EditorialCORONAVIRUS

Continuous on-body sensing for the COVID-19 pandemic: Gaps and opportunities

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Science Advances  02 Sep 2020:
Vol. 6, no. 36, eabd4794
DOI: 10.1126/sciadv.abd4794
Hyoyoung Jeong
John A. Rogers
Shuai Xu

INTRODUCTION

As of 20 June 2020, the Center for Disease Control’s tabulations show more than 2.2 million recorded cases of coronavirus disease 2019 (COVID-19) and nearly 120,000 in deaths in the United States (1). Infected patients present with a wide range of symptoms, from completely asymptomatic to rapidly progressive pneumonia leading to death. Rigorous and widespread testing remains a critical component of strategies for containing this pandemic. The limited availability of molecular diagnostics constrains the use of these technologies to those who present with disease. The current gold standards rely on detection of viral RNA, typically by reverse transcription polymerase chain reaction (RT-PCR), but these approaches, as commonly implemented, have notable disadvantages. First, the nasopharyngeal swab is uncomfortable and may not be tolerated well by all patients, particularly children or the elderly. Second, false-negative test results remain a significant concern, with some RT-PCR tests exhibiting false-negative rates as high as 29% (2). Third, swab samples must be collected by trained staff to avoid false negatives or inconclusive tests (3, 4). Fourth, samples must be transported via viral medium to centralized laboratory facilities, where transport delays from rural or remote areas can reach 48 hours or longer (5). Alternative tests based on antibodies offer some promise, but the appearance of antibodies [immunoglobulin M (IgM) and IgG] can lag weeks to months after the initial exposure (6). Furthermore, positive antibody titers may potentially only reflect prior exposure as opposed to protective immunity. Emerging evidence suggests that re-infection by endemic coronaviruses is not atypical, thereby adding complications to protocols for follow-up molecular testing (6, 7). The net result is a continuing gap between widespread population-level testing and the availability of tests that is likely to persist for the foreseeable future (811). These circumstances motivate the development of complementary technologies for …

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