Diagnosis of COVID-19

As of September 1, 2020, this article/literature list is no longer being actively updated.  If noteworthy studies are released in the future, those may be posted on a case-by-case basis. If you have any questions please contact Kaitlyn Sevarino at sevarino@aaos.org.

Under no circumstances should this list be viewed as AAOS concurring with or endorsing of the study findings, nor has AAOS conducted a systematic review of all surgical literature relevant to COVID-19. The study authors, designs, and data have not been assessed for risk of bias, quality, or accuracy, respectively. Healthcare providers should rely on their own clinical judgment in review and use of these materials.

  1. Lai CKC, Chen Z, Lui G, et al. Prospective study comparing deep-throat saliva with other respiratory tract specimens in the diagnosis of novel coronavirus disease (COVID-19). J Infect Dis.
  2. Li L, Qin L, Xu Z, et al. Using Artificial Intelligence to Detect COVID-19 and Community-acquired Pneumonia Based on Pulmonary CT: Evaluation of the Diagnostic Accuracy. 2020;296(2):E65-E71.
  3. Moreno-Contreras J, Espinoza MA, Sandoval-Jaime C, et al. Saliva sampling and its direct lysis, an excellent option to increase the number of SARS CoV2 diagnostic tests in settings with supply shortages. J Clin Microbiol.
  4. Shao JM, Ayuso SA, Deerenberg EB, Elhage SA, Augenstein V, Heniford BT. A Systematic Review of CT Chest in COVID-19 Diagnosis and its Potential Application in a Surgical Setting. Colorectal Dis.
  5. Pham VH, Gargiulo Isacco C, Nguyen KCD, et al. Rapid and sensitive diagnostic procedure for multiple detection of pandemic Coronaviridae family members SARS-CoV-2, SARS-CoV, MERS-CoV and HCoV: a translational research and cooperation between the Phan Chau Trinh University in Vietnam and University of Bari "Aldo Moro" in Italy. Eur Rev Med Pharmacol Sci. 2020;24(12):7173-7191.
  6. Sakagianni A, Feretzakis G, Kalles D, Koufopoulou C, Kaldis V. Setting up an Easy-to-Use Machine Learning Pipeline for Medical Decision Support: A Case Study for COVID-19 Diagnosis Based on Deep Learning with CT Scans. Stud Health Technol Inform. 2020;272:13-16.
  7. Steuwe A, Rademacher C, Valentin B, et al. Dose optimized chest CT for diagnosis of COVID-19 - Evaluation of the image quality and diagnostic impact. J Radiol Prot.
  8. Uchida K, Sekiguchi H, Higashiyama R, et al. Loop-Mediated Isothermal Amplification Screening for COVID-19 in Asymptomatic Preoperative Orthopedic Patients in a General Hospital in Kanagawa, Japan. 2020;12(7):e9331.
  9. S. Food and Drug Administration. Certain COVID-19 Serology/Antibody Tests Should Not Be Used: Letter to Clinical Laboratory Staff and Health Care Providers. 2020.
  10. Clementi N, Ferrarese R, Tonelli M, et al. Lower nasopharyngeal viral load during the latest phase of COVID-19 pandemic in a northern Italy university hospital. Clin Chem Lab Med.
  11. Kurstjens S, van der Horst A, Herpers R, et al. Rapid identification of SARS-CoV-2-infected patients at the emergency department using routine testing. Clin Chem Lab Med.
  12. Leung EC, Chow VC, Lee MK, Lai RW. Deep throat saliva as an alternative diagnostic specimen type for the detection of SARS-CoV-2. J Med Virol.
  13. Ortiz-Brizuela E, Villanueva-Reza M, González-Lara MF, et al. Clinical and epidemiological characteristics of patients diagnosed with COVID-19 in a tertiary care center in Mexico City: a prospective cohort study. Rev Invest Clin. 2020;72(3):165-177.
  14. Sapkal G, Shete-Aich A, Jain R, et al. Development of indigenous IgG ELISA for the detection of anti-SARS-CoV-2 IgG. Indian J Med Res. 2020;151(5):444-449.
