1
|
Ahuja V, Bowe T, Warnock G, Pitman C, Dwyer DE. Trends in SARS-CoV-2 cycle threshold (Ct) values from nucleic acid testing predict the trajectory of COVID-19 waves. Pathology 2024:S0031-3025(24)00095-3. [PMID: 38670916 DOI: 10.1016/j.pathol.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/08/2024] [Accepted: 02/01/2024] [Indexed: 04/28/2024]
Abstract
Forecasting COVID-19 waves helps with public health planning and resource allocation. Cycle threshold (Ct) values obtained from positive SARS-CoV-2 nucleic acid amplification test (NAAT) results offer limited value for individual patient management, but real-time analysis of temporal trends of aggregated Ct values may provide helpful information to predict the trajectories of COVID-19 waves in the community. Ct value trends on 59,609 SARS-CoV-2 NAAT-positive results from 574,403 tests using a single testing assay system, between September 2021 and January 2023, were examined to monitor the trend of the proportion of positive NAAT with lower Ct values (≤28) in relation to changing COVID-19 case numbers over time. We applied regression with autoregressive integrated moving average errors modelling approach to study the relation between Ct values and case counts. We also developed an insight product to monitor the temporal trends with Ct values obtained from SARS-CoV-2 NAAT-positive results. In this study, the proportion of lower Ct values preceded by a range of 7-32 days the rising population COVID-19 testing rate reflecting onset of a COVID-19 wave. Monitoring population Ct values may assist in predicting increased disease activity.
Collapse
Affiliation(s)
- Vishal Ahuja
- NSW Health Pathology - Public Health Pathology, Sydney, NSW, Australia.
| | - Thomas Bowe
- NSW Health Pathology - Data & Insights, Sydney, NSW, Australia
| | - Gayle Warnock
- NSW Health Pathology - Point of Care Testing, Sydney, NSW, Australia
| | - Catherine Pitman
- NSW Health Pathology - Public Health Pathology, Sydney, NSW, Australia
| | - Dominic E Dwyer
- NSW Health Pathology - Public Health Pathology, Sydney, NSW, Australia; Sydney Infectious Diseases Institute, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
2
|
Tomasicchio M, Jaumdally S, Wilson L, Kotze A, Semple L, Meier S, Pooran A, Esmail A, Pillay K, Roberts R, Kriel R, Meldau R, Oelofse S, Mandviwala C, Burns J, Londt R, Davids M, van der Merwe C, Roomaney A, Kühn L, Perumal T, Scott AJ, Hale MJ, Baillie V, Mahtab S, Williamson C, Joseph R, Sigal A, Joubert I, Piercy J, Thomson D, Fredericks DL, Miller MGA, Nunes MC, Madhi SA, Dheda K. SARS-CoV-2 Viral Replication Persists in the Human Lung for Several Weeks after Symptom Onset. Am J Respir Crit Care Med 2024; 209:840-851. [PMID: 38226855 PMCID: PMC10995573 DOI: 10.1164/rccm.202308-1438oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/12/2024] [Indexed: 01/17/2024] Open
Abstract
Rationale: In the upper respiratory tract, replicating (culturable) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is recoverable for ∼4-8 days after symptom onset, but there is a paucity of data about the frequency and duration of replicating virus in the lower respiratory tract (i.e., the human lung).Objectives: We undertook lung tissue sampling (needle biopsy) shortly after death in 42 mechanically ventilated decedents during the Beta and Delta waves. An independent group of 18 ambulatory patients served as a control group.Methods: Lung biopsy cores from decedents underwent viral culture, histopathological analysis, electron microscopy, transcriptomic profiling, and immunohistochemistry.Measurements and Main Results: Thirty-eight percent (16 of 42) of mechanically ventilated decedents had culturable virus in the lung for a median of 15 days (persisting for up to 4 wk) after symptom onset. Lung viral culture positivity was not associated with comorbidities or steroid use. Delta but not Beta variant lung culture positivity was associated with accelerated death and secondary bacterial infection (P < 0.05). Nasopharyngeal culture was negative in 23.1% (6 of 26) of decedents despite lung culture positivity. This hitherto undescribed biophenotype of lung-specific persisting viral replication was associated with an enhanced transcriptomic pulmonary proinflammatory response but with concurrent viral culture positivity.Conclusions: Concurrent rather than sequential active viral replication continues to drive a heightened proinflammatory response in the human lung beyond the second week of illness and was associated with variant-specific increased mortality and morbidity. These findings have potential implications for the design of interventional strategies and clinical management of patients with severe coronavirus disease (COVID-19).
