Generic placeholder image

Infectious Disorders - Drug Targets


ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Review Article

Diagnostic Stewardship in Times of COVID-19 Pandemic

Author(s): Lipika Singhal*, Ivneet Kour and Varsha Gupta

Volume 22, Issue 5, 2022

Published on: 08 April, 2022

Article ID: e270122200587 Pages: 5

DOI: 10.2174/1871526522666220127115718

Price: $65


A cluster of unknown acute pneumonia cases by a novel coronavirus signaled an outbreak in Wuhan province of China in December 2019. The World Health Organization (WHO) initially declared COVID-19 as the global public health emergency on 30th January 2020 and subsequently a pandemic on March 11, 2020. It was also stated that the spread of COVID-19 may be interrupted by early detection, isolation, prompt treatment, and the implementation of a robust system to trace contacts. Testing is a key strategy and the role of Diagnostic Stewardship (DS) is essential to allocate and engage the present as well as new testing resources strategically, effectively, efficiently, and safely. Thus, diagnostic stewardship aims to select the right test for the right patient, at the right time to generate accurate, clinically relevant results which will optimally influence better clinical care outcomes and will conserve the available health care resources.

Keywords: Diagnostic stewardship, molecular testing, artificial intelligence, biofire, next-generation sequencing, COVID-19.

Graphical Abstract
Lu H, Stratton CW, Tang Y-W. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. J Med Virol 2020; 92(4): 401-2.
[] [PMID: 31950516]
World Health Organization. Novel Coronavirus(2019-nCoV) Situation Report - 12. 2020.
Coronavirus disease (COVID-19) – World Health Organization. Available from:
Zhu N, Zhang D, Wang W, et al. China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382(8): 727-33.
[] [PMID: 31978945]
Backer JA, Klinkenberg D, Wallinga J. Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20-28 January 2020. Euro Surveill 2020; 25(5): 2000062.
[] [PMID: 32046819]
Lall M, Gupta A. Role of microbiology in diagnostic stewardship during the COVID-19 pandemic. MIMER Med J 2020; 4(1): 1-2.
Mercante G, Ferreli F, De Virgilio A, et al. Prevalence of taste and smell dysfunction in coronavirus disease 2019. JAMA Otolaryngol Head Neck Surg 2020; 146(8): 723-8.
[] [PMID: 32556070]
World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. Interim guidance. Pediatr Med Rodz 2020; 16(1): 9-26.
Global antimicrobial resistance and use surveillance system (GLASS). Available from:
Compendium of guidelines, instruction and standard operative procedures for COVID-19 Medical education and drugs department government of maharashtra In:. 2020; p. 3.
Lim J, Lee J. Current laboratory diagnosis of coronavirus disease 2019. Korean J Intern Med (Korean Assoc Intern Med) 2020; 35(4): 741-8.
[] [PMID: 32668512]
CDC. Interim laboratory biosafety guidelines for handling and processing specimens associated with coronavirus disease 2019 (COVID-19) [Internet]. Centers for disease control and prevention. 2020. Available from:
La Scola B, Le Bideau M, Andreani J, et al. Viral RNA load as determined by cell culture as a management tool for discharge of SARS-CoV-2 patients from infectious disease wards. Eur J Clin Microbiol Infect Dis 2020; 39(6): 1059-61.
[] [PMID: 32342252]
Singanayagam A, Patel M, Charlett A, et al. Duration of infectiousness and correlation with RT-PCR cycle threshold values in cases of COVID-19, England, January to May 2020. Euro Surveill 2020; 25(32): 2001483.
[] [PMID: 32794447]
Infectious diseases society of America guidelines on the diagnosis of COVID-19. Available from:
Indian council of medical research department of health research, ministry of health and family welfare, government of India. Performance evaluation of commercial kits for real time PCR for COVID by ICMR identified validation centres. 2020.
Gupta P. Why is SARS-CoV-2 testing not possible in every medical laboratory? Indian J Pathol Microbiol 2020; 63(2): 173-4.
[] [PMID: 32317510]
India M. Specimen referral form for COVID-19_SARS-CoV-2 testing: Ministry of health and family welfare. 2020. Available from:
ICMR issues guidance on rapid antibody test kits for COVID-19, lists manufacturers. 2020. Available from:
Emery SL, Erdman DD, Bowen MD, et al. Real-time reverse transcription-polymerase chain reaction assay for SARS-associated coronavirus. Emerg Infect Dis 2004; 10(2): 311-6.
[] [PMID: 15030703]
Malani A, Shah D, Kang G, et al. Seroprevalence of SARS-CoV-2 in slums versus non-slums in Mumbai, India. Lancet Glob Health 2021; 9(2): e110-1.
[] [PMID: 33197394]
Kumar MS, Bhatnagar T, Manickam P, et al. National sero-surveillance to monitor the trend of SARS-CoV-2 infection transmission in India: Protocol for community-based surveillance. Indian J Med Res 2020; 151(5): 419-23.
[] [PMID: 32611913]
Vaishya R, Javaid M, Khan IH, Haleem A. Artificial Intelligence (AI) applications for COVID-19 pandemic. Diabetes Metab Syndr 2020; 14(4): 337-9.
[] [PMID: 32305024]
Kamal Gulati. Artificial Intelligence (AI) applications for COVID-19 pandemic Covid vaccines. J microbial Immunol 2020; 5(5): 3.
Liotti FM, Menchinelli G, Marchetti S, et al. Evaluating the newly developed biofire COVID-19 test for SARS-CoV-2 molecular detection. Clin Microbiol Infect 2020; 26(12): 1699-700.
[] [PMID: 32735938]
Coronavirus (COVID-19) Update: FDA authorizes first next generation sequence test for diagnosing COVID-19. FDA. 2020. Available from:
Abd-Elsalam S, Ahmed OA, Mansour NO, et al. Remdesivir efficacy in COVID-19 treatment: A randomized controlled trial. Am J Trop Med Hyg 2021; tpmd210606.
[] [PMID: 34649223]
Efficacy of combined sofosbuvir and daclatasvir in the treatment of COVID-19 patients with pneumonia: A multicenter Egyptian study. Expert Rev Anti Infect Ther 2021; 20(2): 1-5.
Abd-Elsalam S, Noor RA, Badawi R, et al. Clinical study evaluating the efficacy of ivermectin in COVID-19 treatment: A randomized controlled study. J Med Virol 2021; 93(10): 5833-8.
[] [PMID: 34076901]
Dabbous HM, Abd-Elsalam S, El-Sayed MH, et al. Efficacy of favipiravir in COVID-19 treatment: A multi-center randomized study. Arch Virol 2021; 166(3): 949-54.
[] [PMID: 33492523]
Abd-Elsalam S, Soliman S, Esmail ES, et al. Do zinc supplements enhance the clinical efficacy of hydroxychloroquine?: A randomized, multicenter trial. Biol Trace Elem Res 2021; 199(10): 3642-6.
[] [PMID: 33247380]
Mohamed AA, Mohamed N, Mohamoud S, et al. SARS-CoV-2: The path of prevention and control. Infect Disord Drug Targets 2021; 21(3): 358-62.
[] [PMID: 32433010]

Rights & Permissions Print Export Cite as
© 2023 Bentham Science Publishers | Privacy Policy