SARS-CoV-2-Diagnostik – was ist wirklich sinnvoll?

Zusammenfassung

Den Goldstandard zur Diagnose einer Infektion mit SARS-CoV-2 stellt aktuell (Stand November 2020) die PCR-Untersuchung dar. Diese ist jedoch vor allem zeitintensiv. In Zukunft könnten sog. Antigentests schnell und patientennah als Point-of-Care-Methode durchgeführt werden, um die Diagnosestellung einer SARS-CoV-2 Infektion zu erleichtern. Veränderungen serologischer Biomarker (wie D-Dimere, Troponin T, CRP) können helfen, Patienten mit einem Risiko für einen schweren COVID-19-Verlauf zu identifizieren. Ein routinemäßiges Screening-CT-Thorax zur Identifizierung einer COVID-19-Pneumonie wird derzeit von den meisten radiologischen Gesellschaften nicht empfohlen. Dennoch nimmt die Zahl der durchgeführten CT-Untersuchungen kontinuierlich zu, und die radiologische Diagnostik nimmt bei an COVID-19 erkrankten Patienten mit pulmonalen Symptomen einen immer wichtigeren Stellenwert in der klinischen Erfassung der Schwere der Lungenbeteiligung ein.

Abstract

The PCR-test for SARS-CoV-2 represents the state of the art in diagnosing COVID-19 disease as at November 2020. However, above all this is time-consuming. In future, so-called antigen tests could be carried out quickly and as a point-of-care method to facilitate the diagnosis of COVID-19. Changes in serological biomarkers (such as D-dimers, troponin T, CRP) can help to identify patients at risk for a severe COVID-19 course. A routine screening CT thorax to identify COVID-19 pneumonia is currently not recommended by most radiological societies. However, the number of CT examinations is increasing steadily and radiological diagnosis in COVID-19 patients with pulmonary symptoms is becoming more and more important.

Was ist wichtig?

• Die PCR-Untersuchung auf SARS-CoV-2 stellt aktuell (Stand November 2020) den Goldstandard bei der Diagnosestellung einer COVID-19-Erkrankung dar.

• Aufgrund der kürzeren Testlaufzeiten und einfacheren Verwendung werden Antigentests in Zukunft an Bedeutung gewinnen.

• Eine rasche Diagnose der Infektion hilft, Infektionsketten zu durchbrechen und den Patienten eine Therapieoption anbieten zu können.

• Die radiologische Untersuchung beschränkt sich meist auf die Computertomografie (CT) des Thorax. Hier können sich bereits früh Zeichen einer COVID-19-Pneumonie zeigen. Zudem kann die CT helfen, den Schweregrad der Erkrankung abzuschätzen. Ein routinemäßiges Screening-CT-Thorax zur Identifizierung einer COVID-19-Pneumonie wird derzeit von den meisten radiologischen Gesellschaften nicht empfohlen [1].

Schlüsselwörter

COVID-19 - Diagnostik - PCR - Radiologie - CT - SARS-CoV-2

Key words

COVID-19 - diagnostic - PCR - radiology - CT - SARS-CoV-2

Publication History

Article published online:
21 January 2021

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