Collapse
Affiliation(s)
- Michele Tomasicchio
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Shameem Jaumdally
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Lindsay Wilson
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Andrea Kotze
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Lynn Semple
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Stuart Meier
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Anil Pooran
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Aliasgar Esmail
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Komala Pillay
- Division of Anatomical Pathology, Department of Pathology, and
| | - Riyaadh Roberts
- Division of Anatomical Pathology, Department of Pathology, and
| | - Raymond Kriel
- Division of Anatomical Pathology, Department of Pathology, and
| | - Richard Meldau
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Suzette Oelofse
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Carley Mandviwala
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Jessica Burns
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Rolanda Londt
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Malika Davids
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Charnay van der Merwe
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Aqeedah Roomaney
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Louié Kühn
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Tahlia Perumal
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | - Alex J. Scott
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
| | | | - Vicky Baillie
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, and
- Department of Science and Technology/National Research Foundation South African Research Chair Initiative in Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sana Mahtab
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, and
- Department of Science and Technology/National Research Foundation South African Research Chair Initiative in Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Alex Sigal
- Africa Health Research Institute, Durban, South Africa; and
| | - Ivan Joubert
- Division of Critical Care, Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa
| | - Jenna Piercy
- Division of Critical Care, Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa
| | - David Thomson
- Division of Critical Care, Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa
| | - David L. Fredericks
- Division of Critical Care, Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa
| | - Malcolm G. A. Miller
- Division of Critical Care, Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa
| | - Marta C. Nunes
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, and
- Department of Science and Technology/National Research Foundation South African Research Chair Initiative in Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre of Excellence in Respiratory Pathogens, Hospices Civils de Lyon and Centre International de Recherche en Infectiologie, Équipe Santé Publique, Épidémiologie et Écologie Évolutive des Maladies Infectieuses, Inserm U1111, CNRS UMR5308, ENS de Lyon, Université Claude Bernard – Lyon 1, Lyon, France
| | - Shabir A. Madhi
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, and
- Department of Science and Technology/National Research Foundation South African Research Chair Initiative in Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Keertan Dheda
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, Cape Town, South Africa
- South African MRC Centre for the Study of Antimicrobial Resistance
- Institute of Infectious Disease and Molecular Medicine
- Faculty of Infectious and Tropical Diseases, Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, United Kingdom
| |
Collapse
|
3
|
Lam C, Johnson-Mackinnon J, Basile K, Fong W, Suster CJ, Gall M, Agius J, Chandra S, Draper J, Martinez E, Drew A, Wang Q, Chen SC, Kok J, Dwyer DE, Sintchenko V, Rockett RJ. A laboratory framework for ongoing optimization of amplification-based genomic surveillance programs. Microbiol Spectr 2023; 11:e0220223. [PMID: 37966271 PMCID: PMC10715188 DOI: 10.1128/spectrum.02202-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/13/2023] [Indexed: 11/16/2023] Open
Abstract
IMPORTANCE This study provides a laboratory framework to ensure ongoing relevance and performance of amplification-based whole genome sequencing to strengthen public health surveillance during extended outbreaks or pandemics. The framework integrates regular reviews of the performance of a genomic surveillance system and highlights the importance of ongoing monitoring and the identification and implementation of improvements to whole genome sequencing methods to enhance public health responses to pathogen outbreaks.