  15. Callahan C, Lee R, Lee G, Zulauf KE, Kirby JE, Arnaout R. Nasal-Swab Testing Misses Patients with Low SARS-CoV-2 Viral Loads. 2020.
  16. Callaway M, Harden S, Ramsden W, et al. A national UK audit for diagnostic accuracy of preoperative CT chest in emergency and elective surgery during COVID-19 pandemic. Clin Radiol.
  17. Gruskay JA, Dvorzhinskiy A, Konnaris MA, et al. Universal Testing for COVID-19 in Essential Orthopaedic Surgery Reveals a High Percentage of Asymptomatic Infections. J Bone Joint Surg Am.
  18. Huang J, Zhao L. A high-throughput strategy for COVID-19 testing based on next-generation sequencing. 2020.
  19. Lan FY, Filler R, Mathew S, et al. COVID-19 symptoms predictive of healthcare workers' SARS-CoV-2 PCR results. PLoS One. 2020;15(6):e0235460.
  20. Lombardi A, Consonni D, Carugno M, et al. Characteristics of 1,573 healthcare workers who underwent nasopharyngeal swab for SARS-CoV-2 in Milano, Lombardy, Italy. Clin Microbiol Infect.
  21. Schmidt SB, Grüter L, Boltzmann M, Rollnik JD. Prevalence of serum IgG antibodies against SARS-CoV-2 among clinic staff. PLoS One. 2020;15(6):e0235417.
  22. Shashikumar SP, Wardi G, Paul P, et al. Development and Prospective Validation of a Transparent Deep Learning Algorithm for Predicting Need for Mechanical Ventilation. 2020.
  23. Song J, Wang H, Liu Y, et al. End-to-end automatic differentiation of the coronavirus disease 2019 (COVID-19) from viral pneumonia based on chest CT. Eur J Nucl Med Mol Imaging. 2020:1-9.
  24. Song Y, Ye Y, Su SH, et al. A Digital Protein Microarray for COVID-19 Cytokine Storm Monitoring. 2020.
  25. Torretta S, Zuccotti G, Cristofaro V, et al. Nonserologic test for COVID-19: How to manage? Head Neck.
  26. Wang C, Deng R, Gou L, et al. Preliminary study to identify severe from moderate cases of COVID-19 using combined hematology parameters. Ann Transl Med. 2020;8(9):593.
  27. Willette AA, Willette SA, Wang Q, et al. Antibody response to infectious diseases and other factors accurately predict COVID-19 infection and severity risk 10-14 years later: a retrospective UK Biobank cohort study. 2020.
  28. Yadaw AS, Li YC, Bose S, Iyengar R, Bunyavanich S, Pandey G. Clinical predictors of COVID-19 mortality. 2020.
  29. Hanson, K. E., Caliendo, A. M., Arias, C. A., Englund, J. A., Lee, M. J., Loeb, M., Patel, R., El Alayli, A., Kalot, M. A., Falck-Ytter, Y., Lavergne, V., Morgan, R. L., Murad, M. H., Sultan, S., Bhimraj, A., Mustafa, R. A. Infectious Diseases Society of America Guidelines on the Diagnosis of COVID-19. Clin Infect Dis 2020; 0:
  30. Huang, C., Wen, T., Shi, F. J., Zeng, X. Y., Jiao, Y. J. Rapid Detection of IgM Antibodies against the SARS-CoV-2 Virus via Colloidal Gold Nanoparticle-Based Lateral-Flow Assay. ACS Omega 2020; 21: 12550-12556
  31. Iglesias, H. A., Mira, B. E., Roura, P. A., Torres, A. H., Escudero, E. M., Mora, C. F., Bendicho, A. I., Docón, A. M., Peñaranda, C. G., Vázquez, E. G. Usefulness of the epidemiological survey and RT-PCR test in pre-surgical patients for assessing the risk of Covid-19. J Hosp Infect 2020; 0:
  32. "Centers for Disease Control and Prevention, Office of Infectious Diseases" Using Antibody Tests for COVID-19. 2020; 0:
