, and their prompt administration have curbed the viral spread in most regions. For instance, in the People's Republic of China, where up to a billion people have been vaccinated thus far, the disease has been virtually conquered, with sporadic pockets of resurgent infection. In other parts of the world such as the UK, Europe and USA the infection is slowly but surely receding.

Unfortunately, although there are many regions, particularly Asia, where COVID-19 is rampantly spreading with few signs of disease abeyance in the near future, particularly due to vaccine insufficiency, as well as the waves of infection and re-infection caused by periodically emerging viral variants. At the time of writing, four major SARS-CoV-2 variants, alpha (UK), beta (African), gamma (Brazilian) and delta (Indian) have been identified, and more appear to be on the way, as long as the pandemic persists in any region of the world.2 While most of the currently available COVID-19 vaccines are highly efficacious in preventing the infections due to the original strain of SARS-CoV-2, they are significantly less effective in preventing variant-induced disease.2 Such statistics and data are a clear indication of the chronic, and dogged ability of the virus to survive and circulate in the community for the next few years, at least.

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