COVID-19… Where are We in 2024?

Patients with SARS-CoV-2 infection may have mild to asymptomatic illness, but some rapidly progress to acute respiratory distress syndrome (ARDS), multiple organ dysfunction syndrome (MODS), and death. 7Less common symptoms include nasal congestion, sore throat, headache, hemoptysis, and diarrhea.Some patients have kidney injury and acute myocardial injury.Elderly patients and those with underlying comorbid conditions such as diabetes mellitus, hypertension, cardiovascular disease, chronic lung disease, chronic kidney disease, chronic liver disease, and obesity are at a higher risk.Patients with two or more comorbidities, superimposed with frailty, form the highest risk group.Laboratory findings are nonspecific but may include elevated C-reactive protein (CRP), decreased albumin, elevated erythrocyte sedimentation rate (ESR), eosinopenia, lymphopenia, and raised lactate dehydrogenase (LDH).Procalcitonin levels may be raised in the presence of secondary bacterial sepsis.Nucleic acid amplification testing (NAAT), most commonly with a reverse-transcription polymerase chain reaction (RT-PCR) assay, to detect SARS-CoV-2 RNA from clinical specimens/swabs is the preferred initial diagnostic test for COVID-19.RT-PCR can be performed on various types of samples, and the sensitivity of the test depends on the type of sample used for the test.Different types of samples used for NAAT are nasopharyngeal, oropharyngeal, saliva, sputum, lower respiratory samples such as tracheal aspirate or bronchoalveolar lavage (BAL) fluid.The primary and preferred sampling method is from the upper respiratory tract (throat) with or without accompanying nasopharyngeal swabs.The specificity of RT-PCR is very high, although it may result in false-positive results.On the contrary, the sensitivity of RT-PCR is estimated to be around 66-80%. 8 The antigen testing method may be used for initial screening, but as its sensitivity is lower than that of NAATs, a negative antigen test needs to be confirmed with NAAT."Loop-mediated isothermal amplification (LAMP)" technology has shown great potential with an estimated sensitivity of 97.5% and a specificity of 99.7%."Enhanced recombinase polymerase amplification (eRPA)" is more isothermal than other applications and 1-