  33. Adams, H. J. A., Kwee, T. C., Yakar, D., Hope, M. D., Kwee, R. M. Systematic Review and Meta-Analysis on the Value of Chest CT in the Diagnosis of Coronavirus Disease (COVID-19): Sol Scientiae, Illustra Nos. AJR Am J Roentgenol 2020; 0: 1-9
  34. Bar, S., Lecourtois, A., Diouf, M., Goldberg, E., Bourbon, C., Arnaud, E., Domisse, L., Dupont, H., Gosset, P. The association of lung ultrasound images with COVID-19 infection in an emergency room cohort. Anaesthesia 2020; 0:
  35. Bein, B., Bachmann, M., Huggett, S., Wegermann, P. SARS-CoV-2/COVID-19: Evidence-Based Recommendations on Diagnosis and Therapy. Geburtshilfe Frauenheilkd 2020; 5: 491-498
  36. Bosworth, A., Whalley, C., Poxon, C., Wanigasooriya, K., Pickles, O., Aldera, E. L., Papakonstantinou, D., Morley, G. L., Walker, E. M., Zielinska, A. E., McLoughlin, D., Webster, C., Plant, T., Ellis, A., Richter, A., Kidd, I. M., Beggs, A. D. Rapid implementation and validation of a cold-chain free SARS-CoV-2 diagnostic testing workflow to support surge capacity. J Clin Virol 2020; 0: 104469
  37. Choe, J. Y., Kim, J. W., Kwon, H. H., Hong, H. L., Jung, C. Y., Jeon, C. H., Park, E. J., Kim, S. K. Diagnostic performance of immunochromatography assay for rapid detection of IgM and IgG in coronavirus disease 2019. J Med Virol 2020; 0:
  38. Haehner, A., Draf, J., Dräger, S., de With, K., Hummel, T. Predictive Value of Sudden Olfactory Loss in the Diagnosis of COVID-19. ORL J Otorhinolaryngol Relat Spec 2020; 0: 1-6
  39. Huang, Z., Tian, D., Liu, Y., Lin, Z., Lyon, C. J., Lai, W., Fusco, D., Drouin, A., Yin, X., Hu, T., Ning, B. Ultra-sensitive and high-throughput CRISPR-p owered COVID-19 diagnosis. Biosensors and Bioelectronics 2020; 0:
  40. Kucirka, L. M., Lauer, S. A., Laeyendecker, O., Boon, D., Lessler, J. Variation in False-Negative Rate of Reverse Transcriptase Polymerase Chain Reaction-Based SARS-CoV-2 Tests by Time Since Exposure. Ann Intern Med 2020; 0:
  41. Pan, Yunbao, Ye, Guangming, Zeng, Xian-Tao, Liu, Guohong, Zeng, Xiaojiao, Jiang, Xianghu, Zhao, Jin, Chen, Liangjun, Guo, Shuang, Deng, Qiaoling, Hong, Xiaoyue, Yang, Ying, Li, Yirong, Wang, Xinghuan Can routine laboratory tests discriminate SARS-CoV-2 infected pneumonia from other causes of community acquired pneumonia?. Clinical and translational medicine 2020; 0:
  42. Sng, L. H., Arlany, L., Toh, L. C., Loo, T. Y., Ilzam, N. S., Wong, B. S. S., Lanca, L. Initial data from an experiment to implement a safe procedure to perform PA erect chest radiographs for COVID-19 patients with a mobile radiographic system in a "clean" zone of the hospital ward. Radiography (Lond) 2020; 0:
  43. Wang, L., Liu, Y., Zhang, T., Jiang, Y., Yang, S., Xu, Y., Song, R., Song, M., Wang, L., Zhang, W., Han, B., Yang, L., Fan, Y., Cheng, C., Wang, J., Xiang, P., Pu, L., Xiong, H., Li, C., Zhang, M., Tan, J., Chen, Z., Liu, J., Wang, X. Differentiating Between 2019 Novel Coronavirus Pneumonia and Influenza Using a Nonspecific Laboratory Marker-Based Dynamic Nomogram. Open Forum Infect Dis 2020; 5: ofaa169
  44. Das, K., Lee, E., Al Jawder, S., Enani, M., Singh, R., Skakni, L., . . . Larsson, S. (2015). Acute middle east respiratory syndrome coronavirus: Temporal lung changes observed on the chest radiographs of 55 patients. American Journal of Roentgenology, 205(3), W267-W274.