Collapse
Affiliation(s)
- Connie Lam
- Centre for Infectious Diseases and Microbiology - Public Health, Institute for Clinical Pathology and Medical Research Westmead Hospital, Westmead, Australia
- Faculty of Medicine and Health, Sydney Infectious Diseases Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Jessica Johnson-Mackinnon
- Centre for Infectious Diseases and Microbiology - Public Health, Institute for Clinical Pathology and Medical Research Westmead Hospital, Westmead, Australia
- Faculty of Medicine and Health, Sydney Infectious Diseases Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Kerri Basile
- Faculty of Medicine and Health, Sydney Infectious Diseases Institute, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Infectious Diseases and Microbiology - Laboratory Services, Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Sydney, Australia
| | - Winkie Fong
- Centre for Infectious Diseases and Microbiology - Public Health, Institute for Clinical Pathology and Medical Research Westmead Hospital, Westmead, Australia
- Faculty of Medicine and Health, Sydney Infectious Diseases Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Carl J.E. Suster
- Centre for Infectious Diseases and Microbiology - Public Health, Institute for Clinical Pathology and Medical Research Westmead Hospital, Westmead, Australia
- Faculty of Medicine and Health, Sydney Infectious Diseases Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Mailie Gall
- Centre for Infectious Diseases and Microbiology - Laboratory Services, Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Sydney, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Jessica Agius
- Centre for Infectious Diseases and Microbiology - Public Health, Institute for Clinical Pathology and Medical Research Westmead Hospital, Westmead, Australia
- Faculty of Medicine and Health, Sydney Infectious Diseases Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Shona Chandra
- Centre for Infectious Diseases and Microbiology - Public Health, Institute for Clinical Pathology and Medical Research Westmead Hospital, Westmead, Australia
- Faculty of Medicine and Health, Sydney Infectious Diseases Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Jenny Draper
- Centre for Infectious Diseases and Microbiology - Laboratory Services, Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Sydney, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Elena Martinez
- Centre for Infectious Diseases and Microbiology - Laboratory Services, Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Sydney, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Alexander Drew
- Centre for Infectious Diseases and Microbiology - Laboratory Services, Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Sydney, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Qinning Wang
- Centre for Infectious Diseases and Microbiology - Laboratory Services, Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Sydney, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Sharon C. Chen
- Centre for Infectious Diseases and Microbiology - Laboratory Services, Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Sydney, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Jen Kok
- Centre for Infectious Diseases and Microbiology - Laboratory Services, Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Sydney, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Dominic E. Dwyer
- Centre for Infectious Diseases and Microbiology - Laboratory Services, Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Sydney, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Vitali Sintchenko
- Centre for Infectious Diseases and Microbiology - Public Health, Institute for Clinical Pathology and Medical Research Westmead Hospital, Westmead, Australia
- Faculty of Medicine and Health, Sydney Infectious Diseases Institute, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca J. Rockett
- Centre for Infectious Diseases and Microbiology - Public Health, Institute for Clinical Pathology and Medical Research Westmead Hospital, Westmead, Australia
- Faculty of Medicine and Health, Sydney Infectious Diseases Institute, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
4
|
Ferguson JD, Tayyar R, Contreras G, Kiener M, Zimmet AN, Contag CA, Rodriguez Nava G, Tompkins LS, Shepard J, Rosenthal A, Subramanian AK, Pinsky BA, Salinas JL. Use of a severe acute respiratory coronavirus virus 2 (SARS-CoV-2) strand-specific assay to evaluate for prolonged viral replication >20 days from illness onset. Infect Control Hosp Epidemiol 2023; 44:2078-2080. [PMID: 37381726 DOI: 10.1017/ice.2023.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) real-time reverse-transcription polymerase chain reaction (rRT-PCR) strand-specific assay can be used to identify active SARS-CoV-2 viral replication. We describe the characteristics of 337 hospitalized patients with at least 1 minus-strand SARS-CoV-2 assay performed >20 days after illness onset. This test is a novel tool to identify high-risk hospitalized patients with prolonged SARS-CoV-2 replication.
Collapse
Affiliation(s)
- Jessica D Ferguson
- Stanford University School of Medicine and Stanford Hospital & Clinics, Stanford, California
| | - Ralph Tayyar
- Stanford University School of Medicine and Stanford Hospital & Clinics, Stanford, California
| | - Gustavo Contreras
- Stanford University School of Medicine and Stanford Hospital & Clinics, Stanford, California
| | - Melanie Kiener
- Stanford University School of Medicine and Stanford Hospital & Clinics, Stanford, California
| | - Alex N Zimmet
- Stanford University School of Medicine and Stanford Hospital & Clinics, Stanford, California
| | - Caitlin A Contag
- Stanford University School of Medicine and Stanford Hospital & Clinics, Stanford, California
| | | | - Lucy S Tompkins
- Stanford University School of Medicine and Stanford Hospital & Clinics, Stanford, California
| | - John Shepard
- Stanford University School of Medicine and Stanford Hospital & Clinics, Stanford, California
| | - Ayelet Rosenthal
- Stanford University School of Medicine and Stanford Hospital & Clinics, Stanford, California
| | - Aruna K Subramanian
- Stanford University School of Medicine and Stanford Hospital & Clinics, Stanford, California
| | - Benjamin A Pinsky
- Stanford University School of Medicine and Stanford Hospital & Clinics, Stanford, California
| | - Jorge L Salinas
- Stanford University School of Medicine and Stanford Hospital & Clinics, Stanford, California
| |
Collapse
|
5
|
Bello SO, Imam MU, Bello MB, Yunusa A, Ahmed Adamu A, Shuaibu A, Igumbor EU, Habib ZG, Popoola MA, Ochu CL, Yahaya Bello A, Deeni YY, Okoye I. Erythromycin, retapamulin, pyridoxine, folic acid, and ivermectin inhibit cytopathic effect, papain-like protease, and M PRO enzymes of SARS-CoV-2. Front Cell Infect Microbiol 2023; 13:1273982. [PMID: 38089816 PMCID: PMC10711598 DOI: 10.3389/fcimb.2023.1273982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/20/2023] [Indexed: 12/18/2023] Open
Abstract
Background Although tremendous success has been achieved in the development and deployment of effective COVID-19 vaccines, developing effective therapeutics for the treatment of those who do come down with the disease has been with limited success. To repurpose existing drugs for COVID-19, we previously showed, qualitatively, that erythromycin, retapamulin, pyridoxine, folic acid, and ivermectin inhibit SARS-COV-2-induced cytopathic effect (CPE) in Vero cells. Aim This study aimed to quantitatively explore the inhibition of SARS-CoV-2-induced CPE by erythromycin, retapamulin, pyridoxine, folic acid, and ivermectin and to determine the effect of these drugs on SARS-CoV-2 papain-like protease and 3CL protease (MPRO) enzymes. Methods Neutral red (3-amino-7-dimethylamino-2-methyl-phenazine hydrochloride) cell viability assay was used to quantify CPE after infecting pre-treated Vero cells with clinical SARS-Cov-2 isolates. Furthermore, SensoLyte® 520 SARS-CoV-2 papain-like protease and SensoLyte® 520 SARS-CoV-2 MPRO activity assay kits were used to evaluate the inhibitory activity of the drugs on the respective enzymes. Results Erythromycin, retapamulin, pyridoxine, folic acid, and ivermectin dose-dependently inhibit SARS-CoV-2-induced CPE in Vero cells, with inhibitory concentration-50 (IC50) values of 3.27 µM, 4.23 µM, 9.29 µM, 3.19 µM, and 84.31 µM, respectively. Furthermore, erythromycin, retapamulin, pyridoxine, folic acid, and ivermectin dose-dependently inhibited SARS-CoV-2 papain-like protease with IC50 values of 0.94 µM, 0.88 µM, 1.14 µM, 1.07 µM, and 1.51 µM, respectively, and inhibited the main protease (MPRO) with IC50 values of 1.35 µM, 1.25 µM, 7.36 µM, 1.15 µM, and 2.44 µM, respectively. Conclusion The IC50 for all the drugs, except ivermectin, was at the clinically achievable plasma concentration in humans, which supports a possible role for the drugs in the management of COVID-19. The lack of inhibition of CPE by ivermectin at clinical concentrations could be part of the explanation for its lack of effectiveness in clinical trials.
Collapse
Affiliation(s)
- Shaibu Oricha Bello
- Department of Pharmacology and Therapeutics, Faculty of Basic Clinical Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
- Nigerian COVID-19 Research Coalition, Nigerian Institute of Medical Research Institute, Lagos, Nigeria
- Centre for Advanced Medical Research and Training, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Mustapha Umar Imam
- Centre for Advanced Medical Research and Training, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
- Department of Medical Biochemistry, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Muhammad Bashir Bello
- Centre for Advanced Medical Research and Training, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
- Department of Veterinary Microbiology, Faculty of Veterinary Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Abdulmajeed Yunusa
- Department of Pharmacology and Therapeutics, Faculty of Basic Clinical Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
- Centre for Advanced Medical Research and Training, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Adamu Ahmed Adamu
- Department of Pharmacology and Therapeutics, Faculty of Basic Clinical Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
- Centre for Advanced Medical Research and Training, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Abdulmalik Shuaibu
- Centre for Advanced Medical Research and Training, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
- Department of Veterinary Microbiology, Faculty of Veterinary Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Ehimario Uche Igumbor
- Nigerian COVID-19 Research Coalition, Nigerian Institute of Medical Research Institute, Lagos, Nigeria
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Zaiyad Garba Habib
- Nigerian COVID-19 Research Coalition, Nigerian Institute of Medical Research Institute, Lagos, Nigeria
- Department of Medicine, University of Abuja Teaching Hospital, Abuja, Nigeria
| | - Mustapha Ayodele Popoola
- Nigerian COVID-19 Research Coalition, Nigerian Institute of Medical Research Institute, Lagos, Nigeria
| | - Chinwe Lucia Ochu
- Nigerian COVID-19 Research Coalition, Nigerian Institute of Medical Research Institute, Lagos, Nigeria
- Nigerian Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Aishatu Yahaya Bello
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Yusuf Yahaya Deeni
- Nigerian COVID-19 Research Coalition, Nigerian Institute of Medical Research Institute, Lagos, Nigeria
- Department of Microbiology and Biotechnology, Federal University of Dutse, Dutse, Nigeria
- Centre for Environmental and Public Health Research and Development, Kano, Nigeria
| | - Ifeoma Okoye
- University of Nigeria Centre for Clinical Trials, University of Nigeria Teaching Hospital, Enugu, Nigeria
| |
Collapse
|
6
|
Wertenauer C, Pfeifer C, Roskos M, März W. Rapid antigen tests for SARS-CoV-2-a synopsis of the medical evidence. Diagn Microbiol Infect Dis 2023; 107:116027. [PMID: 37516068 DOI: 10.1016/j.diagmicrobio.2023.116027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 06/26/2023] [Accepted: 07/11/2023] [Indexed: 07/31/2023]
Abstract
SARS-CoV-2, the causative agent of the COVID-19 pandemic, continues to influence health, economy, and stability worldwide. Diagnostic testing for SARS-CoV-2 is important to contain the COVID-19 pandemic. With the commercial availability of certified antigen (Ag) rapid diagnostic tests (RDTs), which can be used to identify an infection with SARS-CoV-2 an easy-to-use tool was introduced. Self-tests can offer advantages to complement professionally administered rapid antigen detection or nucleic acid amplification testing (NAAT). Compared to real-time polymerase chain reaction (RT-PCR), Ag-RDTs are cost inexpensive, do not need specialized laboratory equipment, facilitating high-throughput testing. However, Ag-RDT sensitivities are strongly dependent on the viral load within the specimen, which has limited their application in clinical settings so far. The methodical limitations of Ag-RDTs may produce false negative test results, particularly when specimens with low viral loads are examined. This may facilitate viral transmissions if protective measurements are lifted mistakenly.
Collapse
Affiliation(s)
- Christoph Wertenauer
- Medical Clinic V, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | | | | | - Winfried März
- Medical Clinic V, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; SYNLAB Academy, SYNLAB Holding Deutschland GmbH, Mannheim, Germany; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| |
Collapse
|
7
|
Abstract
Nucleic acid amplification tests (NAATs), including polymerase chain reaction (PCR) assays, are more sensitive for the detection of SARS-CoV-2 than rapid antigen tests (RATS), and are the gold standard for diagnosis of acute COVID-19. However NAATs can remain positive for weeks following infection due to low-level shedding of non-viable viral fragments. RATs (in particular self-testing) are the mainstay of COVID-19 diagnosis due to their convenience, speed and high specificity. The sensitivity of RATs is highest within seven days of symptom onset. A negative RAT result may warrant a NAAT or repeat RAT for confirmation. The presence of spike antibodies is consistent with either vaccination or infection. Nucleocapsid antibodies suggest a previous infection. Serological tests measuring neutralising antibodies that infer immunity are not readily available.
Collapse
|
8
|
Szobi A, Buranovská K, Vojtaššáková N, Lovíšek D, Özbaşak HÖ, Szeibeczederová S, Kapustian L, Hudáčová Z, Kováčová V, Drobná D, Putaj P, Bírová S, Čirková I, Čarnecký M, Kilián P, Jurkáček P, Čabanová V, Boršová K, Sláviková M, Vaňová V, Klempa B, Čekan P, Paul ED. Vivid COVID-19 LAMP is an ultrasensitive, quadruplexed test using LNA-modified primers and a zinc ion and 5-Br-PAPS colorimetric detection system. Commun Biol 2023; 6:233. [PMID: 36864129 PMCID: PMC9979146 DOI: 10.1038/s42003-023-04612-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/20/2023] [Indexed: 03/04/2023] Open
Abstract
Sensitive and rapid point-of-care assays have been crucial in the global response to SARS-CoV-2. Loop-mediated isothermal amplification (LAMP) has emerged as an important diagnostic tool given its simplicity and minimal equipment requirements, although limitations exist regarding sensitivity and the methods used to detect reaction products. We describe the development of Vivid COVID-19 LAMP, which leverages a metallochromic detection system utilizing zinc ions and a zinc sensor, 5-Br-PAPS, to circumvent the limitations of classic detection systems dependent on pH indicators or magnesium chelators. We make important strides in improving RT-LAMP sensitivity by establishing principles for using LNA-modified LAMP primers, multiplexing, and conducting extensive optimizations of reaction parameters. To enable point-of-care testing, we introduce a rapid sample inactivation procedure without RNA extraction that is compatible with self-collected, non-invasive gargle samples. Our quadruplexed assay (targeting E, N, ORF1a, and RdRP) reliably detects 1 RNA copy/µl of sample (=8 copies/reaction) from extracted RNA and 2 RNA copies/µl of sample (=16 copies/reaction) directly from gargle samples, making it one of the most sensitive RT-LAMP tests and even comparable to RT-qPCR. Additionally, we demonstrate a self-contained, mobile version of our assay in a variety of high-throughput field testing scenarios on nearly 9,000 crude gargle samples. Vivid COVID-19 LAMP can be an important asset for the endemic phase of COVID-19 as well as preparing for future pandemics.
Collapse
Affiliation(s)
- Adrián Szobi
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA
| | - Katarína Buranovská
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA
| | - Nina Vojtaššáková
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA
| | - Daniel Lovíšek
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA
| | - Halil Önder Özbaşak
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA
| | - Sandra Szeibeczederová
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA
| | - Liudmyla Kapustian
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA
| | - Zuzana Hudáčová
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA
- Stanford University, 730 Escondido Rd., Stanford, CA, 94305, USA
| | - Viera Kováčová
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA
- University of Cologne, Institute for Biological Physics, Zülpicher Str. 77, 50937, Köln, Germany
| | - Diana Drobná
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA
| | - Piotr Putaj
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA
| | - Stanislava Bírová
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA
| | - Ivana Čirková
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA
| | - Martin Čarnecký
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA
| | - Peter Kilián
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA
| | - Peter Jurkáček
- AstonITM s.r.o., Račianska 153, 831 54, Bratislava, Slovakia
| | - Viktória Čabanová
- Biomedical Research Center, Slovak Academy of Sciences, Institute of Virology, Dúbravská cesta 9, 845 05, Bratislava, Slovakia
| | - Kristína Boršová
- Biomedical Research Center, Slovak Academy of Sciences, Institute of Virology, Dúbravská cesta 9, 845 05, Bratislava, Slovakia
| | - Monika Sláviková
- Biomedical Research Center, Slovak Academy of Sciences, Institute of Virology, Dúbravská cesta 9, 845 05, Bratislava, Slovakia
| | - Veronika Vaňová
- Biomedical Research Center, Slovak Academy of Sciences, Institute of Virology, Dúbravská cesta 9, 845 05, Bratislava, Slovakia
- Department of Microbiology and Virology, Faculty of Natural Sciences, Comenius University, Ilkovičova 6, 842 15, Bratislava, Slovakia
| | - Boris Klempa
- Biomedical Research Center, Slovak Academy of Sciences, Institute of Virology, Dúbravská cesta 9, 845 05, Bratislava, Slovakia
- Department of Microbiology and Virology, Faculty of Natural Sciences, Comenius University, Ilkovičova 6, 842 15, Bratislava, Slovakia
| | - Pavol Čekan
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia.
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA.
| | - Evan D Paul
- MultiplexDX, s.r.o., Comenius University Science Park, Ilkovičova 8, 841 04, Bratislava, Slovakia.
- MultiplexDX, Inc., One Research Court, Suite 450, Rockville, MD, 20850, USA.
| |
Collapse
|
9
|
Erbaş İC, Keleş YE, Erdeniz EH, Yılmaz AT, Yeşil E, Çakıcı Ö, Akça M, Ulu NK, Dinç F, Çiftdoğan DY, Öncel S, Kuyucu N, Tapısız A, Belet N. Evaluation of possible COVID-19 reinfection in children: A multicenter clinical study. Arch Pediatr 2023; 30:187-191. [PMID: 36804354 PMCID: PMC9902289 DOI: 10.1016/j.arcped.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/17/2022] [Accepted: 01/07/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Although it was originally unknown whether there would be cases of reinfection of coronavirus disease 2019 (COVID-19) as seen with other coronaviruses, cases of reinfection were reported from various regions recently. However, there is little information about reinfection in children. METHODS In this study, we aimed to investigate the incidence and clinical findings of reinfection in pediatric patients who had recovered from COVID-19. We retrospectively evaluated all patients under 18 years of age with COVID-19 infection from a total of eight healthcare facilities in Turkey, between March 2020 and July 2021. Possible reinfection was defined as a record of confirmed COVID-19 infection based on positive reverse transcription-polymerase chain reaction (RT-PCR) test results at least 3 months apart. RESULTS A possible reinfection was detected in 11 out of 8840 children, which yielded an incidence of 0.12%. The median duration between two episodes of COVID-19 was 196 (92-483) days. When initial and second episodes were compared, the rates of symptomatic and asymptomatic disease were similar for both, as was the severity of the disease (p = 1.000). Also, there was no significant difference in duration of symptoms (p = 0.498) or in hospitalization rates (p = 1.000). Only one patient died 15 days after PCR positivity, which resulted in a 9.1% mortality rate for cases of reinfection in pediatric patients. CONCLUSION We observed that children with COVID-19 were less likely to be exposed to reinfection when compared with adults. Although the clinical spectrum of reinfection was mostly similar to the first episode, we reported death of a healthy child during the reinfection.
Collapse
Affiliation(s)
- İrem Ceren Erbaş
- Division of Pediatric Infectious Disease, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey.
| | - Yıldız Ekemen Keleş
- Division of Pediatric Infectious Disease, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Emine Hafize Erdeniz
- Division of Pediatric Infectious Disease, Faculty of Medicine, On Dokuz Mayıs University, Samsun, Turkey
| | - Ayşe Tekin Yılmaz
- Division of Pediatric Infectious Disease, Eskişehir State Hospital, Eskişehir, Turkey
| | - Edanur Yeşil
- Division of Pediatric Infectious Disease, Mersin State Hospital, Mersin, Turkey
| | - Özlem Çakıcı
- Division of Pediatric Infectious Disease, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Mehtap Akça
- Division of Pediatric Infectious Disease, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Nursel Kara Ulu
- Division of Pediatric Infectious Disease, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Fatih Dinç
- Division of Virology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Dilek Yılmaz Çiftdoğan
- Division of Pediatric Infectious Disease, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Selim Öncel
- Division of Pediatric Infectious Disease, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Necdet Kuyucu
- Division of Pediatric Infectious Disease, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Anıl Tapısız
- Division of Pediatric Infectious Disease, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Nurşen Belet
- Division of Pediatric Infectious Disease, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| |
Collapse
|
10
|
Cava F, San Román J, Barreiro P, Candel FJ, Álvarez-Timón FJ, Melero D, Coya N, Guillén R, Cantarero-Prieto D, Lera-Torres J, Cobo-Ortiz N, Canora J, Martínez-Peromingo FJ, Barba R, Carretero MDM, Losa JE, Zapatero A. Temporal Series Analysis of Population Cycle Threshold Counts as a Predictor of Surge in Cases and Hospitalizations during the SARS-CoV-2 Pandemic. Viruses 2023; 15. [PMID: 36851635 DOI: 10.3390/v15020421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 02/05/2023] Open
Abstract
Tools to predict surges in cases and hospitalizations during the COVID-19 pandemic may help guide public health decisions. Low cycle threshold (CT) counts may indicate greater SARS-CoV-2 concentrations in the respiratory tract, and thereby may be used as a surrogate marker of enhanced viral transmission. Several population studies have found an association between the oscillations in the mean CT over time and the evolution of the pandemic. For the first time, we applied temporal series analysis (Granger-type causality) to validate the CT counts as an epidemiological marker of forthcoming pandemic waves using samples and analyzing cases and hospital admissions during the third pandemic wave (October 2020 to May 2021) in Madrid. A total of 22,906 SARS-CoV-2 RT-PCR-positive nasopharyngeal swabs were evaluated; the mean CT value was 27.4 (SD: 2.1) (22.2% below 20 cycles). During this period, 422,110 cases and 36,727 hospital admissions were also recorded. A temporal association was found between the CT counts and the cases of COVID-19 with a lag of 9-10 days (p ≤ 0.01) and hospital admissions by COVID-19 (p < 0.04) with a lag of 2-6 days. According to a validated method to prove associations between variables that change over time, the short-term evolution of average CT counts in the population may forecast the evolution of the COVID-19 pandemic.
