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Manten K, Katzenschlager S, Brümmer LE, Schmitz S, Gaeddert M, Erdmann C, Grilli M, Pollock NR, Macé A, Erkosar B, Carmona S, Ongarello S, Johnson CC, Sacks JA, Faehling V, Bornemann L, Weigand MA, Denkinger CM, Yerlikaya S. Clinical accuracy of instrument-based SARS-CoV-2 antigen diagnostic tests: a systematic review and meta-analysis. Virol J 2024; 21:99. [PMID: 38685117 PMCID: PMC11059670 DOI: 10.1186/s12985-024-02371-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, antigen diagnostic tests were frequently used for screening, triage, and diagnosis. Novel instrument-based antigen tests (iAg tests) hold the promise of outperforming their instrument-free, visually-read counterparts. Here, we provide a systematic review and meta-analysis of the SARS-CoV-2 iAg tests' clinical accuracy. METHODS We systematically searched MEDLINE (via PubMed), Web of Science, medRxiv, and bioRxiv for articles published before November 7th, 2022, evaluating the accuracy of iAg tests for SARS-CoV-2 detection. We performed a random effects meta-analysis to estimate sensitivity and specificity and used the QUADAS-2 tool to assess study quality and risk of bias. Sub-group analysis was conducted based on Ct value range, IFU-conformity, age, symptom presence and duration, and the variant of concern. RESULTS We screened the titles and abstracts of 20,431 articles and included 114 publications that fulfilled the inclusion criteria. Additionally, we incorporated three articles sourced from the FIND website, totaling 117 studies encompassing 95,181 individuals, which evaluated the clinical accuracy of 24 commercial COVID-19 iAg tests. The studies varied in risk of bias but showed high applicability. Of 24 iAg tests from 99 studies assessed in the meta-analysis, the pooled sensitivity and specificity compared to molecular testing of a paired NP swab sample were 76.7% (95% CI 73.5 to 79.7) and 98.4% (95% CI 98.0 to 98.7), respectively. Higher sensitivity was noted in individuals with high viral load (99.6% [95% CI 96.8 to 100] at Ct-level ≤ 20) and within the first week of symptom onset (84.6% [95% CI 78.2 to 89.3]), but did not differ between tests conducted as per manufacturer's instructions and those conducted differently, or between point-of-care and lab-based testing. CONCLUSION Overall, iAg tests have a high pooled specificity but a moderate pooled sensitivity, according to our analysis. The pooled sensitivity increases with lower Ct-values (a proxy for viral load), or within the first week of symptom onset, enabling reliable identification of most COVID-19 cases and highlighting the importance of context in test selection. The study underscores the need for careful evaluation considering performance variations and operational features of iAg tests.
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Affiliation(s)
- Katharina Manten
- Department of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Stephan Katzenschlager
- Department of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - Lukas E Brümmer
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Stephani Schmitz
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
- Department of Developmental Biology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Mary Gaeddert
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Maurizio Grilli
- Library, University Medical Center Mannheim, Mannheim, Germany
| | - Nira R Pollock
- Department of Laboratory Medicine, Boston Children's Hospital, Boston, MA, USA
| | | | | | | | | | - Cheryl C Johnson
- Global HIV, Hepatitis and STIs Programmes, World Health Organization, Geneva, Switzerland
| | - Jilian A Sacks
- Department of Epidemic and Pandemic Preparedness and Prevention, World Health Organization, Geneva, Switzerland
| | - Verena Faehling
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Linus Bornemann
- Institute of Virology, Faculty of Medicine, University Medical Centre, University of Freiburg, Freiburg, Germany
| | - Markus A Weigand
- Department of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - Claudia M Denkinger
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
- German Center for Infection Research (DZIF), partner site Heidelberg University Hospital, Heidelberg, Germany
| | - Seda Yerlikaya
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany.
- German Center for Infection Research (DZIF), partner site Heidelberg University Hospital, Heidelberg, Germany.
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Ryan F, Cole-Hamilton J, Dandamudi N, Futschik ME, Needham A, Saquib R, Kulasegaran-Shylini R, Blandford E, Kidd M, O'Moore É, Hall I, Sudhanva M, Klapper P, Dodgson A, Moore A, Duke M, Tunkel S, Kenny C, Fowler T. Faster detection of asymptomatic COVID-19 cases among care home staff in England through the combination of SARS-CoV-2 testing technologies. Sci Rep 2024; 14:7475. [PMID: 38553484 PMCID: PMC10980794 DOI: 10.1038/s41598-024-57817-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 03/21/2024] [Indexed: 04/02/2024] Open
Abstract
To detect SARS-CoV-2 amongst asymptomatic care home staff in England, a dual-technology weekly testing regime was introduced on 23 December 2020. A lateral flow device (LFD) and quantitative reverse transcription polymerase chain reaction (qRT-PCR) test were taken on the same day (day 0) and a midweek LFD test was taken three to four days later. We evaluated the effectiveness of using dual-technology to detect SARS-CoV-2 between December 2020 to April 2021. Viral concentrations derived from qRT-PCR were used to determine the probable stage of infection and likely level of infectiousness. Day 0 PCR detected 1,493 cases of COVID-19, of which 53% were in the early stages of infection with little to no risk of transmission. Day 0 LFD detected 83% of cases that were highly likely to be infectious. On average, LFD results were received 46.3 h earlier than PCR, enabling removal of likely infectious staff from the workplace quicker than by weekly PCR alone. Demonstrating the rapidity of LFDs to detect highly infectious cases could be combined with the ability of PCR to detect cases in the very early stages of infection. In practice, asymptomatic care home staff were removed from the workplace earlier, breaking potential chains of transmission.
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Affiliation(s)
- Finola Ryan
- Public Health and Clinical Oversight (PHCO), Clinical and Public Health Group, UK Health Security Agency, 10 South Colonade, Canary Wharf, London, E14 4PU, UK
- King's College Hospital NHS Foundation Trust, London, UK
- Division of Surgery & Interventional Science, University College London, London, UK
| | - Joanna Cole-Hamilton
- Public Health and Clinical Oversight (PHCO), Clinical and Public Health Group, UK Health Security Agency, 10 South Colonade, Canary Wharf, London, E14 4PU, UK
| | - Niharika Dandamudi
- Public Health and Clinical Oversight (PHCO), Clinical and Public Health Group, UK Health Security Agency, 10 South Colonade, Canary Wharf, London, E14 4PU, UK
| | - Matthias E Futschik
- Public Health and Clinical Oversight (PHCO), Clinical and Public Health Group, UK Health Security Agency, 10 South Colonade, Canary Wharf, London, E14 4PU, UK
- School of Biomedical Sciences, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Alexander Needham
- Public Health and Clinical Oversight (PHCO), Clinical and Public Health Group, UK Health Security Agency, 10 South Colonade, Canary Wharf, London, E14 4PU, UK
| | - Rida Saquib
- Public Health and Clinical Oversight (PHCO), Clinical and Public Health Group, UK Health Security Agency, 10 South Colonade, Canary Wharf, London, E14 4PU, UK
| | - Raghavendran Kulasegaran-Shylini
- Public Health and Clinical Oversight (PHCO), Clinical and Public Health Group, UK Health Security Agency, 10 South Colonade, Canary Wharf, London, E14 4PU, UK
| | - Edward Blandford
- Public Health and Clinical Oversight (PHCO), Clinical and Public Health Group, UK Health Security Agency, 10 South Colonade, Canary Wharf, London, E14 4PU, UK
| | | | - Éamonn O'Moore
- National Health Protection Office, HSE, Dublin, D01 A4A3, Ireland
| | - Ian Hall
- Department of Mathematics, The University of Manchester, Manchester, UK
- Advanced Analytics, Analytics & Data Science, UK Health Security Agency, London, UK
| | - Malur Sudhanva
- Public Health and Clinical Oversight (PHCO), Clinical and Public Health Group, UK Health Security Agency, 10 South Colonade, Canary Wharf, London, E14 4PU, UK
- King's College Hospital NHS Foundation Trust, London, UK
| | - Paul Klapper
- Public Health and Clinical Oversight (PHCO), Clinical and Public Health Group, UK Health Security Agency, 10 South Colonade, Canary Wharf, London, E14 4PU, UK
- Clinical Virology, Division of Evolution, Infections and Genomics, University of Manchester, Manchester, UK
| | - Andrew Dodgson
- Public Health and Clinical Oversight (PHCO), Clinical and Public Health Group, UK Health Security Agency, 10 South Colonade, Canary Wharf, London, E14 4PU, UK
| | - Adam Moore
- Operational Policy, UK Health Security Agency, London, UK
| | - Madeleine Duke
- Operational Policy, UK Health Security Agency, London, UK
| | - Sarah Tunkel
- Public Health and Clinical Oversight (PHCO), Clinical and Public Health Group, UK Health Security Agency, 10 South Colonade, Canary Wharf, London, E14 4PU, UK
| | - Chris Kenny
- Public Health and Clinical Oversight (PHCO), Clinical and Public Health Group, UK Health Security Agency, 10 South Colonade, Canary Wharf, London, E14 4PU, UK
| | - Tom Fowler
- Public Health and Clinical Oversight (PHCO), Clinical and Public Health Group, UK Health Security Agency, 10 South Colonade, Canary Wharf, London, E14 4PU, UK.
- Queen Mary University of London William Harvey Research Institute, London, UK.
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3
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Matsumura Y, Noguchi T, Shinohara K, Yamamoto M, Nagao M. Development and evaluation of three automated media pooling and molecular diagnostic systems for the detection of SARS-CoV-2. Microbiol Spectr 2024; 12:e0368423. [PMID: 38289934 PMCID: PMC10913432 DOI: 10.1128/spectrum.03684-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/22/2023] [Indexed: 02/01/2024] Open
Abstract
Pooled testing combined with molecular diagnostics for the detection of SARS-CoV-2 is a promising method that can increase testing capacities and save costs. However, pooled testing is also associated with the risks of decreased test sensitivity and specificity. To perform reliable pooled testing, we developed and validated three automated media pooling and molecular diagnostic systems. These pooling systems (geneLEAD-PS, Panther-PS, and Biomek-PS) comprised existing automated molecular detection platforms, corresponding automated media pooling devices, and laboratory information management systems. Analytical sensitivity analysis and mock sample evaluation were performed, and the obtained data were used to determine the sizes of the pool for the validation study. In the validation study, a total of 2,448, 3,228, and 6,420 upper respiratory samples were used for geneLEAD-PS, Panther-PS, and Biomek-PS, respectively, and the diagnostic performances were compared with the reference RT‒PCR assay. A pool size of 6 for geneLEAD-PS and a pool size of 4 for Panther-PS and Biomek-PS were selected for the validation studies. All three systems showed high positive percent agreement values of ≥90.5% and negative percent agreement values of ≥99.8% for any specimen type. Pooled testing resulted in a 65%-71% reduction in cost per sample. The testing capacities of geneLEAD-PS, Panther-PS, and Biomek-PS were 144 samples in 3 hours, 384 samples in 5.5 hours, and 376 samples in 4 hours, respectively. The developed pooling systems showed robust diagnostic performances and will increase the testing capacities of molecular diagnostic tests while saving costs and may contribute to infection control of COVID-19.IMPORTANCEDuring the COVID-19 pandemic, there have been surges in demand for accurate molecular diagnostic testing and laboratory supply shortages. Pooled testing combined with highly sensitive molecular testing, which entails mixing multiple samples as a single sample, is a promising approach to increase testing capacities while reducing the use of consumables. However, pooled testing is associated with risks that compromise diagnostic performance, such as false negatives due to dilution of positive samples or false positives due to cross-contamination. To perform reliable pooled testing, three different pooling systems (an automated pooling device, an automated molecular detection platform, and a laboratory information management system) were developed to accurately interpret pooled testing results. These three systems were validated using multiple clinical samples and showed high concordance with individual testing. The developed pooling systems will contribute to increasing reliable molecular testing capacities while using fewer consumables and saving costs.
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Affiliation(s)
- Yasufumi Matsumura
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Taro Noguchi
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Koh Shinohara
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masaki Yamamoto
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Miki Nagao
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Lu J, Butler-Wu SM. Home and Clinical Laboratory Improvement Amendments-Waived Testing for Infectious Diseases-How Do These Fit in the Testing Landscape? Clin Lab Med 2024; 44:13-21. [PMID: 38280794 DOI: 10.1016/j.cll.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2024]
Abstract
Though testing for infectious diseases has long been performed in traditional clincial laboratory settings, more widespread availability of waived testing is expanding accessibility of patients to rapid test results. This is being further expanded to home testing. Nevertheless, with this greater democratization and availability of clinical testing there are important limitations that need to be balanced. In this article, we review the current test landscape for infectious diseases waived testing and opportunities for assuring optimal quality testing.
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Affiliation(s)
- Jacky Lu
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA
| | - Susan M Butler-Wu
- Department of Pathology, Keck School of Medicine of the University of Southern California, HMR 211, 2011 Zonal Avenue, Los Angeles, CA 90033, USA.
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Bresser M, Erhardt RM, Shanaube K, Simwinga M, Mahlatsi PA, Belus J, Schaap A, Amstutz A, Gachie T, Glass TR, Kangololo B, ’Mota J, Floyd S, Katende B, Klinkenberg E, Ayles H, Reither K, Ruperez M. Evaluation of COVID-19 antigen rapid diagnostic tests for self-testing in Lesotho and Zambia. PLoS One 2024; 19:e0280105. [PMID: 38422077 PMCID: PMC10903820 DOI: 10.1371/journal.pone.0280105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 09/01/2023] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION The use of antigen rapid tests (Ag-RDTs) for self-testing is an important element of the COVID-19 control strategy and has been widely supported. However, scale-up of self-testing for COVID-19 in sub-Saharan Africa is still insufficient and there is limited evidence on the acceptability of self-testing and agreement between Ag-RDT self-testing and Ag-RDT testing by professional users. A joint collaboration (Botnar Research Centre for Child Health-European & Developing countries Clinical Trials Partnership)was established between Lesotho and Zambia to address these gaps in relation to Ag-RDT self-testing and contribute to increasing its use in the region. METHODS A cross-sectional study was conducted with qualitative and quantitative data analysis. Firstly, 14 in-depth cognitive interviews (5 in Zambia and 9 in Lesotho) were performed to assess the participants' understanding of the instructions for use (IFU) for self-testing. In a second step, evaluation of test agreement between Ag-RDT self-testing and Ag-RDT testing by professional user using SD Biosensor STANDARD Q COVID-19 Ag-RDT was performed. In Zambia, usability and acceptability of self-testing were also assessed. RESULTS Cognitive interviews in Lesotho and Zambia showed overall good understanding of IFU. In Zambia, acceptability of self-testing was high, though some participants had difficulties in conducting certain steps in the IFU correctly. Agreement between Ag-RDT self-test and Ag-RDT by professional users in Lesotho (428 participants) and Zambia (1136 participants) was high, 97.3% (403/414, 95% CI: 95.3-98.7) and 99.8% (1116/1118, 95% CI: 99.4-100) respectively. CONCLUSION Findings from this study support the use of Ag-RDT self-testing within COVID-19 control strategies in sub-Saharan Africa, contributing to increase the testing capacity and access in hard-to reach settings.