  45. Gombar, S., Chang, M., Hogan, C., Zehnder, J., Boyd, S., Pinsky, B., & Shah, N. (2020). Persistent detection of SARS-CoV-2 RNA in patients and healthcare workers with COVID-19. J Clin Virol, 129(0), 104477.
  46. Hernigou, J., Cornil, F., Poignard, A., El Bouchaibi, S., Mani, J., Naouri, J. F., Younes, P., Hernigou, P. Thoracic computerised tomography scans in one hundred eighteen orthopaedic patients during the COVID-19 pandemic: identification of chest lesions; added values; help in managing patients; burden on the computerised tomography scan department. Int Orthop 2020; 0:
  47. Tré-Hardy, M., Wilmet, A., Beukinga, I., Dogné, J., Douxfils, J., & Blairon, L. (2020). Validation of a chemiluminescent assay for specific SARS-CoV-2 antibody. Clin Chem Lab Med, 0(0).
  48. Wang, J., Cai, K., He, X., Shen, X., Liu, J., Xu, J., . . . Xu, W. (2020). Multiple-centre clinical evaluation of an ultrafast single-tube assay for SARS-CoV-2 RNA. Clinical Microbiology and Infection, 0(0).
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  50. Australian Government Coronavirus (COVID-19) Information on Work Attendance and Testing for Health and Residential Aged Care Workers. 2020; 0:
  51. Bai, H. X., Wang, R., Xiong, Z., Hsieh, B., Chang, K., Halsey, K., Tran, T. M. L., Choi, J. W., Wang, D. C., Shi, L. B., Mei, J., Jiang, X. L., Pan, I., Zeng, Q. H., Hu, P. F., Li, Y. H., Fu, F. X., Huang, R. Y., Sebro, R., Yu, Q. Z., Atalay, M. K., Liao, W. H. AI Augmentation of Radiologist Performance in Distinguishing COVID-19 from Pneumonia of Other Etiology on Chest CT. Radiology 2020; 0: 201491
  52. Bai, Tao, Tu, Shengjin, Wei, Yuan, Xiao, Li, Jin, Yan, Zhang, Lei, Song, Jun, Liu, Weihua, Zhu, Qingjing, Yang, Ling, Chen, Hua, Hou, Xiaohua Clinical and Laboratory Factors Predicting the Prognosis of Patients with COVID-19: An Analysis of 127 Patients in Wuhan, China. SSRN Electronic Journal 2020; 0:
  53. Begot, E., Prevel, R., Camou, F., Picard, W., Gisbert-Mora, C., Boyer, A., Gruson, D. Critically ill influenza patients-co-infections and cardiovascular events. Annals of Intensive Care 2019; 0:
  54. Callahan, C. J., Lee, R., Zulauf, K. E., Tamburello, L., Smith, K. P., Previtera, J., Cheng, A., Green, A., Azim, A. A., Yano, A., Doraiswami, N., Kirby, J. E., Arnaout, R. A. Open Development and Clinical Validation Of Multiple 3D-Printed Nasopharyngeal Collection Swabs: Rapid Resolution of a Critical COVID-19 Testing Bottleneck. J Clin Microbiol 2020; 0:
  55. Chu, D. K. W., Pan, Y., Cheng, S. M. S., Hui, K. P. Y., Krishnan, P., Liu, Y., Ng, D. Y. M., Wan, C. K. C., Yang, P., Wang, Q., Peiris, M., Poon, L. L. M. Molecular Diagnosis of a Novel Coronavirus (2019-nCoV) Causing an Outbreak of Pneumonia. Clin Chem 2020; 4: 549-555
  56. Corral, J. E., Hoogenboom, S. A., Kröner, P. T., Vazquez-Roque, M. I., Picco, M. F., Farraye, F. A., Wallace, M. B. COVID-19 polymerase chain reaction testing before endoscopy: an economic analysis. Gastrointest Endosc 2020; 0:
  57. Feng, Cong, Huang, Zhi, Wang, Lili, Chen, Xin, Zhai, Yongzhi, Zhu, Feng, Chen, Hua, Wang, Yingchan, Su, Xiangzheng, Huang, Sai, Tian, Lin, Zhu, Weixiu, Sun, Wenzheng, Zhang, Liping, Han, Qingru, Zhang, Juan, Pan, Fei, Chen, Li, Zhu, Zhihong, Xiao, Hongju, Liu, Yu, Liu, Gang, Chen, Wei, Li, Tanshi A Novel Triage Tool of Artificial Intelligence Assisted Diagnosis Aid System for Suspected COVID-19 Pneumonia in Fever Clinics. medRxiv 2020; 0:
  58. Infantino, M., Grossi, V., Lari, B., Bambi, R., Perri, A., Manneschi, M., Terenzi, G., Liotti, I., Ciotta, G., Taddei, C., Benucci, M., Casprini, P., Veneziani, F., Fabbri, S., Pompetti, A., Manfredi, M. Diagnostic accuracy of an automated chemiluminescent immunoassay for anti-SARS-CoV-2 IgM and IgG antibodies: an Italian experience. J Med Virol 2020; 0:
  59. Keeley, A. J., Evans, C., Colton, H., Ankcorn, M., Cope, A., State, A., Bennett, T., Giri, P., de Silva, T. I., Raza, M. Roll-out of SARS-CoV-2 testing for healthcare workers at a large NHS Foundation Trust in the United Kingdom, March 2020. Euro Surveill 2020; 14:
  60. Lechner, M., Chandrasekharan, D., Jumani, K., Liu, J., Gane, S., Lund, V. J., Philpott, C., Jayaraj, S. Anosmia as a presenting symptom of SARS-CoV-2 infection in healthcare workers - A systematic review of the literature, case series, and recommendations for clinical assessment and management. Rhinology 2020; 0:
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  62. Liu, R., Han, H., Liu, F., Lv, Z., Wu, K., Liu, Y., Feng, Y., Zhu, C. Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan, China, from Jan to Feb 2020. Clin Chim Acta 2020; 0: 172-175
  63. Liu, Yingxia, Zhang, Cong, Huang, Fengming, Yang, Yang, Wang, Fuxiang, Yuan, Jing, Zhang, Zheng, Qin, Yuhao, Li, Xiaoyun, Zhao, Dandan, Li, Shunwang, Tan, Shuguang, Wang, Zhaoqin, Li, Jinxiu, Shen, Chenguang, Li, Jianming, Peng, Ling, Wu, Weibo, Cao, Mengli, Xing, Li, Xu, Zhixiang, Chen, Li, Zhou, Congzhao, Liu, William J., Liu, Lei, Jiang, Chengyu Elevated plasma level of selective cytokines in COVID-19 patients reflect viral load and lung injury. National Science Review 2020; 0:
  64. Luo, L., Luo, Z., Jia, Y., Zhou, C., He, J., Lyu, J., Shen, X. CT differential diagnosis of COVID-19 and non-COVID-19 in symptomatic suspects: a practical scoring method. BMC Pulm Med 2020; 1: 129
  65. Murphy, K., Smits, H., Knoops, A. J. G., Korst, Mbjm, Samson, T., Scholten, E. T., Schalekamp, S., Schaefer-Prokop, C. M., Philipsen, Rhhm, Meijers, A., Melendez, J., van Ginneken, B., Rutten, M. COVID-19 on the Chest Radiograph: A Multi-Reader Evaluation of an AI System. Radiology 2020; 0: 201874
  66. Pan, Yunbao, Ye, Guangming, Zeng, Xian-Tao, Liu, Guohong, Zeng, Xiaojiao, Jiang, Xianghu, Zhao, Jin, Chen, Liangjun, Guo, Shuang, Deng, Qiaoling, Hong, Xiaoyue, Yang, Ying, Li, Yirong, Wang, Xinghuan Can routine laboratory tests discriminate SARS-CoV-2 infected pneumonia from other causes of community acquired pneumonia?. Clinical and translational medicine 2020; 0:
  67. Rhoads, D. D., Cherian, S. S., Roman, K., Stempak, L. M., Schmotzer, C. L., Sadri, N. Comparison of Abbott ID Now, Diasorin Simplexa, and CDC FDA EUA methods for the detection of SARS-CoV-2 from nasopharyngeal and nasal swabs from individuals diagnosed with COVID-19. J Clin Microbiol 2020; 0:
  68. Roland, L. T., Gurrola, J. G., 2nd, Loftus, P. A., Cheung, S. W., Chang, J. L. Smell and taste symptom-based predictive model for COVID-19 diagnosis. Int Forum Allergy Rhinol 2020; 0:
  69. Rubin, G. D., Ryerson, C. J., Haramati, L. B., Sverzellati, N., Kanne, J. P., Raoof, S., Schluger, N. W., Volpi, A., Yim, J. J., Martin, I. B. K., Anderson, D. J., Kong, C., Altes, T., Bush, A., Desai, S. R., Goldin, J., Goo, J. M., Humbert, M., Inoue, Y., Kauczor, H. U., Luo, F., Mazzone, P. J., Prokop, M., Remy-Jardin, M., Richeldi, L., Schaefer-Prokop, C. M., Tomiyama, N., Wells, A. U., Leung, A. N. The Role of Chest Imaging in Patient Management during the COVID-19 Pandemic: A Multinational Consensus Statement from the Fleischner Society. Chest 2020; 0:
  70. Sun, L., Liu, G., Song, F., Shi, N., Liu, F., Li, S., Li, P., Zhang, W., Jiang, X., Zhang, Y., Sun, L., Chen, X., Shi, Y. Combination of four clinical indicators predicts the severe/critical symptom of patients infected COVID-19. J Clin Virol 2020; 0: 104431
  71. Tostmann, A., Bradley, J., Bousema, T., Yiek, W. K., Holwerda, M., Bleeker-Rovers, C., Ten Oever, J., Meijer, C., Rahamat-Langendoen, J., Hopman, J., van der Geest-Blankert, N., Wertheim, H. Strong associations and moderate predictive value of early symptoms for SARS-CoV-2 test positivity among healthcare workers, the Netherlands, March 2020. Euro Surveill 2020; 16:
  72. Ucar, F., Korkmaz, D. COVIDiagnosis-Net: Deep Bayes-SqueezeNet based diagnosis of the coronavirus disease 2019 (COVID-19) from X-ray images. Med Hypotheses 2020; 0: 109761
  73. Victor Okhuese, A. Estimation of the Probability of Reinfection With COVID-19 by the Susceptible-Exposed-Infectious-Removed-Undetectable-Susceptible Model. JMIR Public Health Surveill 2020; 2: e19097
  74. Wacharapluesadee, S., Kaewpom, T., Ampoot, W., Ghai, S., Khamhang, W., Worachotsueptrakun, K., Wanthong, P., Nopvichai, C., Supharatpariyakorn, T., Putcharoen, O., Paitoonpong, L., Suwanpimolkul, G., Jantarabenjakul, W., Hemachudha, P., Krichphiphat, A., Buathong, R., Plipat, T., Hemachudha, T. Evaluating the efficiency of specimen pooling for PCR-based detection of COVID-19. J Med Virol 2020; 0:
  75. Wan, D. Y., Luo, X. Y., Dong, W., Zhang, Z. W. Current practice and potential strategy in diagnosing COVID-19. Eur Rev Med Pharmacol Sci 2020; 8: 4548-4553
  76. Yang, S., Jiang, L., Cao, Z., Wang, L., Cao, J., Feng, R., Zhang, Z., Xue, X., Shi, Y., Shan, F. Deep learning for detecting corona virus disease 2019 (COVID-19) on high-resolution computed tomography: a pilot study. Ann Transl Med 2020; 7: 450
  77. Yang, Y., Shen, C., Li, J., Yuan, J., Wei, J., Huang, F., Wang, F., Li, G., Li, Y., Xing, L., Peng, L., Yang, M., Cao, M., Zheng, H., Wu, W., Zou, R., Li, D., Xu, Z., Wang, H., Zhang, M., Zhang, Z., Gao, G. F., Jiang, C., Liu, L., Liu, Y. Plasma IP-10 and MCP-3 levels are highly associated with disease severity and predict the progression of COVID-19. J Allergy Clin Immunol 2020; 0: