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Yang WW, Hsu CW, Chan YJ, Su SB, Feng IJ, Hou CY, Huang CY. Using Real-Time PCR Fluorescence Reaction Values to Improve SARS-CoV-2 Virus Detection and Benefit Clinical Decision-Making. Life (Basel) 2023; 13:life13030683. [PMID: 36983837 PMCID: PMC10057560 DOI: 10.3390/life13030683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/05/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
This study aimed to compare the SARS-CoV-2 nucleic acid detection results of the BD MAX™ System and other platforms to formulate an optimized laboratory verification process. The re-examination of 400 samples determined as positive by BD MAX™ indicated that the inconsistency rate between BD MAX™ and the other platforms was 65.8%; the inconsistency rate of single-gene-positive results was as high as 99.2%. A receiver operating characteristic curve was drawn for the relative light unit (RLU) values of samples positive for a single gene, and RLU 800 was used as the cutoff. After setting the retest standard as single-gene positive and RLU ≥ 800, the number of the 260 BD MAX™ single-gene positives that needed to be confirmed again was 36 (13.8%) and the number that could be directly reported as negative was 224 (86.2%). This verification process can shorten the reporting period and speed up the epidemic adjustment time and turnover rate of special wards, thereby improving SARS-CoV-2 detection efficiency and clinical decision-making.
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Affiliation(s)
- Wan-Wen Yang
- Department of Clinical Pathology, Chi-Mei Medical Center, Liouying, Tainan 736402, Taiwan
| | - Chin-Wen Hsu
- Department of Family Medicine, Chi-Mei Medical Center, Liouying, Tainan 736402, Taiwan
| | - Yu-Ju Chan
- Department of Family Medicine, Chi-Mei Medical Center, Liouying, Tainan 736402, Taiwan
| | - Shih-Bin Su
- Division of Occupational Medicine, Chi-Mei Medical Center, Liouying, Tainan 736402, Taiwan
- Division of Occupational Medicine, Chi-Mei Medical Center, Tainan 710402, Taiwan
| | - I-Jung Feng
- Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung 804201, Taiwan
| | - Chia-Yi Hou
- Department of Clinical Pathology, Chi-Mei Medical Center, Liouying, Tainan 736402, Taiwan
- Correspondence: (C.-Y.H.); (C.-Y.H.)
| | - Chien-Yuan Huang
- Division of Occupational Medicine, Chi-Mei Medical Center, Liouying, Tainan 736402, Taiwan
- Division of Occupational Medicine, Chi-Mei Medical Center, Tainan 710402, Taiwan
- Correspondence: (C.-Y.H.); (C.-Y.H.)
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Wang Y, Li X, Wang Y, Tu Z, Xu J, Pan J, Zhou Q. Comparison of the performance of two real-time fluorescent quantitative PCR kits for the detection of SARS-CoV-2 nucleic acid: a study based on large real clinical samples. Virol J 2022; 19:191. [PMID: 36401275 PMCID: PMC9675236 DOI: 10.1186/s12985-022-01922-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 11/10/2022] [Indexed: 11/19/2022] Open
Abstract
Background The global pandemic of coronavirus disease 2019 (COVID-19) has led to the development of multiple detection kits by national manufacturers for severe acute respiratory syndrome coronavirus 2 viral nucleic acid testing. The purpose of this study is to evaluate the performance of different kits (i.e., Maccura kit and Sansure kit) in real clinical work using clinical samples, which will help with the optimization of the test kits. Method During the past three months (March–May 2022), 1399 pharyngeal swabs from suspected COVID-19 patients have been initially screened using the Maccura kit in Jilin, China, and the test results were verified using the Sansure kit. The cycle threshold (Ct) values generated by the two kits were compared at different viral load levels. Correlation and consistency of the Ct values were investigated using Spearman correlation, Deming regression, and Bland–Altman plots. The cut-off Ct values of the Maccura kit were recalculated by referencing the result of the Sansure kit as a standard. Furthermore, another 163 pharyngeal swabs from suspected COVID-19 patients were collected to verify the new cut-off values. Results As a result of the Maccura kit testing, 1192 positive cases and 207 suspected COVID-19 cases were verified. After re-examination by the Sansure kit, 1118 positive cases were confirmed. The difference between the Ct values provided by the two kits was statistically significant, except for the N gene at high viral load. The Ct values obtained from the two kits presented a linear positive correlation. The Maccura kit used new cut-off Ct values of 35.00 (ORF1ab gene) and 35.07 (N gene). Based on that, the validation pass rate for the new cut-off Ct values was 91.41%. Conclusion Since the Maccura kit is found to have false positives in actual clinical work, recalculation of the cut-off values can reduce this occurrence. In order to improve the accuracy of the testing, laboratories should use two kits for COVID-19 testing, and the adjusting and optimizing of the kits for their situation are needed.
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Simeunovic‐Ostojic M, Herremans EE, Thai K, Maas J. Anorexia nervosa and
COVID
‐19 infection: Clinical case report. Clin Case Rep 2022; 10:e6216. [PMID: 36093463 PMCID: PMC9440278 DOI: 10.1002/ccr3.6216] [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: 12/27/2021] [Revised: 07/04/2022] [Accepted: 07/16/2022] [Indexed: 11/12/2022] Open
Abstract
The true risk of COVID‐19 infection in anorexia nervosa (AN) including the duration of viral RNA shedding and infectivity is still unclear. We report on a case of a patient with severe AN with a mild course of COVID‐19 and prolonged viral RNA shedding for at least 39 days after symptom onset. A careful evaluation of long‐term infectivity must include viral load, live virus isolation, and viral genome sequencing. We report on a case of a patient with severe anorexia nervosa (AN) with unusually prolonged viral clearance, despite a mild course of COVID‐19. Careful evaluation and preventive actions should be tailored to each patient with AN requiring hospitalization considering the potential for disease transmission and viral mutation.
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Affiliation(s)
| | - Evy E. Herremans
- Center for Eating Disorders Helmond Mental Health Center Region Oost‐Brabant Boekel The Netherlands
| | - Khoa Thai
- Star‐shl Medical Diagnostic Center Rotterdam The Netherlands
| | - Joyce Maas
- Center for Eating Disorders Helmond Mental Health Center Region Oost‐Brabant Boekel The Netherlands
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Chan HT, Keung MH, Nguyen I, Ip EL, Chew SM, Siler D, Saville M, Hawkes D. Exploring beyond the limit: How comparative stochastic performance affects retesting outcomes in six commercial SARS CoV-2 nucleic acid amplification tests. JOURNAL OF CLINICAL VIROLOGY PLUS 2022; 2:100079. [PMID: 35528049 PMCID: PMC9055756 DOI: 10.1016/j.jcvp.2022.100079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/20/2022] [Accepted: 04/27/2022] [Indexed: 01/17/2023] Open
Abstract
Objectives To examine the comparative stochasticity profile of six commercial SARS-CoV-2 nucleic acid amplification tests (NAATs) and how this may affect retesting paradigms. Methods Commercial quality control (QC) material was serially diluted in viral transport media to create a panel covering 10-10,000 copies/ml. The panel was tested across six commercial NAATs. A subset of high cycle threshold results was retested on a rapid PCR assay to simulate retesting protocols commonly used to discriminate false positives. Results Performance beyond the LOD differed among assays, with three types of stochasticity profiles observed. The ability of the rapid PCR assay to reproduce a true weak positive specimen was restricted to its own stochastic performance at the corresponding viral concentration. Conclusion Stochastic performance of various NAATs overlap across low viral concentrations and affect retesting outcomes. Relying on retesting alone to discriminate false positives risk missing true positives even when a more sensitive assay is deployed for confirmatory testing.
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Affiliation(s)
- Hiu Tat Chan
- VCS Pathology, Australian Centre for the Prevention of Cervical Cancer, 265 Faraday Street, Carlton South, VIC 3053, Australia,Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, VIC 3086, Australia,Corresponding author at: VCS Pathology, Australian Centre for the Prevention of Cervical Cancer, 265 Faraday Street, Carlton South, VIC 3053, Australia
| | - Marco H.T. Keung
- VCS Pathology, Australian Centre for the Prevention of Cervical Cancer, 265 Faraday Street, Carlton South, VIC 3053, Australia
| | - Ivy Nguyen
- VCS Pathology, Australian Centre for the Prevention of Cervical Cancer, 265 Faraday Street, Carlton South, VIC 3053, Australia
| | - Ellen L.O. Ip
- VCS Pathology, Australian Centre for the Prevention of Cervical Cancer, 265 Faraday Street, Carlton South, VIC 3053, Australia
| | - Su M. Chew
- VCS Pathology, Australian Centre for the Prevention of Cervical Cancer, 265 Faraday Street, Carlton South, VIC 3053, Australia
| | | | - Marion Saville
- VCS Pathology, Australian Centre for the Prevention of Cervical Cancer, 265 Faraday Street, Carlton South, VIC 3053, Australia,Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, VIC 3010, Australia,Department of Obstetrics and Gynaecology, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - David Hawkes
- VCS Pathology, Australian Centre for the Prevention of Cervical Cancer, 265 Faraday Street, Carlton South, VIC 3053, Australia,Department of Pharmacology and Biochemistry, University of Melbourne, Parkville, VIC 3010, Australia,Department of Pathology, University of Malaya, Kuala Lumpur 50603, Malaysia
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