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Affiliation(s)
- Moniek Bresser
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Rahel Milena Erhardt
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | | | | | | | - Jennifer Belus
- University of Basel, Basel, Switzerland
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Albertus Schaap
- Zambart, University of Zambia, Lusaka, Zambia
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Alain Amstutz
- University of Basel, Basel, Switzerland
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Thomas Gachie
- Zambart, University of Zambia, Lusaka, Zambia
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Tracy Renée Glass
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | | | - John ’Mota
- SolidarMed, Partnerships for Health, Maseru, Lesotho
| | - Sian Floyd
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Eveline Klinkenberg
- London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Global Health and Amsterdam Institute for Global Health and Development, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Helen Ayles
- Zambart, University of Zambia, Lusaka, Zambia
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Klaus Reither
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Maria Ruperez
- London School of Hygiene & Tropical Medicine, London, United Kingdom
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Pannipulath Venugopal V, Babu Saheer L, Maktabdar Oghaz M. COVID-19 lateral flow test image classification using deep CNN and StyleGAN2. Front Artif Intell 2024; 6:1235204. [PMID: 38348096 PMCID: PMC10860423 DOI: 10.3389/frai.2023.1235204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/28/2023] [Indexed: 02/15/2024] Open
Abstract
Introduction Artificial intelligence (AI) in healthcare can enhance clinical workflows and diagnoses, particularly in large-scale operations like COVID-19 mass testing. This study presents a deep Convolutional Neural Network (CNN) model for automated COVID-19 RATD image classification. Methods To address the absence of a RATD image dataset, we crowdsourced 900 real-world images focusing on positive and negative cases. Rigorous data augmentation and StyleGAN2-ADA generated simulated images to overcome dataset limitations and class imbalances. Results The best CNN model achieved a 93% validation accuracy. Test accuracies were 88% for simulated datasets and 82% for real datasets. Augmenting simulated images during training did not significantly improve real-world test image performance but enhanced simulated test image performance. Discussion The findings of this study highlight the potential of the developed model in expediting COVID-19 testing processes and facilitating large-scale testing and tracking systems. The study also underscores the challenges in designing and developing such models, emphasizing the importance of addressing dataset limitations and class imbalances. Conclusion This research contributes to the deployment of large-scale testing and tracking systems, offering insights into the potential applications of AI in mitigating outbreaks similar to COVID-19. Future work could focus on refining the model and exploring its adaptability to other healthcare scenarios.
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Affiliation(s)
| | - Lakshmi Babu Saheer
- School of Computing and Information Science, Anglia Ruskin University, Cambridge, United Kingdom
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7
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Zapico SC, Roca G. Making the Most of Lateral Flow Immunochromatographic Tests: An Efficient Protocol to Recover DNA. Methods Protoc 2024; 7:8. [PMID: 38251201 PMCID: PMC10801598 DOI: 10.3390/mps7010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
Lateral flow immunochromatographic (LFI) tests are widely used in both biomedical and forensic sciences for different applications. In forensic sciences, their main use is to detect body fluids at crime scenes. However, there are situations in which the amount of potential biological evidence is so low that DNA extraction is favored with respect to the identification of body fluids. Here, an efficient and quick protocol is presented to integrate the detection of body fluids through LFI with DNA extraction from a sample swab and buffer, providing a complete characterization of the biological evidence. This protocol is a modification of a general DNA extraction silica-based kit, whose main application is for blood and tissues. Thus, it could be carried out in different settings (forensic labs, hospitals, other testing labs) without the necessity of buying a specific kit for swabs. The validation of this protocol is supported by the results presented here and previous publications from our group, obtaining DNA in good quantity and with good quality. This proves the potential application of the protocol in both forensic scenarios, to fully characterize biological evidence, and biomedical settings, to molecularly confirm the results of LFI tests.
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Affiliation(s)
- Sara C. Zapico
- Department of Chemistry and Environmental Science, New Jersey Institute of Technology, Newark, NJ 07102, USA
- Anthropology Department and Laboratories of Analytical Biology, National Museum of Natural History, Smithsonian Institution, Washington, DC 20560, USA
| | - Gabriela Roca
- SERATEC Gesellschaft für Biotechnologie mbH, 37079 Göttingen, Germany;
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Liu Y, Li Y, Hang Y, Wang L, Wang J, Bao N, Kim Y, Jang HW. Rapid assays of SARS-CoV-2 virus and noble biosensors by nanomaterials. NANO CONVERGENCE 2024; 11:2. [PMID: 38190075 PMCID: PMC10774473 DOI: 10.1186/s40580-023-00408-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024]
Abstract
The COVID-19 outbreak caused by SARS-CoV-2 in late 2019 has spread rapidly across the world to form a global epidemic of respiratory infectious diseases. Increased investigations on diagnostic tools are currently implemented to assist rapid identification of the virus because mass and rapid diagnosis might be the best way to prevent the outbreak of the virus. This critical review discusses the detection principles, fabrication techniques, and applications on the rapid detection of SARS-CoV-2 with three categories: rapid nuclear acid augmentation test, rapid immunoassay test and biosensors. Special efforts were put on enhancement of nanomaterials on biosensors for rapid, sensitive, and low-cost diagnostics of SARS-CoV-2 virus. Future developments are suggested regarding potential candidates in hospitals, clinics and laboratories for control and prevention of large-scale epidemic.
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Affiliation(s)
- Yang Liu
- School of Public Health, Nantong University, Nantong, 226019, Jiangsu, People's Republic of China
- Department of Materials Science and Engineering, Research Institute of Advanced Materials, Seoul National University, Seoul, 08826, Republic of Korea
- NantongEgens Biotechnology Co., LTD, Nantong, 226019, Jiangsu, People's Republic of China
| | - Yilong Li
- School of Public Health, Nantong University, Nantong, 226019, Jiangsu, People's Republic of China
| | - Yuteng Hang
- School of Public Health, Nantong University, Nantong, 226019, Jiangsu, People's Republic of China
| | - Lei Wang
- NantongEgens Biotechnology Co., LTD, Nantong, 226019, Jiangsu, People's Republic of China
| | - Jinghan Wang
- Department of Materials Science and Engineering, Research Institute of Advanced Materials, Seoul National University, Seoul, 08826, Republic of Korea
| | - Ning Bao
- School of Public Health, Nantong University, Nantong, 226019, Jiangsu, People's Republic of China
| | - Youngeun Kim
- Department of Materials Science and Engineering, Research Institute of Advanced Materials, Seoul National University, Seoul, 08826, Republic of Korea.
| | - Ho Won Jang
- Department of Materials Science and Engineering, Research Institute of Advanced Materials, Seoul National University, Seoul, 08826, Republic of Korea.
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Pohanka M. Current trends in digital camera-based bioassays for point-of-care tests. Clin Chim Acta 2024; 552:117677. [PMID: 38000459 DOI: 10.1016/j.cca.2023.117677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023]
Abstract
Point-of-care and bedside tests are analytical devices suitable for a growing role in the current healthcare system and provide the opportunity to achieve an exact diagnosis by an untrained person and in various conditions and sites where it is necessary. Using a digital camera integrated into a well-accessible device like a smartphone brings a new way in which a colorimetric point-of-care diagnostic test can provide unbiased data. This review summarizes basic facts about the colorimetric point-of-care tests, principles of how to use a portable device with a camera in the assay, applications of digital cameras for the current tests, and new devices described in the recent papers. An overview of the recent literature and a discussion of recent developments and future trends are provided.
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Affiliation(s)
- Miroslav Pohanka
- Faculty of Military Health Sciences, University of Defense, Trebesska 1575, Hradec Kralove CZ-50001, Czech Republic.
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10
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Cunningham N, Hopkins S. Lessons identified for a future pandemic. J Antimicrob Chemother 2023; 78:ii43-ii49. [PMID: 37995355 PMCID: PMC10666982 DOI: 10.1093/jac/dkad310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
Abstract
Pandemics are complex events requiring a coordinated, global response. The response to the pandemic exposed vulnerabilities in system preparedness. Lessons arising from the COVID-19 pandemic are characterized by four broad themes: (i) investment in public health and health infrastructure, (ii) countermeasures (medical and non-medical), (iii) risk communication and public health measures and (iv) investment in people and partnerships. Learning from the COVID-19 pandemic identifies an approach that focusses on capacities and capabilities that are pathogen agnostic, ensuring that we can respond to diverse emerging infectious disease threats will be essential. The lessons learned from previous and ongoing infectious disease outbreaks should be kept under constant review, in line with technological and scientific advances, to improve our ability to detect, mitigate and respond to new and emerging threats.
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Affiliation(s)
- Neil Cunningham
- Clinical and Public Health Group, United Kingdom Health Security Agency (UKHSA), London, UK
| | - Susan Hopkins
- Clinical and Public Health Group, United Kingdom Health Security Agency (UKHSA), London, UK
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Shaver N, Bennett A, Beck A, Vyas N, Zitiktye G, Lam E, Whelan B, O'Regan R, Conway A, Skidmore B, Moher D, Little J. Performance of different rapid antigen testing strategies for SARS-CoV-2: A living rapid review. Eur J Clin Invest 2023; 53:e14058. [PMID: 37424144 DOI: 10.1111/eci.14058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/08/2023] [Accepted: 06/20/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Rapid antigen detection tests (RADTs) for SARS-CoV-2 testing offer several advantages over molecular tests, but there is little evidence supporting an ideal testing algorithm. We aimed to examine the diagnostic test accuracy (DTA) and the effectiveness of different RADT SARS-CoV-2 testing strategies. METHODS Following PRISMA DTA guidance, we carried out a living rapid review and meta-analysis. Searches were conducted in Ovid MEDLINE® ALL, Embase and Cochrane CENTRAL electronic databases until February 2022. Results were visualized using forest plots and included in random-effects univariate meta-analyses, where eligible. RESULTS After screening 8010 records, 18 studies were included. Only one study provided data on incidence outcomes. Seventeen studies were DTA reports with direct comparisons of RADT strategies, using RT-PCR as the reference standard. Testing settings varied, corresponding to original SARS-CoV-2 or early variants. Strategies included differences in serial testing, the individual collecting swabs and swab sample locations. Overall, specificity remained high (>98%) across strategies. Although results were heterogeneous, the sensitivity for healthcare worker-collected samples was greater than for self-collected samples. Nasal samples had comparable sensitivity when compared to paired RADTs with nasopharyngeal samples, but sensitivity was much lower for saliva samples. The limited evidence for serial testing suggested higher sensitivity if RADTs were administered every 3 days compared to less frequent testing. CONCLUSIONS Additional high-quality research is needed to confirm our findings; all studies were judged to be at risk of bias, with significant heterogeneity in sensitivity estimates. Evaluations of testing algorithms in real-world settings are recommended, especially for transmission and incidence outcomes.
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Affiliation(s)
- Nicole Shaver
- Knowledge Synthesis and Application Unit, Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Alexandria Bennett
- Knowledge Synthesis and Application Unit, Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Andrew Beck
- Knowledge Synthesis and Application Unit, Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Niyati Vyas
- Knowledge Synthesis and Application Unit, Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Eric Lam
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Barbara Whelan
- Evidence Synthesis Ireland & Cochrane Ireland, School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Rhea O'Regan
- Evidence Synthesis Ireland & Cochrane Ireland, School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Aileen Conway
- Evidence Synthesis Ireland & Cochrane Ireland, School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Becky Skidmore
- Independent Information Specialist, Ottawa, Ontario, Canada
| | - David Moher
- Knowledge Synthesis and Application Unit, Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Julian Little
- Knowledge Synthesis and Application Unit, Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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12
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Walter J, Eludin Z, Drabovich AP. Redefining serological diagnostics with immunoaffinity proteomics. Clin Proteomics 2023; 20:42. [PMID: 37821808 PMCID: PMC10568870 DOI: 10.1186/s12014-023-09431-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/19/2023] [Indexed: 10/13/2023] Open
Abstract
Serological diagnostics is generally defined as the detection of specific human immunoglobulins developed against viral, bacterial, or parasitic diseases. Serological tests facilitate the detection of past infections, evaluate immune status, and provide prognostic information. Serological assays were traditionally implemented as indirect immunoassays, and their design has not changed for decades. The advantages of straightforward setup and manufacturing, analytical sensitivity and specificity, affordability, and high-throughput measurements were accompanied by limitations such as semi-quantitative measurements, lack of universal reference standards, potential cross-reactivity, and challenges with multiplexing the complete panel of human immunoglobulin isotypes and subclasses. Redesign of conventional serological tests to include multiplex quantification of immunoglobulin isotypes and subclasses, utilize universal reference standards, and minimize cross-reactivity and non-specific binding will facilitate the development of assays with higher diagnostic specificity. Improved serological assays with higher diagnostic specificity will enable screenings of asymptomatic populations and may provide earlier detection of infectious diseases, autoimmune disorders, and cancer. In this review, we present the major clinical needs for serological diagnostics, overview conventional immunoassay detection techniques, present the emerging immunoassay detection technologies, and discuss in detail the advantages and limitations of mass spectrometry and immunoaffinity proteomics for serological diagnostics. Finally, we explore the design of novel immunoaffinity-proteomic assays to evaluate cell-mediated immunity and advance the sequencing of clinically relevant immunoglobulins.
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Affiliation(s)
- Jonathan Walter
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, 10-102 Clinical Sciences Building, Edmonton, AB, T6G 2G3, Canada
| | - Zicki Eludin
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, 10-102 Clinical Sciences Building, Edmonton, AB, T6G 2G3, Canada
| | - Andrei P Drabovich
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, 10-102 Clinical Sciences Building, Edmonton, AB, T6G 2G3, Canada.
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13
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Papamatthaiou S, Boxall-Clasby J, Douglas EJA, Jajesniak P, Peyret H, Mercer-Chalmers J, Kumar VKS, Lomonossoff GP, Reboud J, Laabei M, Cooper JM, Kasprzyk-Hordern B, Moschou D. LoCKAmp: lab-on-PCB technology for <3 minute virus genetic detection. LAB ON A CHIP 2023; 23:4400-4412. [PMID: 37740394 PMCID: PMC10563828 DOI: 10.1039/d3lc00441d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/02/2023] [Indexed: 09/24/2023]
Abstract
The recent COVID-19 outbreak highlighted the need for lab-on-chip diagnostic technology fit for real-life deployment in the field. Existing bottlenecks in multistep analytical microsystem integration and upscalable, standardized fabrication techniques delayed the large-scale deployment of lab-on-chip solutions during the outbreak, throughout a global diagnostic test shortage. This study presents a technology that has the potential to address these issues by redeploying and repurposing the ubiquitous printed circuit board (PCB) technology and manufacturing infrastructure. We demonstrate the first commercially manufactured, miniaturised lab-on-PCB device for loop-mediated isothermal amplification (LAMP) genetic detection of SARS-CoV-2. The system incorporates a mass-manufactured, continuous-flow PCB chip with ultra-low cost fluorescent detection circuitry, rendering it the only continuous-flow μLAMP platform with off-the-shelf optical detection components. Ultrafast, SARS-CoV-2 RNA amplification in wastewater samples was demonstrated within 2 min analysis, at concentrations as low as 17 gc μL-1. We further demonstrate our device operation by detecting SARS-CoV-2 in 20 human nasopharyngeal swab samples, without the need for any RNA extraction or purification. This renders the presented miniaturised nucleic-acid amplification-based diagnostic test the fastest reported SARS-CoV-2 genetic detection platform, in a practical implementation suitable for deployment in the field. This technology can be readily extended to the detection of alternative pathogens or genetic targets for a very broad range of applications and matrices. LoCKAmp lab-on-PCB chips are currently mass-manufactured in a commercial, ISO-compliant PCB factory, at a small-scale production cost of £2.50 per chip. Thus, with this work, we demonstrate a high technology-readiness-level lab-on-chip-based genetic detection system, successfully benchmarked against standard analytical techniques both for wastewater and nasopharyngeal swab SARS-CoV-2 detection.
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Affiliation(s)
- Sotirios Papamatthaiou
- Department of Electronic and Electrical Engineering, University of Bath, Bath BA2 7AY, UK.
| | | | | | - Pawel Jajesniak
- Division of Biomedical Engineering, James Watt School of Engineering, University of Glasgow, Glasgow, UK
| | - Hadrien Peyret
- Department of Biochemistry and Metabolism, John Innes Centre, Norwich Research Park, Colney, NR4 7UH, UK
| | - June Mercer-Chalmers
- Department of Electronic and Electrical Engineering, University of Bath, Bath BA2 7AY, UK.
| | - Varun K S Kumar
- Department of Electronic and Electrical Engineering, University of Bath, Bath BA2 7AY, UK.
| | - George P Lomonossoff
- Department of Biochemistry and Metabolism, John Innes Centre, Norwich Research Park, Colney, NR4 7UH, UK
| | - Julien Reboud
- Division of Biomedical Engineering, James Watt School of Engineering, University of Glasgow, Glasgow, UK
| | - Maisem Laabei
- Department of Life Sciences, University of Bath, Bath BA2 7AY, UK
| | - Jonathan M Cooper
- Division of Biomedical Engineering, James Watt School of Engineering, University of Glasgow, Glasgow, UK
| | | | - Despina Moschou
- Department of Electronic and Electrical Engineering, University of Bath, Bath BA2 7AY, UK.
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14
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Liu S, Hou Y, Li Z, Yang C, Liu G. μPADs on Centrifugal Microfluidic Discs for Rapid Sample-to-Answer Salivary Diagnostics. ACS Sens 2023; 8:3520-3529. [PMID: 37669403 DOI: 10.1021/acssensors.3c01093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
A fully integrated device for salivary detection with a sample-in-answer-out fashion is critical for noninvasive point-of-care testing (POCT), especially for the screening of contagious disease infection. Microfluidic paper-based analytical devices (μPADs) have demonstrated their huge potential in POCT due to their low cost and easy adaptation with other components. This study developed a generic POCT platform by integrating a centrifugal microfluidic disc with μPADs to realize sample-to-answer salivary diagnostics. Specifically, a custom centrifugal microfluidic disc integrated with μPADs is fabricated, which demonstrated a high efficiency in saliva treatment. To demonstrate the capability of the integrated device for salivary analysis, the SARS-CoV-2 Nucleocapsid (N) protein, a reliable biomarker for SARS-CoV-2 acute infection, is used as the model analyte. By the chemical treatment of the μPAD surface, and by optimizing the protein immobilization conditions, the on-disc μPADs were able to detect the SARS-CoV-2 N protein down to 10 pg mL-1 with a dynamic range of 10-1000 pg mL-1 and an assay time of 8 min. The integrated device was successfully used for the quantification of the N protein of pseudovirus in saliva with high specificity and demonstrated a comparable performance to the commercial paper lateral flow assay test strips.
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Affiliation(s)
- Shixian Liu
- CUHK(SZ)-Boyalife Joint Laboratory of Regenerative Medicine Engineering, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
- Ciechanover Institute of Precision and Regenerative Medicine, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
| | - Yuting Hou
- CUHK(SZ)-Boyalife Joint Laboratory of Regenerative Medicine Engineering, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
- Ciechanover Institute of Precision and Regenerative Medicine, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
| | - Zirui Li
- CUHK(SZ)-Boyalife Joint Laboratory of Regenerative Medicine Engineering, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
- Ciechanover Institute of Precision and Regenerative Medicine, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
| | - Chenyu Yang
- CUHK(SZ)-Boyalife Joint Laboratory of Regenerative Medicine Engineering, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
- Ciechanover Institute of Precision and Regenerative Medicine, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
| | - Guozhen Liu
- CUHK(SZ)-Boyalife Joint Laboratory of Regenerative Medicine Engineering, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
- Ciechanover Institute of Precision and Regenerative Medicine, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
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15
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Wallace S, Kartau M, Kakkar T, Davis C, Szemiel A, Samardzhieva I, Vijayakrishnan S, Cole S, De Lorenzo G, Maillart E, Gautier K, Lapthorn AJ, Patel AH, Gadegaard N, Kadodwala M, Hutchinson E, Karimullah AS. Multiplexed Biosensing of Proteins and Virions with Disposable Plasmonic Assays. ACS Sens 2023; 8:3338-3348. [PMID: 37610841 PMCID: PMC10521139 DOI: 10.1021/acssensors.2c02238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 08/08/2023] [Indexed: 08/25/2023]
Abstract
Our growing ability to tailor healthcare to the needs of individuals has the potential to transform clinical treatment. However, the measurement of multiple biomarkers to inform clinical decisions requires rapid, effective, and affordable diagnostics. Chronic diseases and rapidly evolving pathogens in a larger population have also escalated the need for improved diagnostic capabilities. Current chemical diagnostics are often performed in centralized facilities and are still dependent on multiple steps, molecular labeling, and detailed analysis, causing the result turnaround time to be over hours and days. Rapid diagnostic kits based on lateral flow devices can return results quickly but are only capable of detecting a handful of pathogens or markers. Herein, we present the use of disposable plasmonics with chiroptical nanostructures as a platform for low-cost, label-free optical biosensing with multiplexing and without the need for flow systems often required in current optical biosensors. We showcase the detection of SARS-CoV-2 in complex media as well as an assay for the Norovirus and Zika virus as an early developmental milestone toward high-throughput, single-step diagnostic kits for differential diagnosis of multiple respiratory viruses and any other emerging diagnostic needs. Diagnostics based on this platform, which we term "disposable plasmonics assays," would be suitable for low-cost screening of multiple pathogens or biomarkers in a near-point-of-care setting.
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Affiliation(s)
- Stephanie Wallace
- School of Chemistry, University of Glasgow, Joseph Black Building, University Avenue, G12 8QQ Glasgow, U.K
| | - Martin Kartau
- School of Chemistry, University of Glasgow, Joseph Black Building, University Avenue, G12 8QQ Glasgow, U.K
| | - Tarun Kakkar
- School of Chemistry, University of Glasgow, Joseph Black Building, University Avenue, G12 8QQ Glasgow, U.K
| | - Chris Davis
- MRC-University of Glasgow Centre for Virus Research, 464 Bearsden Road, G61 1QH Glasgow, U.K
| | - Agnieszka Szemiel
- MRC-University of Glasgow Centre for Virus Research, 464 Bearsden Road, G61 1QH Glasgow, U.K
| | - Iliyana Samardzhieva
- School of Chemistry, University of Glasgow, Joseph Black Building, University Avenue, G12 8QQ Glasgow, U.K
| | - Swetha Vijayakrishnan
- MRC-University of Glasgow Centre for Virus Research, 464 Bearsden Road, G61 1QH Glasgow, U.K
| | - Sarah Cole
- MRC-University of Glasgow Centre for Virus Research, 464 Bearsden Road, G61 1QH Glasgow, U.K
| | - Giuditta De Lorenzo
- MRC-University of Glasgow Centre for Virus Research, 464 Bearsden Road, G61 1QH Glasgow, U.K
| | - Emmanuel Maillart
- HORIBA France SAS, 14, Boulevard Thomas Gobert-Passage Jobin Yvon, CS 45002, 91120 Palaiseau, France
| | - Kevin Gautier
- School of Chemistry, University of Glasgow, Joseph Black Building, University Avenue, G12 8QQ Glasgow, U.K
| | - Adrian J Lapthorn
- School of Chemistry, University of Glasgow, Joseph Black Building, University Avenue, G12 8QQ Glasgow, U.K
| | - Arvind H Patel
- MRC-University of Glasgow Centre for Virus Research, 464 Bearsden Road, G61 1QH Glasgow, U.K
| | - Nikolaj Gadegaard
- James Watt School of Engineering, University of Glasgow, Rankine Building, Oakfield Avenue, G12 8LT Glasgow, U.K
| | - Malcolm Kadodwala
- School of Chemistry, University of Glasgow, Joseph Black Building, University Avenue, G12 8QQ Glasgow, U.K
| | - Edward Hutchinson
- MRC-University of Glasgow Centre for Virus Research, 464 Bearsden Road, G61 1QH Glasgow, U.K
| | - Affar S Karimullah
- School of Chemistry, University of Glasgow, Joseph Black Building, University Avenue, G12 8QQ Glasgow, U.K
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16
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van der Feltz S, Schlünssen V, Basinas I, Begtrup LM, Burdorf A, Bonde JPE, Flachs EM, Peters S, Pronk A, Stokholm ZA, van Tongeren M, van Veldhoven K, Oude Hengel KM, Kolstad HA. Associations between an international COVID-19 job exposure matrix and SARS-CoV-2 infection among 2 million workers in Denmark. Scand J Work Environ Health 2023; 49:375-385. [PMID: 37167299 PMCID: PMC10790132 DOI: 10.5271/sjweh.4099] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVES This study investigates the associations between the Danish version of a job exposure matrix for COVID-19 (COVID-19-JEM) and Danish register-based SARS-CoV-2 infection information across three waves of the pandemic. The COVID-19-JEM consists of four dimensions on transmission: two on mitigation measures, and two on precarious work characteristics. METHODS The study comprised 2 021 309 persons from the Danish working population between 26 February 2020 and 15 December 2021. Logistic regression models were applied to assess the associations between the JEM dimensions and overall score and SARS-CoV-2 infection across three infection waves, with peaks in March-April 2020, December-January 2021, and February-March 2022. Sex, age, household income, country of birth, wave, residential region and during wave 3 vaccination status were accounted for. RESULTS Higher risk scores within the transmission and mitigation dimensions and the overall JEM score resulted in higher odds ratios (OR) of a SARS-CoV-2 infection. OR attenuated across the three waves with ranges of 1.08-5.09 in wave 1, 1.06-1.60 in wave 2, and 1.05-1.45 in those not (fully) vaccinated in wave 3. In wave 3, no associations were found for those fully vaccinated. In all waves, the two precarious work dimensions showed weaker or inversed associations. CONCLUSIONS The COVID-19-JEM is a promising tool for assessing occupational exposure to SARS-CoV-2 and other airborne infectious agents that mainly spread between people who are in close contact with each other. However, its usefulness depends on applied restrictions and the vaccination status in the population of interest.
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Affiliation(s)
- Sophie van der Feltz
- Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Palle Juul-Jensens Boulevard 35, 8200 Aarhus N, Denmark.
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17
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Hogg C, Boots S, Howorth D, Williams C, Heginbothom M, Salmon J, Howe R. Test performance of lateral flow rapid antigen tests for COVID-19 in Welsh adult care home staff using routine surveillance data. PLoS One 2023; 18:e0290406. [PMID: 37611000 PMCID: PMC10446167 DOI: 10.1371/journal.pone.0290406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/07/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Lateral flow tests (LFTs) have been used to screen for SARS-CoV2 in Wales since January 2021. Between May and August 2021, adult care home staff policy was for biweekly Innova LFT and weekly Polymerase Chain Reaction (PCR) testing while asymptomatic. We estimated test performance of LFTs conducted in adult care home staff using PCR tests as a reference standard. METHODS Test results from surveillance data were matched by individual where both LFT and PCR were taken on the same day. We calculated sensitivity, specificity, positive and negative predictive values, and agreement using Matthew's correlation coefficient. Ct values of positive PCR results were compared by matched LFT result. Analysis was conducted using R v4.1.3. RESULTS We analysed 115,593 test pairs, 499 (0.43%) of which were PCR positive. Median age was 48 (IQR: 22) and 85.00% of the study population were female. Test result agreement was 99.59% (95%CI 99.55-99.63; MCC: 0.38, p<0.001). Sensitivity and specificity were 25.65% (95%CI 22.02-29.67) and 99.91% (95%CI 99.89-99.93), respectively. PPV was 55.90% (95%CI 49.42-62.17) and NPV was 99.68% (95%CI 99.64-99.71). Crude Ct values were significantly lower in positive PCR tests matched to a positive LFT compared to a negative LFT. CONCLUSIONS Specificity and negative predictive value were high in an asymptomatic population of care home staff indicating this test is an effective tool for identifying cases of SARS-CoV-2 infection during periods of high prevalence where transmission is likely, due to the presence of high viral loads. Positive predictive value results are lower than existing literature yet should be considered in light of the asymptomatic study population and low prevalence (under 1%) at the time most of these tests were conducted. Performance improved at times of higher prevalence during the study. These results suggest that whilst lateral flow tests are effective for identifying SARS-COV-2 infections with high viral loads, they are not effective at identifying cases with a low viral load. When an LFT provides a negative result, false negatives should be considered and additional diagnostic tests performed.
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Affiliation(s)
- Craig Hogg
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, Wales, United Kingdom
| | - Sian Boots
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, Wales, United Kingdom
| | - Daniel Howorth
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, Wales, United Kingdom
| | - Christopher Williams
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, Wales, United Kingdom
| | - Margaret Heginbothom
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, Wales, United Kingdom
| | - Jane Salmon
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, Wales, United Kingdom
| | - Robin Howe
- Public Health Wales Microbiology, Cardiff, Wales, United Kingdom
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18
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Lin PC, Huang CJ, Lu YM, Huang HL, Wu ZY, Chang CC, Chu FY. Diagnostic performance of GenBody COVID-19 rapid antigen test for laboratory and non-laboratory medical professionals in real practice: A retrospective study. Medicine (Baltimore) 2023; 102:e34927. [PMID: 37603502 PMCID: PMC10443765 DOI: 10.1097/md.0000000000034927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/03/2023] [Indexed: 08/23/2023] Open
Abstract
Point-of-care tests for coronavirus disease 2019 (COVID-19) antigen detection have been widely used for rapid diagnosis in various settings. However, research on the diagnostic performance of the COVID-19 antigen test performed by non-laboratory personnel is limited. In this study, we aimed to elucidate the diagnostic performance of GenBody COVID-19 rapid antigen between laboratory professionals and non-laboratory staff. We retrospectively analyzed the data of patients who underwent both GenBody COVID-19 rapid antigen testing and reverse transcription polymerase chain reaction (RT-PCR) between November 01, 2021, and June 30, 2022. The diagnostic performance of the antigen test was compared between laboratory and non-laboratory operators, using RT-PCR as the gold standard. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, positive predictive value, negative predictive value, and accuracy were calculated and sensitivity analysis was performed based on the PCR cycle threshold (Ct) value. Of the 11,963 patients, 1273 (10.6%) tested positive using real-time RT-PCR. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, positive predictive value, negative predictive value, and accuracy of the GenBody COVID-19 rapid antigen test with 95% confidence interval were 79.92% (77.26%-82.39%), 99.23% (98.73%-99.57%), 103.25 (62.31-171.11), 0.2 (0.18-0.23), 510.18 (299.81-868.18), 98.11% (96.91%-98.85%), 90.75% (89.64%-91.75%) and 92.76% (91.76%-93.67%), respectively, for non-laboratory staff and 79.80% (74.78%-84.22%), 99.99% (99.94%-100.00%), 6983.92 (983.03-49617.00), 0.2 (0.16-0.25), 34566.45 (4770.30-250474.46) 99.58% (97.09%-99.94%), 99.32% (99.15%-99.46%), and 99.33% (99.13%-99.48%), respectively, for laboratory staff. Notably, when the PCR Ct value exceeded 25, the sensitivity of both the groups decreased to < 40%. The diagnostic performance of GenBody COVID-19 rapid antigen performed by non-laboratory staff was comparable to that of laboratory professionals. However, it should be noted that the sensitivity of the antigen tests decreased when the PCR Ct value exceeded 25. Overall, the GenBody COVID-19 antigen test is a viable option for non-laboratory staff during an epidemic.
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Affiliation(s)
- Pei-Chin Lin
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chun-Jung Huang
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yen-Ming Lu
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Huei-Ling Huang
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Zong-Ying Wu
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chih-Chun Chang
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Yilan, Taiwan
| | - Fang-Yeh Chu
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan City, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Yuanpei University of Medical Technology, Hsinchu City, Taiwan
- School of Medical Laboratory Science and Biotechnology, Taipei Medical University, Taipei City, Taiwan
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19
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Natu R, Herbertson L, Sena G, Strachan K, Guha S. A Systematic Analysis of Recent Technology Trends of Microfluidic Medical Devices in the United States. MICROMACHINES 2023; 14:1293. [PMID: 37512604 PMCID: PMC10384103 DOI: 10.3390/mi14071293] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/14/2023] [Accepted: 06/16/2023] [Indexed: 07/30/2023]
Abstract
In recent years, the U.S. Food and Drug Administration (FDA) has seen an increase in microfluidic medical device submissions, likely stemming from recent advancements in microfluidic technologies. This recent trend has only been enhanced during the COVID-19 pandemic, as microfluidic-based test kits have been used for diagnosis. To better understand the implications of this emerging technology, device submissions to the FDA from 2015 to 2021 containing microfluidic technologies have been systematically reviewed to identify trends in microfluidic medical applications, performance tests, standards used, fabrication techniques, materials, and flow systems. More than 80% of devices with microfluidic platforms were found to be diagnostic in nature, with lateral flow systems accounting for about 35% of all identified microfluidic devices. A targeted analysis of over 40,000 adverse event reports linked to microfluidic technologies revealed that flow, operation, and data output related failures are the most common failure modes for these device types. Lastly, this paper highlights key considerations for developing new protocols for various microfluidic applications that use certain analytes (e.g., blood, urine, nasal-pharyngeal swab), materials, flow, and detection mechanisms. We anticipate that these considerations would help facilitate innovation in microfluidic-based medical devices.
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Affiliation(s)
- Rucha Natu
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Silver Spring, MD 20993, USA
| | - Luke Herbertson
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Silver Spring, MD 20993, USA
| | - Grazziela Sena
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Silver Spring, MD 20993, USA
| | - Kate Strachan
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Silver Spring, MD 20993, USA
| | - Suvajyoti Guha
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Silver Spring, MD 20993, USA
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20
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Kinnamon DS, Heggestad JT, Liu J, Nguyen T, Ly V, Hucknall AM, Fontes CM, Britton RJ, Cai JP, Chan JFW, Yuen KY, Le T, Chilkoti A. Environmentally Resilient Microfluidic Point-of-Care Immunoassay Enables Rapid Diagnosis of Talaromycosis. ACS Sens 2023; 8:2228-2236. [PMID: 37279466 PMCID: PMC10449026 DOI: 10.1021/acssensors.3c00209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Point-of-care tests (POCTs) are increasingly being used in field settings, particularly outdoors. The performance of current POCTs─most commonly the lateral flow immunoassay─can be adversely affected by ambient temperature and humidity. We developed a self-contained immunoassay platform─the D4 POCT─that can be conducted at the POC by integrating all reagents in a capillary-driven passive microfluidic cassette that minimizes user intervention. The assay can be imaged and analyzed on a portable fluorescence reader─the D4Scope─and provide quantitative outputs. Here, we systematically investigated the resilience of our D4 POCT to varied temperature and humidity and to physiologically diverse human whole blood samples that span a wide range of physiological hematocrit (30-65%). For all conditions, we showed that the platform maintained high sensitivity (0.05-0.41 ng/mL limits of detection). The platform also demonstrated good accuracy in reporting true analyte concentration across environmental extremes when compared to the manually operated format of the same test to detect a model analyte─ovalbumin. Additionally, we engineered an improved version of the microfluidic cassette that improved the ease-of-use of the device and shortened the time-to-result. We implemented this new cassette to create a rapid diagnostic test to detect talaromycosis infection in patients with advanced HIV disease at the POC, demonstrating comparable sensitivity and specificity to the laboratory test for the disease.
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Affiliation(s)
- David S Kinnamon
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina 27708, United States
| | - Jacob T Heggestad
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina 27708, United States
| | - Jason Liu
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina 27708, United States
| | - Thu Nguyen
- Division of Infectious Diseases and International Health, Duke University School of Medicine, Durham, North Carolina 27708, United States
| | - Vo Ly
- Hospital for Tropical Disease, Ho Chi Minh City 73009, Vietnam
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 72714, Vietnam
| | - Angus M Hucknall
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina 27708, United States
| | - Cassio M Fontes
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina 27708, United States
| | - Rhett J Britton
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina 27708, United States
| | - Jian-Piao Cai
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam 000000, Hong Kong
| | - Jasper Fuk-Woo Chan
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam 000000, Hong Kong
- Hainan Medical University─The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Haikou 571101, Hainan, China
| | - Kwok-Yung Yuen
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam 000000, Hong Kong
- Hainan Medical University─The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Haikou 571101, Hainan, China
| | - Thuy Le
- Division of Infectious Diseases and International Health, Duke University School of Medicine, Durham, North Carolina 27708, United States
| | - Ashutosh Chilkoti
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina 27708, United States
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21
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Fittall M, Liu J, Platt J, Ionescu M, Sheehan R, Johal S, Mew R, Clark J, Watts I, Tripathy A, Little M, Patel G, Panneerselvam H, Appanna N, Burke E, McKenzie H, Tilby M, Khan S, Lee LYW. The National COVID Cancer Antibody Survey: a hyper-accelerated study proof of principle for cancer research. Br J Cancer 2023; 128:1977-1980. [PMID: 37081188 PMCID: PMC10118226 DOI: 10.1038/s41416-023-02251-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/05/2023] [Accepted: 03/20/2023] [Indexed: 04/22/2023] Open
Abstract
The COVID-19 pandemic has led to a range of novel and adaptive research designs. In this perspective, we use our experience coordinating the National COVID Cancer Antibody Survey to demonstrate how a balance between speed and integrity can be achieved within a hyper-accelerated study design. Using the COVID-19 pandemic as an example, we show this approach is necessary in the face of uncertain and evolving situations wherein reliable information is needed in a timely fashion to guide policy. We identify streamlined participant involvement, healthcare systems integration, data architecture and real-world real-time analytics as key areas that differentiate this design from traditional cancer trials, and enable rapid results. Caution needs to be taken to avoid the exclusion of patient subgroups without digital access or literacy. We summarise the merits and defining features of hyper-accelerated cancer studies.
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Affiliation(s)
- Matthew Fittall
- Cancer Institute, University College London, London, WC1E 6DD, UK
| | - Justin Liu
- Leeds Institute of Medical Research, University of Leeds, Leeds, LS9 7TF, UK
| | - James Platt
- Leeds Institute of Medical Research, University of Leeds, Leeds, LS9 7TF, UK
| | - Maria Ionescu
- UK Health Security Agency, Fleetbank House, London, EC4Y 8AE, UK
| | | | | | - Rosie Mew
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, EX2 5DW, UK
| | - James Clark
- Oxford University Hospitals, Oxford, OX3 9DU, UK
| | - Izzy Watts
- University College Hospitals NHS Foundation Trust, London, NW1 2PG, UK
| | - Arvind Tripathy
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, ST4 6QG, UK
| | | | - Grisma Patel
- Maidstone and Tunbridge Wells NHS Trust, Kent, TN2 4QJ, UK
| | | | | | - Emma Burke
- Oxford University Hospitals, Oxford, OX3 9DU, UK
| | - Hayley McKenzie
- University Hospital Southampton NHS Foundation Trust, Hampshire, SO16 6YD, UK
| | - Michael Tilby
- University Hospital Coventry, UHCW NHS Trust, Coventry, CV2 2DX, UK
| | - Sam Khan
- University of Leicester, Leicester, LE1 7RH, UK
| | - Lennard Y W Lee
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, EX2 5DW, UK.
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22
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Whitfield CA, van Tongeren M, Han Y, Wei H, Daniels S, Regan M, Denning DW, Verma A, Pellis L, Hall I. Modelling the impact of non-pharmaceutical interventions on workplace transmission of SARS-CoV-2 in the home-delivery sector. PLoS One 2023; 18:e0284805. [PMID: 37146037 PMCID: PMC10162531 DOI: 10.1371/journal.pone.0284805] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 04/06/2023] [Indexed: 05/07/2023] Open
Abstract
OBJECTIVE We aimed to use mathematical models of SARS-COV-2 to assess the potential efficacy of non-pharmaceutical interventions on transmission in the parcel delivery and logistics sector. METHODS We devloped a network-based model of workplace contacts based on data and consultations from companies in the parcel delivery and logistics sectors. We used these in stochastic simulations of disease transmission to predict the probability of workplace outbreaks in this settings. Individuals in the model have different viral load trajectories based on SARS-CoV-2 in-host dynamics, which couple to their infectiousness and test positive probability over time, in order to determine the impact of testing and isolation measures. RESULTS The baseline model (without any interventions) showed different workplace infection rates for staff in different job roles. Based on our assumptions of contact patterns in the parcel delivery work setting we found that when a delivery driver was the index case, on average they infect only 0.14 other employees, while for warehouse and office workers this went up to 0.65 and 2.24 respectively. In the LIDD setting this was predicted to be 1.40, 0.98, and 1.34 respectively. Nonetheless, the vast majority of simulations resulted in 0 secondary cases among customers (even without contact-free delivery). Our results showed that a combination of social distancing, office staff working from home, and fixed driver pairings (all interventions carried out by the companies we consulted) reduce the risk of workplace outbreaks by 3-4 times. CONCLUSION This work suggests that, without interventions, significant transmission could have occured in these workplaces, but that these posed minimal risk to customers. We found that identifying and isolating regular close-contacts of infectious individuals (i.e. house-share, carpools, or delivery pairs) is an efficient measure for stopping workplace outbreaks. Regular testing can make these isolation measures even more effective but also increases the number of staff isolating at one time. It is therefore more efficient to use these isolation measures in addition to social distancing and contact reduction interventions, rather than instead of, as these reduce both transmission and the number of people needing to isolate at one time.
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Affiliation(s)
- Carl A. Whitfield
- Department of Mathematics, University of Manchester, Manchester, England
- Division of Infection, Immunity & Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, England
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
| | - Martie van Tongeren
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, England
| | - Yang Han
- Department of Mathematics, University of Manchester, Manchester, England
| | - Hua Wei
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, England
| | - Sarah Daniels
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, England
| | - Martyn Regan
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, England
- National COVID-19 Response Centre, UK Health Security Agency, London, England
| | - David W. Denning
- Division of Infection, Immunity & Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, England
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
| | - Arpana Verma
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, England
| | - Lorenzo Pellis
- Department of Mathematics, University of Manchester, Manchester, England
| | - Ian Hall
- Department of Mathematics, University of Manchester, Manchester, England
- Manchester Academic Health Science Centre, University of Manchester, Manchester, England
- Public Health Advice, Guidance and Expertise, UK Health Security Agency, London, England
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23
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Salahandish R, Hyun JE, Haghayegh F, Tabrizi HO, Moossavi S, Khetani S, Ayala-Charca G, Berenger BM, Niu YD, Ghafar-Zadeh E, Nezhad AS. CoVSense: Ultrasensitive Nucleocapsid Antigen Immunosensor for Rapid Clinical Detection of Wildtype and Variant SARS-CoV-2. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2206615. [PMID: 36995043 DOI: 10.1002/advs.202206615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/31/2023] [Indexed: 05/27/2023]
Abstract
The widespread accessibility of commercial/clinically-viable electrochemical diagnostic systems for rapid quantification of viral proteins demands translational/preclinical investigations. Here, Covid-Sense (CoVSense) antigen testing platform; an all-in-one electrochemical nano-immunosensor for sample-to-result, self-validated, and accurate quantification of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid (N)-proteins in clinical examinations is developed. The platform's sensing strips benefit from a highly-sensitive, nanostructured surface, created through the incorporation of carboxyl-functionalized graphene nanosheets, and poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) conductive polymers, enhancing the overall conductivity of the system. The nanoengineered surface chemistry allows for compatible direct assembly of bioreceptor molecules. CoVSense offers an inexpensive (<$2 kit) and fast/digital response (<10 min), measured using a customized hand-held reader (<$25), enabling data-driven outbreak management. The sensor shows 95% clinical sensitivity and 100% specificity (Ct<25), and overall sensitivity of 91% for combined symptomatic/asymptomatic cohort with wildtype SARS-CoV-2 or B.1.1.7 variant (N = 105, nasal/throat samples). The sensor correlates the N-protein levels to viral load, detecting high Ct values of ≈35, with no sample preparation steps, while outperforming the commercial rapid antigen tests. The current translational technology fills the gap in the workflow of rapid, point-of-care, and accurate diagnosis of COVID-19.
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Affiliation(s)
- Razieh Salahandish
- BioMEMS and Bioinspired Microfluidic Laboratory, Department of Biomedical Engineering, University of Calgary, Calgary, AB, T2N 1N4, Canada
- Department of Mechanical and Manufacturing Engineering, University of Calgary, Calgary, AB, T2N 1N4, Canada
- Laboratory of Advanced Biotechnologies for Health Assessments (LAB-HA), Department of Electrical Engineering and Computer Science, Lassonde School of Engineering, York University, Toronto, M3J 1P3, Canada
| | - Jae Eun Hyun
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Fatemeh Haghayegh
- BioMEMS and Bioinspired Microfluidic Laboratory, Department of Biomedical Engineering, University of Calgary, Calgary, AB, T2N 1N4, Canada
- Department of Mechanical and Manufacturing Engineering, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Hamed Osouli Tabrizi
- Biologically Inspired Sensors and Actuators (BioSA), Department of Electrical Engineering and Computer Science, Lassonde School of Engineering, York University, Toronto, M3J 1P3, Canada
| | - Shirin Moossavi
- BioMEMS and Bioinspired Microfluidic Laboratory, Department of Biomedical Engineering, University of Calgary, Calgary, AB, T2N 1N4, Canada
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, T2N 1N4, Canada
- International Microbiome Centre, Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Sultan Khetani
- BioMEMS and Bioinspired Microfluidic Laboratory, Department of Biomedical Engineering, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Giancarlo Ayala-Charca
- Biologically Inspired Sensors and Actuators (BioSA), Department of Electrical Engineering and Computer Science, Lassonde School of Engineering, York University, Toronto, M3J 1P3, Canada
| | - Byron M Berenger
- Alberta Public Health Laboratory, Alberta Precision Laboratories, 3330 Hospital Drive, Calgary, AB, T2N 4W4, Canada
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Yan Dong Niu
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Ebrahim Ghafar-Zadeh
- Biologically Inspired Sensors and Actuators (BioSA), Department of Electrical Engineering and Computer Science, Lassonde School of Engineering, York University, Toronto, M3J 1P3, Canada
| | - Amir Sanati Nezhad
- BioMEMS and Bioinspired Microfluidic Laboratory, Department of Biomedical Engineering, University of Calgary, Calgary, AB, T2N 1N4, Canada
- Department of Mechanical and Manufacturing Engineering, University of Calgary, Calgary, AB, T2N 1N4, Canada
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, AB, T2N 1N4, Canada
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24
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Sihota A, Barrett B, Bonell C, Chehade A, Dhaliwal J, Kani M, Kellar J, Kwong C, Ravinatarajan P, Schwartz KL, Smith S, Thiffault J, Woit C, Vaisman A. SARS-CoV-2 rapid diagnostic testing: Canadian consensus guidance for pharmacists. Can Pharm J (Ott) 2023; 156:128-136. [PMID: 37197090 PMCID: PMC10116221 DOI: 10.1177/17151635231164631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Affiliation(s)
| | - Brett Barrett
- School of Pharmacy, University of Waterloo and
Grand River Hospital, Kitchener, Ontario
| | - Cameron Bonell
- Interior Health Authority and Faculty of
Pharmaceutical Sciences, University of British Columbia, Kelowna, British
Columbia
| | | | | | | | - Jamie Kellar
- Leslie Dan Faculty of Pharmacy, University of
Toronto, Toronto, Ontario
| | - Conny Kwong
- Rexall Pharmacy Group Ltd., Winnipeg,
Manitoba
| | | | - Kevin L. Schwartz
- Dalla Lana School of Public Health, University
of Toronto, Toronto, Ontario
- Division of Infectious Diseases, Unity Health
Toronto, St. Joseph’s Health Centre, Toronto, Ontario
| | | | | | | | - Alon Vaisman
- Department of Medicine, University of Toronto,
Toronto, Ontario
- Division of Infectious Diseases, University
Health Network, Toronto, Ontario
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25
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Lovison OA, Grigaitė R, Volpato FCZ, Iles JK, Lacey J, Barreto F, Pandiri SR, Balzan LDLR, Cantarelli VV, Barth AL, Iles RK, Martins AF. Validation of a MALDI-TOF MS Method for SARS-CoV-2 Detection on the Bruker Biotyper and Nasopharyngeal Swabs: A Brazil-UK Collaborative Study. Diagnostics (Basel) 2023; 13:diagnostics13081470. [PMID: 37189571 DOI: 10.3390/diagnostics13081470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 05/17/2023] Open
Abstract
We developed a MALDI-TOF mass spectrometry method for the detection of the SARS-CoV-2 virus in saliva-gargle samples using Shimadzu MALDI-TOF mass spectrometers in the UK. This was validated in the USA to CLIA-LDT standards for asymptomatic infection detection remotely via sharing protocols, shipping key reagents, video conferencing, and data exchange. In Brazil, more so than in the UK and USA, there is a need to develop non-PCR-dependent, rapid, and affordable SARS-CoV-2 infection screening tests that also identify variant SARS-CoV-2 and other virus infections. In addition, travel restrictions necessitated remote collaboration with validation on the available clinical MALDI-TOF-the Bruker Biotyper (microflex® LT/SH)-and on nasopharyngeal swab samples, as salivary gargle samples were not available. The Bruker Biotyper was shown to be almost log103 more sensitive at the detection of high molecular weight spike proteins. A protocol for saline swab soaks out was developed, and duplicate swab samples collected in Brazil were analyzed by MALDI-TOF MS. The swab collected sample spectra that varied from that of saliva-gargle in three additional mass peaks in the mass region expected for IgG heavy chains and human serum albumin. A subset of clinical samples with additional high mass, probably spike-related proteins, were also found. Further, spectral data comparisons and analysis, subjected to machine learning algorithms in order to resolve RT-qPCR positive from RT-qPCR negative swab samples, showed 56-62% sensitivity, 87-91% specificity, and a 78% agreement with RT-qPCR scoring for SARS-CoV-2 infection.
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Affiliation(s)
- Otávio A Lovison
- Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil
- Núcleo de Bioinformática (Bioinformatics Core), Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre 90160-093, RS, Brazil
| | | | - Fabiana C Z Volpato
- Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil
| | - Jason K Iles
- Map Sciences Ltd., The iLab, Priory Park, Bedford MK44 3RZ, UK
| | - Jon Lacey
- Map Sciences Ltd., The iLab, Priory Park, Bedford MK44 3RZ, UK
| | - Fabiano Barreto
- Laboratório Federal de Defesa Agropecuária, Porto Alegre 91780-580, RS, Brazil
| | - Sai R Pandiri
- Map Sciences Ltd., The iLab, Priory Park, Bedford MK44 3RZ, UK
| | | | - Vlademir V Cantarelli
- Departamento de Ciências Básicas da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre 90050-170, RS, Brazil
| | - Afonso Luis Barth
- Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil
| | - Ray K Iles
- Map Sciences Ltd., The iLab, Priory Park, Bedford MK44 3RZ, UK
| | - Andreza F Martins
- Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil
- Núcleo de Bioinformática (Bioinformatics Core), Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre 90160-093, RS, Brazil
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26
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Lim NWH, Lim JT, Dickens BL. Border Control for Infectious Respiratory Disease Pandemics: A Modelling Study for H1N1 and Four Strains of SARS-CoV-2. Viruses 2023; 15:v15040978. [PMID: 37112958 PMCID: PMC10144227 DOI: 10.3390/v15040978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Post-pandemic economic recovery relies on border control for safe cross-border movement. Following the COVID-19 pandemic, we investigate whether effective strategies generalize across diseases and variants. For four SARS-CoV-2 variants and influenza A-H1N1, we simulated 21 strategy families of varying test types and frequencies, quantifying expected transmission risk, relative to no control, by strategy family and quarantine length. We also determined minimum quarantine lengths to suppress relative risk below given thresholds. SARS-CoV-2 variants showed similar relative risk across strategy families and quarantine lengths, with at most 2 days' between-variant difference in minimum quarantine lengths. ART-based and PCR-based strategies showed comparable effectiveness, with regular testing strategies requiring at most 9 days. For influenza A-H1N1, ART-based strategies were ineffective. Daily ART testing reduced relative risk only 9% faster than without regular testing. PCR-based strategies were moderately effective, with daily PCR (0-day delay) testing requiring 16 days for the second-most stringent threshold. Viruses with high typical viral loads and low transmission risk given low viral loads, such as SARS-CoV-2, are effectively controlled with moderate-sensitivity tests (ARTs) and modest quarantine periods. Viruses with low typical viral loads and substantial transmission risk at low viral loads, such as influenza A-H1N1, require high-sensitivity tests (PCR) and longer quarantine periods.
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Affiliation(s)
- Nigel Wei-Han Lim
- Saw Swee Hock School of Public Health, National University of Singapore 12 Science Drive 2, #10-01, Singapore 117549, Singapore
| | - Jue Tao Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University Experimental Medicine Building, 59 Nanyang Drive, Singapore 636921, Singapore
| | - Borame Lee Dickens
- Saw Swee Hock School of Public Health, National University of Singapore 12 Science Drive 2, #10-01, Singapore 117549, Singapore
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27
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Tang G, Zhang Z, Tan W, Long F, Sun J, Li Y, Zou S, Yang Y, Cai K, Li S, Wang Z, Liu J, Mao G, Ma Y, Zhao GP, Tian ZG, Zhao W. RT-RPA-Cas12a-based assay facilitates the discrimination of SARS-CoV-2 variants of concern. SENSORS AND ACTUATORS. B, CHEMICAL 2023; 381:133433. [PMID: 36743821 PMCID: PMC9884195 DOI: 10.1016/j.snb.2023.133433] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/09/2022] [Accepted: 01/04/2023] [Indexed: 06/18/2023]
Abstract
Timely and accurate detection of SARS-CoV-2 variants of concern (VOCs) is urgently needed for pandemic surveillance and control. Great efforts have been made from a mass of scientists in increasing the detection sensitivity and operability, and reducing the turn-around time and cost. Here, we report a nucleic acid testing-based method aiming to detect and discriminate SARS-CoV-2 mutations by combining RT-RPA and CRISPR-Cas12a detecting assays (RRCd). With a detection limit of 10 copies RNA/reaction, RRCd was validated in 194 clinical samples, showing 89% positive predictive agreement and 100% negative predictive agreement, respectively. Critically, using specific crRNAs, representatives of single nucleotide polymorphisms and small deletions in SARS-CoV-2 VOCs including N501Y, T478K and ΔH69-V70 were discriminated by RRCd, demonstrating 100% specificity in clinical samples with C t < 33. The method completes within 65 min and could offer visible results without using any electrical devices, which probably facilitate point-of-care testing of SARS-CoV-2 variants and other epidemic viruses.
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Affiliation(s)
- Guiyue Tang
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Zilong Zhang
- Shanghai International Travel Healthcare Center, Shanghai Customs District P. R. China, Shanghai 200335, China
| | - Wei Tan
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Fei Long
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Jingxian Sun
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Yingying Li
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Siwei Zou
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Yujiao Yang
- CAS Key Laboratory of Synthetic Biology, CAS Center for Excellence in Molecular Plant Sciences, Chinese Academy of Sciences, Shanghai 200032, China
| | - Kezhu Cai
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- School of Engineering, Southern University of Science and Technology, Shenzhen 518055, China
| | - Shenwei Li
- Shanghai International Travel Healthcare Center, Shanghai Customs District P. R. China, Shanghai 200335, China
| | - Zhiyi Wang
- Shanghai International Travel Healthcare Center, Shanghai Customs District P. R. China, Shanghai 200335, China
| | - Jiakun Liu
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Guobing Mao
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Yingxin Ma
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Guo-Ping Zhao
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- CAS Key Laboratory of Synthetic Biology, CAS Center for Excellence in Molecular Plant Sciences, Chinese Academy of Sciences, Shanghai 200032, China
- Department of Microbiology and Microbial Engineering, School of Life Sciences, Fudan University, Shanghai 200433, China
| | - Zhen-Gan Tian
- Shanghai International Travel Healthcare Center, Shanghai Customs District P. R. China, Shanghai 200335, China
| | - Wei Zhao
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
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Pohanka M. Immunosensors for Assay of Toxic Biological Warfare Agents. BIOSENSORS 2023; 13:402. [PMID: 36979614 PMCID: PMC10046508 DOI: 10.3390/bios13030402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 06/18/2023]
Abstract
An immunosensor for the assay of toxic biological warfare agents is a biosensor suitable for detecting hazardous substances such as aflatoxin, botulinum toxin, ricin, Shiga toxin, and others. The application of immunosensors is used in outdoor assays, point-of-care tests, as a spare method for more expensive devices, and even in the laboratory as a standard analytical method. Some immunosensors, such as automated flow-through analyzers or lateral flow tests, have been successfully commercialized as tools for toxins assay, but the research is ongoing. New devices are being developed, and the use of advanced materials and assay techniques make immunosensors highly competitive analytical devices in the field of toxic biological warfare agents assay. This review summarizes facts about current applications and new trends of immunosensors regarding recent papers in this area.
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Affiliation(s)
- Miroslav Pohanka
- Faculty of Military Health Sciences, University of Defense, Trebesska 1575, CZ-50001 Hradec Kralove, Czech Republic
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29
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Hughes DM, Bird SM, Cheyne CP, Ashton M, Campbell MC, García-Fiñana M, Buchan I. Rapid antigen testing in COVID-19 management for school-aged children: an observational study in Cheshire and Merseyside, UK. J Public Health (Oxf) 2023; 45:e38-e47. [PMID: 35137216 PMCID: PMC8903429 DOI: 10.1093/pubmed/fdac003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/22/2021] [Accepted: 01/02/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Twice weekly lateral flow tests (LFTs) for secondary school children was UK Government policy from 8 March 2021. We evaluate use of LFTs (both supervised at test centres, and home test kits) in school-aged children in Cheshire and Merseyside. METHODS We report (i) number of LFT positives (ii) proportion of LFT positive with confirmatory reverse transcription polymerase chain reaction (PCR) test within 2 days, and (iii) agreement between LFT-positive and confirmatory PCR, and dependence of (i-iii) on COVID-19 prevalence. FINDINGS 1 248 468 LFTs were taken by 211 255 12-18 years old, and 163 914 by 52 116 5-11 years old between 6 November 2020 and 31 July 2021. Five thousand three hundred and fourteen (2.5%) 12-18 years old and 1996 (3.8%) 5-11 years old returned LFT positives, with 3829 (72.1%) and 1535 (76.9%) confirmatory PCRs, and 3357 (87.7%) and 1383 (90.1%) confirmatory PCR-positives, respectively.Monthly proportions of LFT positive with PCR negative varied between 4.7% and 35.3% in 12-18 years old (corresponding proportion of all tests positive: 9.7% and 0.3%).Deprivation and non-White ethnicity were associated with reduced uptake of confirmatory PCR. INTERPRETATION Substantial inequalities in confirmatory testing need more attention to avoid further disadvantage through education loss. When prevalence is low additional measures, including confirmatory testing, are needed. Local Directors of Public Health taking more control over schools testing may be needed. FUNDING DHSC, MRC, NIHR, EPSRC.
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Affiliation(s)
- David M Hughes
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Sheila M Bird
- MRC Biostatistics Unit, Cambridge, UK.,Edinburgh University's College of Medicine and Veterinary Medicine, Edinburgh, UK
| | | | - Matthew Ashton
- Department of Public Health, Liverpool City Council, Liverpool, UK
| | | | | | - Iain Buchan
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
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30
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Shi J, Zhang Y, Yang M. Recent development of microfluidics-based platforms for respiratory virus detection. BIOMICROFLUIDICS 2023; 17:024104. [PMID: 37035101 PMCID: PMC10076069 DOI: 10.1063/5.0135778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/27/2023] [Indexed: 06/19/2023]
Abstract
With the global outbreak of SARS-CoV-2, the inadequacies of current detection technology for respiratory viruses have been recognized. Rapid, portable, accurate, and sensitive assays are needed to expedite diagnosis and early intervention. Conventional methods for detection of respiratory viruses include cell culture-based assays, serological tests, nucleic acid detection (e.g., RT-PCR), and direct immunoassays. However, these traditional methods are often time-consuming, labor-intensive, and require laboratory facilities, which cannot meet the testing needs, especially during pandemics of respiratory diseases, such as COVID-19. Microfluidics-based techniques can overcome these demerits and provide simple, rapid, accurate, and cost-effective analysis of intact virus, viral antigen/antibody, and viral nucleic acids. This review aims to summarize the recent development of microfluidics-based techniques for detection of respiratory viruses. Recent advances in different types of microfluidic devices for respiratory virus diagnostics are highlighted, including paper-based microfluidics, continuous-flow microfluidics, and droplet-based microfluidics. Finally, the future development of microfluidic technologies for respiratory virus diagnostics is discussed.
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Affiliation(s)
- Jingyu Shi
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon 999077, Hong Kong SAR, People's Republic of China
| | - Yu Zhang
- Department of Mechanical and Automotive Engineering, Royal Melbourne Institute of Technology, Melbourne, VIC 3000, Australia
| | - Mo Yang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon 999077, Hong Kong SAR, People's Republic of China
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31
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Abstract
SARS-CoV-2 viral load and detection of infectious virus in the respiratory tract are the two key parameters for estimating infectiousness. As shedding of infectious virus is required for onward transmission, understanding shedding characteristics is relevant for public health interventions. Viral shedding is influenced by biological characteristics of the virus, host factors and pre-existing immunity (previous infection or vaccination) of the infected individual. Although the process of human-to-human transmission is multifactorial, viral load substantially contributed to human-to-human transmission, with higher viral load posing a greater risk for onward transmission. Emerging SARS-CoV-2 variants of concern have further complicated the picture of virus shedding. As underlying immunity in the population through previous infection, vaccination or a combination of both has rapidly increased on a global scale after almost 3 years of the pandemic, viral shedding patterns have become more distinct from those of ancestral SARS-CoV-2. Understanding the factors and mechanisms that influence infectious virus shedding and the period during which individuals infected with SARS-CoV-2 are contagious is crucial to guide public health measures and limit transmission. Furthermore, diagnostic tools to demonstrate the presence of infectious virus from routine diagnostic specimens are needed.
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Affiliation(s)
- Olha Puhach
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benjamin Meyer
- Centre for Vaccinology, Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Isabella Eckerle
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland.
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
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32
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Suzuki H, Akashi Y, Kato D, Takeuchi Y, Kiyasu Y, Terada N, Kurihara Y, Kuwahara M, Muramatsu S, Ueda A, Notake S, Nakamura K. Analytical performance of the rapid qualitative antigen kit for the detection of SARS-CoV-2 during widespread circulation of the Omicron variant. J Infect Chemother 2023; 29:257-262. [PMID: 36417995 PMCID: PMC9675935 DOI: 10.1016/j.jiac.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 11/07/2022] [Accepted: 11/16/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Rapid qualitative antigen testing is essential in the clinical management of COVID-19. However, most evaluations of antigen tests have been performed before the emergence of the Omicron variant. METHODS This prospective observational study evaluated QuickNavi-COVID19 Ag, a rapid antigen detection test between December 2021 and February 2022 in Japan, using real-time reverse transcription (RT)-PCR as a reference. Two nasopharyngeal samples were simultaneously collected for antigen testing and for RT-PCR. Variant analysis of the SARS-CoV-2 genomic sequencing was also performed. RESULTS In total, nasopharyngeal samples were collected from 1073 participants (417 positive; 919 symptomatic; 154 asymptomatic) for analysis. Compared with those of RT-PCR, the sensitivity, specificity, positive predictive value, and negative predictive value were 94.2% (95% CI: 91.6%-96.3%), 99.5% (95% CI: 98.7%-99.9%), 99.2% (95% CI: 97.8%-99.8%), and 96.5% (95% CI: 94.8%-97.7%), respectively. The sensitivity among symptomatic individuals was 94.3% (95% CI: 91.5%-96.4%). Overall, 85.9% of sequences were classified as Omicron sublineage BA.1, 12.4% were Omicron sublineage BA.2, and 1.6% were Delta B.1.617.2. (Delta variant). Most of the samples (87.1%) had Ct values of <25, and the sensitivity was 47.4% for low viral load samples (Ct ≥ 30); a similar trend has been observed in both symptomatic and asymptomatic groups. CONCLUSIONS The QuickNavi-COVID19 Ag test showed sufficient diagnostic performance for the detection of the SARS-CoV-2 Omicron sublineages BA.1 and BA.2 from nasopharyngeal samples. However, the current study was mainly performed in symptomatic patients and the results are not sufficiently applicable for asymptomatic patients.
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Affiliation(s)
- Hiromichi Suzuki
- Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan,Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan,Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan,Corresponding author. Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yusaku Akashi
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan,Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan,Akashi Internal Medicine Clinic, 3-1-63 Asahigaoka, Kashiwara, Osaka, 582-0026, Japan
| | - Daisuke Kato
- Denka Co., Ltd. Gosen Site, Research & Development Division, Reagent R&D Department, 1-2-2 Minami-hon-cho, Gosen-shi, Niigata, 959-1695, Japan
| | - Yuto Takeuchi
- Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan,Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan
| | - Yoshihiko Kiyasu
- Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan,Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan,Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Norihiko Terada
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan,Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yoko Kurihara
- Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Miwa Kuwahara
- Denka Co., Ltd. Gosen Site, Research & Development Division, Reagent R&D Department, 1-2-2 Minami-hon-cho, Gosen-shi, Niigata, 959-1695, Japan
| | - Shino Muramatsu
- Denka Co., Ltd. Gosen Site, Research & Development Division, Reagent R&D Department, 1-2-2 Minami-hon-cho, Gosen-shi, Niigata, 959-1695, Japan
| | - Atsuo Ueda
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Shigeyuki Notake
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Koji Nakamura
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
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Cai CGX, Lim NWH, Huynh VA, Ananthakrishnan A, Dabak SV, Dickens BSL, Faradiba D, KC S, Morton A, Park M, Rachatan C, Sittimart M, Wee HL, Lou J, Teerawattananon Y. Economic Analysis of Border Control Policies during COVID-19 Pandemic: A Modelling Study to Inform Cross-Border Travel Policy between Singapore and Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4011. [PMID: 36901023 PMCID: PMC10001629 DOI: 10.3390/ijerph20054011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
With countries progressing towards high COVID-19 vaccination rates, strategies for border reopening are required. This study focuses on Thailand and Singapore, two countries that share significant tourism visitation, to illustrate a framework for optimizing COVID-19 testing and quarantine policies for bilateral travel with a focus on economic recovery. The timeframe is the month of October 2021, when Thailand and Singapore were preparing to reopen borders for bilateral travel. This study was conducted to provide evidence for the border reopening policy decisions. Incremental net benefit (INB) compared to the pre-opening period was quantified through a willingness-to-travel model, a micro-simulation COVID-19 transmission model and an economic model accounting for medical and non-medical costs/benefits. Multiple testing and quarantine policies were examined, and Pareto optimal (PO) policies and the most influential components were identified. The highest possible INB for Thailand is US $125.94 million, under a PO policy with no quarantine but with antigen rapid tests (ARTs) pre-departure and upon arrival to enter both countries. The highest possible INB for Singapore is US $29.78 million, under another PO policy with no quarantine on both sides, no testing to enter Thailand, and ARTs pre-departure and upon arrival to enter Singapore. Tourism receipts and costs/profits of testing and quarantine have greater economic impacts than that from COVID-19 transmission. Provided healthcare systems have sufficient capacity, great economic benefits can be gained for both countries by relaxing border control measures.
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Affiliation(s)
- Celestine Grace Xueting Cai
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), 12 Science Drive 2, #10-01, Singapore 117549, Singapore
| | - Nigel Wei-Han Lim
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), 12 Science Drive 2, #10-01, Singapore 117549, Singapore
| | - Vinh Anh Huynh
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), 12 Science Drive 2, #10-01, Singapore 117549, Singapore
| | - Aparna Ananthakrishnan
- Health Intervention and Technology Assessment Program (HITAP), Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Road, Nonthaburi 11000, Thailand
| | - Saudamini Vishwanath Dabak
- Health Intervention and Technology Assessment Program (HITAP), Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Road, Nonthaburi 11000, Thailand
| | - Borame Sue Lee Dickens
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), 12 Science Drive 2, #10-01, Singapore 117549, Singapore
| | - Dian Faradiba
- Health Intervention and Technology Assessment Program (HITAP), Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Road, Nonthaburi 11000, Thailand
| | - Sarin KC
- Health Intervention and Technology Assessment Program (HITAP), Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Road, Nonthaburi 11000, Thailand
| | - Alec Morton
- Department of Management Science, University of Strathclyde, 16 Richmond Street, Glasgow G1 1XQ, UK
| | - Minah Park
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), 12 Science Drive 2, #10-01, Singapore 117549, Singapore
| | - Chayapat Rachatan
- Health Intervention and Technology Assessment Program (HITAP), Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Road, Nonthaburi 11000, Thailand
| | - Manit Sittimart
- Health Intervention and Technology Assessment Program (HITAP), Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Road, Nonthaburi 11000, Thailand
| | - Hwee-Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), 12 Science Drive 2, #10-01, Singapore 117549, Singapore
- Department of Pharmacy, Faculty of Science, NUS, 18 Science Drive 4, Singapore 117559, Singapore
| | - Jing Lou
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), 12 Science Drive 2, #10-01, Singapore 117549, Singapore
| | - Yot Teerawattananon
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), 12 Science Drive 2, #10-01, Singapore 117549, Singapore
- Health Intervention and Technology Assessment Program (HITAP), Department of Health, Ministry of Public Health, 6th Floor, 6th Building, Tiwanon Road, Nonthaburi 11000, Thailand
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34
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Harwood R, Rad L, Kelly C, Shelton C, Shepherd E, Roderick M, Whittaker E, Dyke S, Patel SV, Gent N, Kenny SE. Lateral flow test performance in children for SARS-CoV-2 using anterior nasal and buccal swabbing: sensitivity, specificity, negative and positive predictive values. Arch Dis Child 2023; 108:137-140. [PMID: 36657801 PMCID: PMC9887373 DOI: 10.1136/archdischild-2022-324353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/16/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine if the sensitivity of the lateral flow test is dependent on the viral load and on the location of swabbing in the respiratory tract in children. DESIGN Phase 1: Routinely performed reverse transcriptase PCR (RT-PCR) using nose and throat (NT) swabs or endotracheal (ET) aspirates were compared with Innova lateral flow tests (LFTs) using anterior nasal (AN) swabs. Phase 2: RT-PCR-positive children underwent paired AN RT-PCR and LFT and/or paired AN RT-PCR and buccal LFT. SETTING Tertiary paediatric hospitals. PATIENTS Children under the age of 18 years. Phase 1: undergoing routine testing, phase 2: known SARS-CoV-2 positive. RESULTS Phase 1: 435 paired swabs taken in 431 asymptomatic patients resulted in 8 positive RT-PCRs, 9 PCR test failures and 418 negative RT-PCRs from NT or ET swabs. The test performance of AN LFT demonstrated sensitivity: 25% (4%-59%), specificity: 100% (99%-100%), positive predictive value (PPV): 100% (18%-100%) and negative predictive value (NPV): 99% (97%-99%).Phase 2: 14 AN RT-PCR-positive results demonstrated a sensitivity of 77% (50%-92%) of LFTs performed on AN swabs. 15/16 paired buccal LFT swabs were negative. CONCLUSION The NPV, PPV and specificity of LFTs are excellent. The sensitivity of LFTs compared with RT-PCR is good when the samples are colocated but may be reduced when the LFT swab is taken from the AN. Buccal swabs are not appropriate for LFT testing. Careful consideration of the swabbing reason, the tolerance of the child and the requirements for test processing (eg, rapidity of results) should be undertaken within hospital settings. TRIAL REGISTRATION NUMBER NCT04629157.
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Affiliation(s)
- Rachel Harwood
- Paediatric Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK .,Cellular and Molecular Physiology, University of Liverpool, Liverpool, UK
| | - Laura Rad
- Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
| | | | - Cliff Shelton
- Wythenshawe Hospital, Manchester, Greater Manchester, UK
| | | | - Marion Roderick
- Paediatric Infectious Diseases and Immunology, Bristol Royal Hospital for Children, Bristol, UK
| | - Elizabeth Whittaker
- Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK
| | | | - Sanjay Vallabh Patel
- Paediatric Infectious Diseases and Immunology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Nick Gent
- Mathematical modelling, UKHSA, London, UK
| | - Simon E Kenny
- Paediatric Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK,Medical Director for Children and Young People, NHS England and NHS Improvement North West, Manchester, UK
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35
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Hällqvist J, Lane D, Shapanis A, Davis K, Heywood WE, Doykov I, Śpiewak J, Ghansah N, Keevil B, Gupta P, Jukes-Jones R, Singh R, Foley D, Vissers JPC, Pattison R, Ferries S, Wardle R, Bartlett A, Calton LJ, Anderson L, Razavi M, Pearson T, Pope M, Yip R, Ng LL, Nicholas BI, Bailey A, Noel D, Dalton RN, Heales S, Hopley C, Pitt AR, Barran P, Jones DJL, Mills K, Skipp P, Carling RS. Operation Moonshot: rapid translation of a SARS-CoV-2 targeted peptide immunoaffinity liquid chromatography-tandem mass spectrometry test from research into routine clinical use. Clin Chem Lab Med 2023; 61:302-310. [PMID: 36395058 DOI: 10.1515/cclm-2022-1000] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/04/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES During 2020, the UK's Department of Health and Social Care (DHSC) established the Moonshot programme to fund various diagnostic approaches for the detection of SARS-CoV-2, the pathogen behind the COVID-19 pandemic. Mass spectrometry was one of the technologies proposed to increase testing capacity. METHODS Moonshot funded a multi-phase development programme, bringing together experts from academia, industry and the NHS to develop a state-of-the-art targeted protein assay utilising enrichment and liquid chromatography tandem mass spectrometry (LC-MS/MS) to capture and detect low levels of tryptic peptides derived from SARS-CoV-2 virus. The assay relies on detection of target peptides, ADETQALPQRK (ADE) and AYNVTQAFGR (AYN), derived from the nucleocapsid protein of SARS-CoV-2, measurement of which allowed the specific, sensitive, and robust detection of the virus from nasopharyngeal (NP) swabs. The diagnostic sensitivity and specificity of LC-MS/MS was compared with reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) via a prospective study. RESULTS Analysis of NP swabs (n=361) with a median RT-qPCR quantification cycle (Cq) of 27 (range 16.7-39.1) demonstrated diagnostic sensitivity of 92.4% (87.4-95.5), specificity of 97.4% (94.0-98.9) and near total concordance with RT-qPCR (Cohen's Kappa 0.90). Excluding Cq>32 samples, sensitivity was 97.9% (94.1-99.3), specificity 97.4% (94.0-98.9) and Cohen's Kappa 0.95. CONCLUSIONS This unique collaboration between academia, industry and the NHS enabled development, translation, and validation of a SARS-CoV-2 method in NP swabs to be achieved in 5 months. This pilot provides a model and pipeline for future accelerated development and implementation of LC-MS/MS protein/peptide assays into the routine clinical laboratory.
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Affiliation(s)
- Jenny Hällqvist
- University College London Translational Mass Spectrometry Research Group Unit, London, UK
- UCL Queen Square Institute of Neurology, London, UK
| | - Dan Lane
- The Department of Chemical Pathology and Metabolic Diseases, Leicester Royal Infirmary, Leicester, UK
- Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Andrew Shapanis
- Centre for Proteomic Research, University of Southampton, Southampton, UK
- Biological Sciences, University of Southampton, Southampton, UK
| | - Kayleigh Davis
- Biochemical Sciences, Synnovis, Guys & St Thomas' NHSFT, London, UK
| | - Wendy E Heywood
- University College London Translational Mass Spectrometry Research Group Unit, London, UK
| | - Ivan Doykov
- University College London Translational Mass Spectrometry Research Group Unit, London, UK
| | - Justyna Śpiewak
- University College London Translational Mass Spectrometry Research Group Unit, London, UK
| | - Nana Ghansah
- Neurometabolic Unit, National Hospital, London, UK
| | - Brian Keevil
- Department of Biochemistry, Manchester University NHS Trust, Manchester, UK
| | - Pankaj Gupta
- The Department of Chemical Pathology and Metabolic Diseases, Leicester Royal Infirmary, Leicester, UK
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Rebekah Jukes-Jones
- The Department of Chemical Pathology and Metabolic Diseases, Leicester Royal Infirmary, Leicester, UK
- van Geest MS-OMICS Facility, University of Leicester, Leicester, UK
| | - Raj Singh
- van Geest MS-OMICS Facility, University of Leicester, Leicester, UK
| | - Dominic Foley
- Waters Corporation, Wilmslow, UK
- Waters Corporation, Milford, MA, USA
| | | | - Rebecca Pattison
- Waters Corporation, Wilmslow, UK
- Waters Corporation, Milford, MA, USA
| | - Samantha Ferries
- Waters Corporation, Wilmslow, UK
- Waters Corporation, Milford, MA, USA
| | - Robert Wardle
- Waters Corporation, Wilmslow, UK
- Waters Corporation, Milford, MA, USA
| | - Amy Bartlett
- Waters Corporation, Wilmslow, UK
- Waters Corporation, Milford, MA, USA
| | - Lisa J Calton
- Waters Corporation, Wilmslow, UK
- Waters Corporation, Milford, MA, USA
| | - Leigh Anderson
- SISCAPA Assay Technologies, Inc., Washington, DC, USA
- SISCAPA Assay Technologies, Inc., Victoria, BC, Canada
| | - Morteza Razavi
- SISCAPA Assay Technologies, Inc., Washington, DC, USA
- SISCAPA Assay Technologies, Inc., Victoria, BC, Canada
| | - Terry Pearson
- SISCAPA Assay Technologies, Inc., Washington, DC, USA
- SISCAPA Assay Technologies, Inc., Victoria, BC, Canada
| | - Matt Pope
- SISCAPA Assay Technologies, Inc., Washington, DC, USA
- SISCAPA Assay Technologies, Inc., Victoria, BC, Canada
| | - Richard Yip
- SISCAPA Assay Technologies, Inc., Washington, DC, USA
- SISCAPA Assay Technologies, Inc., Victoria, BC, Canada
| | - Leong L Ng
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- van Geest MS-OMICS Facility, University of Leicester, Leicester, UK
| | | | - Alistair Bailey
- Centre for Proteomic Research, University of Southampton, Southampton, UK
| | - Dan Noel
- Biological Sciences, University of Southampton, Southampton, UK
| | - R Neil Dalton
- WellChild Laboratory, Evelina London Children's Hospital, London, UK
| | - Simon Heales
- Neurometabolic Unit, National Hospital, London, UK
| | | | - Andrew R Pitt
- Manchester Institute of Biotechnology, University of Manchester, Manchester, UK
| | - Perdita Barran
- Manchester Institute of Biotechnology, University of Manchester, Manchester, UK
| | - Donald J L Jones
- van Geest MS-OMICS Facility, University of Leicester, Leicester, UK
| | - Kevin Mills
- University College London Translational Mass Spectrometry Research Group Unit, London, UK
| | - Paul Skipp
- Centre for Proteomic Research, University of Southampton, Southampton, UK
- Biological Sciences, University of Southampton, Southampton, UK
| | - Rachel S Carling
- Biochemical Sciences, Synnovis, Guys & St Thomas' NHSFT, London, UK
- GKT School Medical Education, Kings College London, London, UK
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Recent updates on liposomal formulations for detection, prevention and treatment of coronavirus disease (COVID-19). Int J Pharm 2023; 630:122421. [PMID: 36410670 PMCID: PMC9674400 DOI: 10.1016/j.ijpharm.2022.122421] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 11/12/2022] [Accepted: 11/17/2022] [Indexed: 11/20/2022]
Abstract
The unprecedented outbreak of severe acute respiratory syndrome-2 (SARS-CoV-2) worldwide has rendered it one of the most notorious pandemics ever documented in human history. As of November 2022, nearly 626 million cases of infection and over 6.6 million deaths have been reported globally. The scientific community has made significant progress in therapeutics and prevention for the management of coronavirus disease (COVID-19), including the development of vaccines and antiviral agents such as monoclonal antibodies and antiviral drugs. Although many advancements and a plethora of positive results have been obtained and global restrictions are being uplifted, obstacles in efficiently delivering these therapies, such as their rapid clearance, suboptimal biodistribution, and toxicity to organs, have yet to be addressed. To address these drawbacks, researchers have attempted applying nanotechnology-based formulations. Here, we summarized the recent data about COVID-19, its emergence, pathophysiology and life cycle, diagnosis, and currently-available medications. Subsequently, we discussed the progress in lipid nanocarriers, such as liposomes in infection detection and control. This review provides critical insights into the design of the latest liposomal-based formulations for tackling the barriers to detecting, preventing, and treating SARS-CoV-2.
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Lou J, Lim NWH, Cai CGX, Dickens BSL, Huynh VA, Wee HL. Cost benefit analysis of alternative testing and quarantine policies for travelers for infection control: A case study of Singapore during the COVID-19 pandemic. Front Public Health 2023; 11:1101986. [PMID: 36908469 PMCID: PMC9996245 DOI: 10.3389/fpubh.2023.1101986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/23/2023] [Indexed: 02/25/2023] Open
Abstract
Background Border control mitigates local infections but bears a heavy economic cost, especially for tourism-reliant countries. While studies have supported the efficacy of border control in suppressing cross-border transmission, the trade-off between costs from imported and secondary cases and from lost economic activities has not been studied. This case study of Singapore during the COVID-19 pandemic aims to understand the impacts of varying quarantine length and testing strategies on the economy and health system. Additionally, we explored the impact of permitting unvaccinated travelers to address emerging equity concerns. We assumed that community transmission is stable and vaccination rates are high enough that inbound travelers are not dissuaded from traveling. Methods The number of travelers was predicted considering that longer quarantine reduces willingness to travel. A micro-simulation model predicted the number of COVID-19 cases among travelers, the resultant secondary cases, and the probability of being symptomatic in each group. The incremental net monetary benefit (INB) of Singapore was quantified under each border-opening policy compared to pre-opening status, based on tourism receipts, cost/profit from testing and quarantine, and cost and health loss due to COVID-19 cases. Results Compared to polymerase chain reaction (PCR), rapid antigen test (ART) detects fewer imported cases but results in fewer secondary cases. Longer quarantine results in fewer cases but lower INB due to reduced tourism receipts. Assuming the proportion of unvaccinated travelers is small (8% locally and 24% globally), allowing unvaccinated travelers will accrue higher INB without exceeding the intensive care unit (ICU) capacity. The highest monthly INB from all travelers is $2,236.24 m, with 46.69 ICU cases per month, achieved with ARTs at pre-departure and on arrival without quarantine. The optimal policy in terms of highest INB is robust under changes to various model assumptions. Among all cost-benefit components, the top driver for INB is tourism receipts. Conclusions With high vaccination rates locally and globally alongside stable community transmission, opening borders to travelers regardless of vaccination status will increase economic growth in the destination country. The caseloads remain manageable without exceeding ICU capacity, and costs of cases are offset by the economic value generated from travelers.
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Affiliation(s)
- Jing Lou
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Nigel Wei-Han Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | - Borame Sue Lee Dickens
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Vinh Anh Huynh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Hwee-Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
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Guest PC, Hawkins SFC, Rahmoune H. Rapid Detection of SARS-CoV-2 Variants of Concern by Genomic Surveillance Techniques. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1412:491-509. [PMID: 37378785 DOI: 10.1007/978-3-031-28012-2_27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
This chapter describes the application of genomic, transcriptomic, proteomic, and metabolomic methods in the study of SARS-CoV-2 variants of concern. We also describe the important role of machine learning tools to identify the most significant biomarker signatures and discuss the latest point-of-care devices that can be used to translate these findings to the physician's office or to bedside care. The main emphasis is placed on increasing our diagnostic capacity and predictability of disease outcomes to guide the most appropriate treatment strategies.
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Affiliation(s)
- Paul C Guest
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil
- Department of Psychiatry, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Laboratory of Translational Psychiatry, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | | | - Hassan Rahmoune
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK
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Artika IM, Dewi YP, Nainggolan IM, Siregar JE, Antonjaya U. Real-Time Polymerase Chain Reaction: Current Techniques, Applications, and Role in COVID-19 Diagnosis. Genes (Basel) 2022; 13:genes13122387. [PMID: 36553654 PMCID: PMC9778061 DOI: 10.3390/genes13122387] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Successful detection of the first SARS-CoV-2 cases using the real-time polymerase chain reaction (real-time PCR) method reflects the power and usefulness of this technique. Real-time PCR is a variation of the PCR assay to allow monitoring of the PCR progress in actual time. PCR itself is a molecular process used to enzymatically synthesize copies in multiple amounts of a selected DNA region for various purposes. Real-time PCR is currently one of the most powerful molecular approaches and is widely used in biological sciences and medicine because it is quantitative, accurate, sensitive, and rapid. Current applications of real-time PCR include gene expression analysis, mutation detection, detection and quantification of pathogens, detection of genetically modified organisms, detection of allergens, monitoring of microbial degradation, species identification, and determination of parasite fitness. The technique has been used as a gold standard for COVID-19 diagnosis. Modifications of the standard real-time PCR methods have also been developed for particular applications. This review aims to provide an overview of the current applications of the real-time PCR technique, including its role in detecting emerging viruses such as SARS-CoV-2.
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Affiliation(s)
- I Made Artika
- Department of Biochemistry, Faculty of Mathematics and Natural Sciences, Bogor Agricultural University, Bogor 16680, Indonesia
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Bogor 16911, Indonesia
- Correspondence:
| | - Yora Permata Dewi
- Emerging Virus Research Unit, Eijkman Institute for Molecular Biology, Jalan Diponegoro 69, Jakarta 10430, Indonesia
| | - Ita Margaretha Nainggolan
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Bogor 16911, Indonesia
| | - Josephine Elizabeth Siregar
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Bogor 16911, Indonesia
| | - Ungke Antonjaya
- Eijkman Oxford Clinical Research Unit, Eijkman Institute for Molecular Biology, Jalan Diponegoro 69, Jakarta 10430, Indonesia
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Oh SM, Lee JS, Jo HJ, Kim D, Park D, Hwang YH, Choi Y, Lee CM, Lee S, Chang E, Lee E, Kim TS, Seong MW, Choe PG, Kim NJ. Clinical application of the Panbio™ COVID-19 Ag rapid test device and SSf-COVID19 kit for the detection of SARS-CoV-2 infection. BMC Res Notes 2022; 15:357. [PMID: 36471453 PMCID: PMC9720920 DOI: 10.1186/s13104-022-06226-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE We evaluated the sensitivity and specificity of the Panbio™ COVID-19 Ag rapid test device using nasal swabs and those of the SSf-COVID19 kit, one of RT-PCR tests, using saliva specimens. These tests were compared with RT-PCR tests using nasopharyngeal swabs for the diagnosis of SARS-CoV-2 infection. The three diagnostic tests were simultaneously conducted for patients aged ≥ 18 years, who were about to be hospitalized or had been admitted for COVID-19 confirmed by RT-PCR in two research hospitals from August 20 to October 29, 2021. Nasal swabs were tested using the Panbio™ COVID-19 Ag rapid test device. More than 1 mL of saliva was self-collected and tested using the SSf-COVID19 kit. RESULTS In total, 157 patients were investigated; 124 patients who were about to be hospitalized and 33 patients already admitted for COVID-19. The overall sensitivity and specificity of the Panbio™ COVID-19 Ag rapid test device with nasal swabs were 64.7% (95% confidence interval [CI] 47.9-78.5%) and 100.0% (95% CI 97.0-100.0%), respectively. The median time to confirm a positive result was 180 s (interquartile range 60-255 s). The overall sensitivity and specificity of the SSf-COVID19 kit with saliva specimens were 94.1% (95% CI 80.9-98.4%) and 100.0% (95% CI 97.0-100.0%), respectively.
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Affiliation(s)
- Sang-Min Oh
- grid.31501.360000 0004 0470 5905Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080 Seoul, Republic of Korea ,grid.411545.00000 0004 0470 4320Present Address: Department of Internal Medicine, Jeonbuk National University Medical School and Hospital, 20 Geonjiro, Deokjin-gu, 54907 Jeonju, Jeollabuk-do Republic of Korea
| | - Jee-Soo Lee
- grid.31501.360000 0004 0470 5905Department of Laboratory Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080 Seoul, Republic of Korea
| | - Hyeon Jae Jo
- grid.31501.360000 0004 0470 5905Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080 Seoul, Republic of Korea
| | - Donghwan Kim
- grid.31501.360000 0004 0470 5905Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080 Seoul, Republic of Korea
| | - Dohyeon Park
- grid.31501.360000 0004 0470 5905Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080 Seoul, Republic of Korea
| | - Young Hoon Hwang
- grid.31501.360000 0004 0470 5905Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080 Seoul, Republic of Korea
| | - Yunsang Choi
- grid.31501.360000 0004 0470 5905Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080 Seoul, Republic of Korea
| | - Chan Mi Lee
- grid.31501.360000 0004 0470 5905Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080 Seoul, Republic of Korea
| | - Seungjae Lee
- grid.31501.360000 0004 0470 5905Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080 Seoul, Republic of Korea
| | - Euijin Chang
- grid.31501.360000 0004 0470 5905Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080 Seoul, Republic of Korea
| | - Eunyoung Lee
- grid.31501.360000 0004 0470 5905Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080 Seoul, Republic of Korea ,grid.412479.dDivision of Infectious Diseases, Seoul Metropolitan Government – Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, 07061 Seoul, Republic of Korea
| | - Taek Soo Kim
- grid.31501.360000 0004 0470 5905Department of Laboratory Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080 Seoul, Republic of Korea
| | - Moon-Woo Seong
- grid.31501.360000 0004 0470 5905Department of Laboratory Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080 Seoul, Republic of Korea
| | - Pyoeng Gyun Choe
- grid.31501.360000 0004 0470 5905Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080 Seoul, Republic of Korea
| | - Nam Joong Kim
- grid.31501.360000 0004 0470 5905Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, 03080 Seoul, Republic of Korea
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Abe H, Ushijima Y, Bikangui R, Ondo GN, Moure A, Yali-Assy-Oyamli Y, Yoshikawa R, Lell B, Adegnika AA, Yasuda J. Long-term validation of a reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay for the rapid detection of SARS-CoV-2 from March 2020 to October 2021 in Central Africa, Gabon. PLoS Negl Trop Dis 2022; 16:e0010964. [PMID: 36455044 DOI: 10.1371/journal.pntd.0010964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 12/13/2022] [Accepted: 11/19/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Despite the development of several methods for diagnosing COVID-19, long-term validation of such methods remains limited. In the early phase of the COVID-19 pandemic, we developed a rapid and sensitive diagnostic method based on reverse transcription loop-mediated isothermal amplification (RT-LAMP) methodology, which is suitable for point-of-care application or for use in resource-limited settings to detect SARS-CoV-2. To assess the applicability of the RT-LAMP assay technique to resource-limited regions, such as rural areas in Africa, and to verify the usability of the method against various SARS-CoV-2 variants, the method was validated using clinical samples collected longitudinally during the pandemic. METHODOLOGY/PRINCIPAL FINDINGS First, the sensitivity of the RT-LAMP assay for detecting 10 SARS-CoV-2 variants was evaluated using viral RNA samples extracted from cell culture with a portable battery-supported device, resulting in the successful detection of 20-50 copies of the viral genome within 15 min, regardless of the variant. COVID-19 positive samples collected in Gabon between March 2020 and October 2021 were used to evaluate the sensitivity of the assay and to calculate the copy number of the SARS-CoV-2 genome. More than 292 copies of the viral genome were detected with 100% probability within 15 min in almost all tests. CONCLUSIONS This long-term validation study clearly demonstrated the applicability of the RT-LAMP assay for the clinical diagnosis of COVID-19 in resource-limited settings of Africa, such as rural areas in Gabon. The results show the potential of the assay as a promising COVID-19 diagnostic method, especially in rural and remote regions located far from the official diagnosis facilities in urban or semi-urban areas.
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Affiliation(s)
- Haruka Abe
- Department of Emerging Infectious Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Yuri Ushijima
- Department of Emerging Infectious Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | | | | | - Ayong Moure
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | | | - Rokusuke Yoshikawa
- Department of Emerging Infectious Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- National Research Center for the Control and Prevention of Infectious Diseases (CCPID), Nagasaki University, Nagasaki, Japan
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Medical University of Vienna, Vienna, Austria
| | - Ayola A Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- German Center for Infection Research, Tübingen, Germany
| | - Jiro Yasuda
- Department of Emerging Infectious Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- National Research Center for the Control and Prevention of Infectious Diseases (CCPID), Nagasaki University, Nagasaki, Japan
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The Performance of Lateral Flow Tests in the Age of the Omicron: A Rapid Systematic Review. LIFE (BASEL, SWITZERLAND) 2022; 12:life12111941. [PMID: 36431077 PMCID: PMC9695766 DOI: 10.3390/life12111941] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022]
Abstract
Prompt detection and isolation of COVID-19 cases is vital for preventing further viral transmission, and lateral flow or rapid antigen tests have been an important diagnostic tool in this pandemic. However, concerns have emerged regarding the sensitivity of these devices for the new BA.1, BA.2, and BA.4/5 omicron variants, which have greater transmissibility and extensive mutations in its spike (S) and nucleocapsid (N) proteins. N protein is an important target protein for existing lateral flow devices. This paper therefore aimed to provide a rapid review of available literature on the performance of the lateral flow tests for detecting the omicron coronavirus variant. A systematic literature search of PubMed, EMBASE, OVID Medline, and Google Scholar found six published studies and four preprints investigating the performance of existing lateral flow devices for the omicron variant, as compared to the B.1.617.2 (Delta) variant. Overall, it appears that the devices have poorer performance for the omicron variant and when testing samples with cycle threshold (Ct) values greater than 25 and in asymptomatic individuals. As most available data were preliminary and had small sample sizes, it is recommended that these data be further studied to better inform and adapt our public health responses.
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Daily use of lateral flow devices by contacts of confirmed COVID-19 cases to enable exemption from isolation compared with standard self-isolation to reduce onward transmission of SARS-CoV-2 in England: a randomised, controlled, non-inferiority trial. THE LANCET. RESPIRATORY MEDICINE 2022; 10:1074-1085. [PMID: 36228640 PMCID: PMC9625116 DOI: 10.1016/s2213-2600(22)00267-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/19/2022] [Accepted: 07/12/2022] [Indexed: 11/05/2022]
Abstract
Background In the UK, during the study period (April to July, 2021), all contacts of people with COVID-19 were required to self-isolate for 10 days, which had adverse impacts on individuals and society. Avoiding the need to self-isolate for those who remain uninfected would be beneficial. We investigated whether daily use of lateral flow devices (LFDs) to test for SARS-CoV-2, with removal of self-isolation for 24 h if negative, could be a safe alternative to self-isolation as a means to minimise onward transmission of the virus. Methods We conducted a randomised, controlled, non-inferiority trial in adult contacts identified by COVID-19 contact tracing in England. Consenting participants were randomly assigned to self-isolation (single PCR test, 10-day isolation) or daily contact testing (DCT; seven LFD tests, two PCR tests, no isolation if negative on LFD); participants from a single household were assigned to the same group. Participants were prospectively followed up, with the effect of each intervention on onward transmission established from routinely collected NHS Test and Trace contact tracing data for participants who tested PCR-positive for SARS-CoV-2 during the study period and tertiary cases arising from their contacts (ie, secondary contacts). The primary outcome of the study was the attack rate, the percentage of secondary contacts (close contacts of SARS-CoV-2-positive study participants) who became COVID-19 cases (tertiary cases) in each group. Attack rates were derived from Bernoulli regression models using Huber-White (robust) sandwich estimator clustered standard errors. Attack rates were adjusted for household exposure, vaccination status, and ability to work from home. The non-inferiority margin was 1·9%. The primary analysis was a modified intention-to-treat analysis excluding those who actively withdrew from the study as data from these participants were no longer held. This study is registered with the Research Registry (number 6809). Data collection is complete; analysis is ongoing. Findings Between April 29 and July 28, 2021, 54 923 eligible individuals were enrolled in the study, with final group allocations (following withdrawals) of 26 123 (52·6%) participants in the DCT group and 23 500 (47·4%) in the self-isolation group. Overall, 4694 participants tested positive for SARS-CoV-2 by PCR (secondary cases), 2364 (10·1%) in the self-isolation group and 2330 (8·9%) in the DCT group. Adjusted attack rates (among secondary contacts) were 7·5% in the self-isolation group and 6·3% in the DCT group (difference of –1·2% [95% CI –2·3 to –0·2]; significantly lower than the non-inferiority margin of 1·9%). Interpretation DCT with 24 h exemption from self-isolation for essential activities appears to be non-inferior to self-isolation. This study, which provided evidence for the UK Government's daily lateral flow testing policy for vaccinated contacts of COVID-19 cases, indicated that daily testing with LFDs could allow individuals to reduce the risk of onward transmission while minimising the adverse effects of self-isolation. Although contacts in England are no longer required to isolate, the findings will be relevant for future policy decisions around COVID-19 or other communicable infections. Funding UK Government Department of Health and Social Care.
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Potter CJ, Hu Y, Xiong Z, Wang J, McLeod E. Point-of-care SARS-CoV-2 sensing using lens-free imaging and a deep learning-assisted quantitative agglutination assay. LAB ON A CHIP 2022; 22:3744-3754. [PMID: 36047372 PMCID: PMC9529856 DOI: 10.1039/d2lc00289b] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The persistence of the global COVID-19 pandemic caused by the SARS-CoV-2 virus has continued to emphasize the need for point-of-care (POC) diagnostic tests for viral diagnosis. The most widely used tests, lateral flow assays used in rapid antigen tests, and reverse-transcriptase real-time polymerase chain reaction (RT-PCR), have been instrumental in mitigating the impact of new waves of the pandemic, but fail to provide both sensitive and rapid readout to patients. Here, we present a portable lens-free imaging system coupled with a particle agglutination assay as a novel biosensor for SARS-CoV-2. This sensor images and quantifies individual microbeads undergoing agglutination through a combination of computational imaging and deep learning as a way to detect levels of SARS-CoV-2 in a complex sample. SARS-CoV-2 pseudovirus in solution is incubated with acetyl cholinesterase 2 (ACE2)-functionalized microbeads then loaded into an inexpensive imaging chip. The sample is imaged in a portable in-line lens-free holographic microscope and an image is reconstructed from a pixel superresolved hologram. Images are analyzed by a deep-learning algorithm that distinguishes microbead agglutination from cell debris and viral particle aggregates, and agglutination is quantified based on the network output. We propose an assay procedure using two images which results in the accurate determination of viral concentrations greater than the limit of detection (LOD) of 1.27 × 103 copies per mL, with a tested dynamic range of 3 orders of magnitude, without yet reaching the upper limit. This biosensor can be used for fast SARS-CoV-2 diagnosis in low-resource POC settings and has the potential to mitigate the spread of future waves of the pandemic.
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Affiliation(s)
- Colin J Potter
- Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA.
- College of Medicine, University of Arizona, Tucson, Arizona 85724, USA
| | - Yanmei Hu
- Department of Pharmacology, University of Arizona, Tucson, Arizona 85724, USA
| | - Zhen Xiong
- Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA.
| | - Jun Wang
- Department of Pharmacology, University of Arizona, Tucson, Arizona 85724, USA
| | - Euan McLeod
- Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA.
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Kosnik IG, Dermota U, Golle A, Cretnik TZ. Rapid antigen test for SARS-CoV-2: results of validation and use in real life. Future Virol 2022. [PMID: 36186521 PMCID: PMC9514382 DOI: 10.2217/fvl-2022-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 09/12/2022] [Indexed: 11/24/2022]
Abstract
Aim: To verify a SARS-CoV-2 rapid antigen test (RAT) compared with PCR. Materials & methods: Validation of RAT included 2295 subjects. Next matching of RAT with the PCR was checked in 13,852 subjects referred to PCR after being positive in RAT. Results: Sensitivity and specificity of RAT were 77.38 and 99.10%, respectively. A 74.60% of RAT positive results were confirmed with PCR. Conclusion: The test met WHO susceptibility criteria in a group of symptomatic subjects. In terms of specificity, it met requirements in all subjects. The concordance of RAT with PCR in real life was in line with our verification data.
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Affiliation(s)
- Irena Grmek Kosnik
- National Laboratory for Health, Environment & Food, Prvomajska 2, 2000, Maribor, Slovenia
| | - Urska Dermota
- National Laboratory for Health, Environment & Food, Prvomajska 2, 2000, Maribor, Slovenia
| | - Andrej Golle
- National Laboratory for Health, Environment & Food, Prvomajska 2, 2000, Maribor, Slovenia
| | - Tjasa Zohar Cretnik
- National Laboratory for Health, Environment & Food, Prvomajska 2, 2000, Maribor, Slovenia
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Correia BP, Sousa MP, Sousa CEA, Mateus D, Sebastião AI, Cruz MT, Matos AM, Pereira AC, Moreira FTC. Development of colorimetric cellulose-based test-strip for the rapid detection of antibodies against SARS-CoV2 virus. CELLULOSE (LONDON, ENGLAND) 2022; 29:9311-9322. [PMID: 36158137 PMCID: PMC9483301 DOI: 10.1007/s10570-022-04808-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 08/10/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Given the pandemic situation, there is an urgent need for an accurate test to monitor antibodies anti-SARS-CoV-2, providing crucial epidemiological and clinical information to monitor the evolution of coronavirus disease in 2019 (COVID-19) and to stratify the immunized and asymptomatic population. Therefore, this paper describes a new cellulose-based test strip for rapid and cost-effective quantitative detection of antibodies to SARS-CoV2 virus by colorimetric transduction. For this purpose, Whatman paper was chemically modified with sodium metaperiodate to introduce aldehyde groups on its surface. Subsequently, the spike protein of the virus is covalently bound by forming an imine group. The chemical control of cellulose paper modification was evaluated by Fourier transform infrared spectroscopy, thermogravimetry and contact angle analysis. Colorimetric detection of the antibodies was performed by a conventional staining method using Ponceau S solution as the dye. Color analysis was performed after image acquisition with a smartphone using Image J software. The color intensity varied linearly with the logarithm of the anti-S concentration (from 10 ng/mL to 1 μg/mL) in 500-fold diluted serum samples when plotted against the green coordinate extracted from digital images. The test strip was selective in the presence of nucleocapsid antibodies, urea, glucose, and bovine serum albumin with less than 15% interference, and detection of antibodies in human serum was successfully performed. Overall, this is a simple and affordable design that can be readily used for mass population screening and does not require sophisticated equipment or qualified personnel. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10570-022-04808-y.
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Affiliation(s)
- Bárbara P. Correia
- BioMark/ISEP, School of Engineering, Polytechnic School of Porto, R. Dr. António Bernardino de Almeida, 431, 4249-015 Porto, Portugal
- CEB - Centre of Biological Engineering, University of Minho, Braga, Portugal
| | - Mariana P. Sousa
- BioMark/ISEP, School of Engineering, Polytechnic School of Porto, R. Dr. António Bernardino de Almeida, 431, 4249-015 Porto, Portugal
- CEB - Centre of Biological Engineering, University of Minho, Braga, Portugal
| | - Cristina E. A. Sousa
- BioMark/ISEP, School of Engineering, Polytechnic School of Porto, R. Dr. António Bernardino de Almeida, 431, 4249-015 Porto, Portugal
- CEB - Centre of Biological Engineering, University of Minho, Braga, Portugal
| | - Daniela Mateus
- Faculty of Farmacy, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Ana Isabel Sebastião
- Faculty of Farmacy, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Maria Teresa Cruz
- Faculty of Farmacy, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Ana Miguel Matos
- Faculty of Farmacy, University of Coimbra, 3000-548 Coimbra, Portugal
- Chemical Engineering Processes and Forest Products Research Center, CIEPQPF, Faculty of Sciences and Technology, University of Coimbra, 3030-790 Coimbra, Portugal
| | - Ana Cláudia Pereira
- BioMark/ISEP, School of Engineering, Polytechnic School of Porto, R. Dr. António Bernardino de Almeida, 431, 4249-015 Porto, Portugal
- CEB - Centre of Biological Engineering, University of Minho, Braga, Portugal
| | - Felismina T. C. Moreira
- BioMark/ISEP, School of Engineering, Polytechnic School of Porto, R. Dr. António Bernardino de Almeida, 431, 4249-015 Porto, Portugal
- CEB - Centre of Biological Engineering, University of Minho, Braga, Portugal
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C. Zapico S, Dytso A, Rubio L, Roca G. The Perfect Match: Assessment of Sample Collection Efficiency for Immunological and Molecular Findings in Different Types of Fabrics. Int J Mol Sci 2022; 23:ijms231810686. [PMID: 36142599 PMCID: PMC9502974 DOI: 10.3390/ijms231810686] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/10/2022] [Accepted: 09/11/2022] [Indexed: 11/16/2022] Open
Abstract
Body fluid identification at crime scenes can be crucial in retrieving the appropriate evidence that leads to the perpetrator and, in some cases, the victim. For this purpose, immunochromatographic tests are simple, fast and suitable for crime scenes. The potential sample is retrieved with a swab, normally a cotton swab, moistened in a specific buffer. Nonetheless, there are other swab types available, which have been proven to be efficient for DNA isolation and analysis. The aim of this study is to evaluate the efficiency of different swab types for body fluid identification as well as DNA isolation and characterization. Fifty microliters of human saliva were deposited in three different types of fabric (denim, cotton, and polyester). After 24 h at room temperature, samples were recovered by applying three different swab types, and the tests were performed. Subsequently, total DNA was recovered from the sample buffer. Cotton swabs performed worse in denim and cotton fabrics in both immunochromatography tests and DNA yield. No differences were observed for polyester. In contrast, and except for two replicates, it was possible to obtain a full DNA profile per fabric and swab type, and to identify the mtDNA haplogroup. In this paper, the impact of swab types on body fluid identification through the application of immunochromatographic tests is analyzed for the first time. This work corroborates previous research related to the influence of swab types in nuclear DNA isolation and characterization.
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Affiliation(s)
- Sara C. Zapico
- New Jersey Institute of Technology, Department of Chemistry and Environmental Science, 161 Warren Street, Tiernan Hall, 365, Newark, NJ 07102, USA
- Smithsonian Institution, National Museum of Natural History, Anthropology Department, 10th and Constitution Ave., NW, Washington, DC 20560, USA
- Correspondence: or
| | - Alex Dytso
- New Jersey Institute of Technology, Department of Electrical and Computer Engineering, University Heights, Newark, NJ 07102, USA
| | - Leticia Rubio
- Fulbright Visiting Scholar Program, Department of Chemistry and Environmental Science, 161 Warren Street, Tiernan Hall, 365, Newark, NJ 07102, USA or
- Department of Human Anatomy and Legal Medicine, Facultad de Medicina, Universidad de Málaga, 29071 Málaga, Spain
| | - Gabriela Roca
- SERATEC®, Gesellschaft für Biotechnologie mbH, Ernst-Ruhstrat-Strasse 5, 37079 Göttingen, Germany
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Wu Y, Hu Y, Jiang N, Anantharanjit R, Yetisen AK, Cordeiro MF. Quantitative brain-derived neurotrophic factor lateral flow assay for point-of-care detection of glaucoma. LAB ON A CHIP 2022; 22:3521-3532. [PMID: 35979801 DOI: 10.1039/d2lc00431c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Glaucoma, a ruinous group of eye diseases with progressive degeneration of the optic nerve and vision loss, is the leading cause of irreversible blindness. Accurate and timely diagnosis of glaucoma is critical to promote secondary prevention and early disease-modifying therapies. Reliable, cheap, and rapid tests for measuring disease activities are highly required. Brain-derived neurotrophic factor (BDNF) plays an important role in maintaining the function and survival of the central nervous system. Decreased BDNF levels in tear fluid can be seen in glaucoma patients, which indicates that BDNF can be regarded as a novel biomarker for glaucoma. Conventional ELISA is the standard method to measure the BDNF level, but the multi-step operation and strict storage conditions limit its usage in point-of-care settings. Herein, a one-step and a portable glaucoma detection method was developed based on the lateral flow assay (LFA) to quantify the BDNF concentration in artificial tear fluids. The results of the LFA were analyzed by using a portable and low-cost system consisting of a smartphone camera and a dark readout box fabricated by 3D printing. The concentration of BDNF was quantified by analyzing the colorimetric intensity of the test line and the control line. This assay yields reliable quantitative results from 25 to 300 pg mL-1 with an experimental detection limit of 14.12 pg mL-1. The LFA shows a high selectivity for BDNF and high stability in different pH environments. It can be readily adapted for sensitive and quantitative testing of BDNF in a point-of-care setting. The BDNF LFA strip shows it has great potential to be used in early glaucoma detection.
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Affiliation(s)
- Yue Wu
- Department of Chemical Engineering, Imperial College London, South Kensington, London, UK.
- Department of Surgery and Cancer, Imperial College London, South Kensington, London, UK.
| | - Yubing Hu
- Department of Chemical Engineering, Imperial College London, South Kensington, London, UK.
| | - Nan Jiang
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Rajeevan Anantharanjit
- Department of Surgery and Cancer, Imperial College London, South Kensington, London, UK.
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London, London, UK
| | - Ali K Yetisen
- Department of Chemical Engineering, Imperial College London, South Kensington, London, UK.
| | - M Francesca Cordeiro
- Department of Surgery and Cancer, Imperial College London, South Kensington, London, UK.
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London, London, UK
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
- Glaucoma and Retinal Neurodegeneration Group, Department of Visual Neuroscience, UCL Institute of Ophthalmology, London, UK
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Schwartz KL, Bogoch II, MacInTosh D, Barrow J, Sindrey D, Jha P, Brown KA, Maxwell B, Hammond K, Greenberg M, Wasser E. SARS-CoV-2 rapid antigen screening of asymptomatic employees: a pilot project. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2022; 113:898-903. [PMID: 36097245 PMCID: PMC9466303 DOI: 10.17269/s41997-022-00691-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 08/19/2022] [Indexed: 12/14/2022]
Abstract
SETTING Rapid antigen screening can be effective in identifying infectious individuals in occupational settings to reduce transmission and outbreaks. We report results from a pilot project at the Greater Toronto Airports Authority (GTAA) and describe the operationalization. Toronto Pearson is a large international airport encompassing over 400 employers and, pre-pandemic, with approximately 50,000 employees. INTERVENTION An employee screening program was piloted between March 8 and May 28, 2021, to implement rapid antigen testing for asymptomatic employees. Recruitment targeted enrolment of 400 employees and yielded participation of 717 from 58 companies. Employees were recommended to book three times per week for nasal swabs on site, and were tested on the Abbot PanbioTM rapid antigen test. No action was taken from a negative result, and if positive, the employee was told to isolate at home and obtain a confirmatory polymerase chain reaction test. OUTCOMES A total of 5117 tests were performed on 717 individuals over 12 weeks; 5091 tests were negative (99.5%), and 22 individuals tested positive (3.1% positivity rate). One hundred twenty-four (17%) completed the post-participation survey. All respondents reported that testing did not change their behaviour at work with respect to public health recommendations, and only 1 (1%) reported behaviour change outside of work (socializing with family) as a result of the program. IMPLICATIONS This pilot program identified 22 (3.1%) potentially infectious employees. Onsite testing was feasible and highly accepted by this group of employees who completed the survey. Education resulted in reasonable uptake and no substantial change in behaviour, although the survey response rate may limit generalizability. Home-based testing may facilitate larger recruitment.
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Affiliation(s)
- Kevin L. Schwartz
- Unity Health Toronto, 30 The Queensway, Toronto, ON M6R 1B5 Canada ,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | - Isaac I. Bogoch
- Toronto General Hospital, University Health Network, Toronto, Ontario Canada ,Faculty of Medicine, University of Toronto, Toronto, Ontario Canada
| | | | - Jeffrey Barrow
- Greater Toronto Airports Authority, Toronto, Ontario Canada
| | - Dennis Sindrey
- National Research Council, Industrial Research Assistance Program, Ottawa, Ontario Canada
| | - Prabhat Jha
- Unity Health Toronto, 30 The Queensway, Toronto, ON M6R 1B5 Canada ,Faculty of Medicine, University of Toronto, Toronto, Ontario Canada
| | - Kevin A. Brown
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | | | - Kath Hammond
- Greater Toronto Airports Authority, Toronto, Ontario Canada
| | | | - Eddie Wasser
- Greater Toronto Airports Authority, Toronto, Ontario Canada
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50
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Gosling M, Bacon J. Acute-onset respiratory signs in a Labrador Retriever with a positive SARS-CoV-2 rapid antigen test and infection confirmed by RT-PCR analysis: a case report. J Vet Sci 2022; 23:e80. [PMID: 36259099 PMCID: PMC9715386 DOI: 10.4142/jvs.22119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/31/2022] [Accepted: 08/16/2022] [Indexed: 12/15/2022] Open
Abstract
A 10-year-old male neutered Labrador Retriever presented with a history of acute-onset tachypnoea, lethargy and anorexia. The dog was pyrexic, tachypnoeic and dyspnoeic on examination. A rapid antigen test for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was performed on an oropharyngeal swab and yielded a positive result. SARS-CoV-2 infection was subsequently confirmed by reverse transcription polymerase chain reaction (RT-PCR) analysis. Both of the dog's owners had positive rapid antigen test and RT-PCR analysis results for SARS-CoV-2. Additional diagnostics included computed tomography. Resolution of the dog's clinical signs was achieved with symptomatic treatment.
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Affiliation(s)
- Mark Gosling
- Wear Referrals, Bradbury, Stockton-on-Tees, County Durham, TS21 2ES, England
| | - Jessica Bacon
- Wear Referrals, Bradbury, Stockton-on-Tees, County Durham, TS21 2ES, England
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