Collapse
|
11
|
Theaux C, Martin Y, Montoto Piazza L, Wenk G, Notaristefano G, Miño L, Sevilla ME, Aprea V, Claps A, Nabaes Jodar M, Acuña D, Salvatori M, Álvarez L, Langan ME, Turk G, Del Olmo R, Viegas M, Bruno M, Bokser V. Persistence of SARS-CoV-2 RNA shedding and infectivity in immunized population: Prospective study along different epidemiological periods in Argentina. PLoS One 2023; 18:e0285704. [PMID: 37196044 DOI: 10.1371/journal.pone.0285704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 04/30/2023] [Indexed: 05/19/2023] Open
Abstract
During the pandemic of COVID-19, numerous waves of infections affected the two hemispheres with different impacts on each country. Throughout these waves, and with the emergence of new variants, health systems and scientists have tried to provide real-time responses to the complex biology of SARS-CoV-2, dealing with different clinical presentations, biological characteristics, and clinical impact of these variants. In this context, knowing the extent period in which an infected individual releases infectious viral particles has important implications for public health. This work aimed to investigate viral RNA shedding and infectivity of SARS-CoV-2 beyond 10 days after symptom onset (SO). A prospective multicenter study was performed between July/2021 and February/2022 on 116 immunized strategic personnel with COVID-19 diagnosed by RT-qPCR, with asymptomatic (7%), mild (91%) or moderate disease (2%). At the time of diagnosis, 70% had 2 doses of vaccines, 26% had 2 plus a booster, and 4% had one dose. After day 10 from SO, sequential nasopharyngeal swabs were taken to perform RT-qPCR, viral isolation, and S gene sequencing when possible. Viral sequences were obtained in 98 samples: 43% were Delta, 16% Lambda, 15% Gamma, 25% Omicron (BA.1) and 1% Non-VOC/VOI, in accordance with the main circulating variants at each moment. SARS-CoV-2 RNA was detected 10 days post SO in 57% of the subjects. Omicron was significantly less persistent. Noteworthy, infective viruses could not be isolated in any of the samples. In conclusion, a 10-days isolation period was useful to prevent further infections, and proved valid for the variants studied. Recently, even shorter periods have been applied, as the Omicron variant is prevalent, and worldwide population is largely vaccinated. In the future, facing the possible emergence of new variants and considering immunological status, a return to 10 days may be necessary.
Collapse
Affiliation(s)
- Clara Theaux
- División Laboratorio, Departamento de Diagnóstico y Tratamiento, Hospital General de Agudos Dr. Carlos G. Durand, Ciudad Autónoma de Buenos Aires, Argentina
| | - Yamila Martin
- Hospital Municipal de Rehabilitación Respiratoria María Ferrer, Ciudad Autónoma de Buenos Aires, Argentina
| | - Luciana Montoto Piazza
- Departamento de Diagnóstico y Tratamiento, Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires, Argentina
| | - Gretel Wenk
- Departamento de Diagnóstico y Tratamiento, Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires, Argentina
| | - Guillermo Notaristefano
- División Laboratorio, Departamento de Diagnóstico y Tratamiento, Hospital General de Agudos Dr. Carlos G. Durand, Ciudad Autónoma de Buenos Aires, Argentina
| | - Laura Miño
- División Promoción y Protección de la Salud, Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires, Argentina
| | - María Eugenia Sevilla
- División Promoción y Protección de la Salud, Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires, Argentina
| | - Valeria Aprea
- División Promoción y Protección de la Salud, Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires, Argentina
| | - Aldana Claps
- Departamento de Diagnóstico y Tratamiento, Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires, Argentina
| | - Mercedes Nabaes Jodar
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Ciudad Autónoma de Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Argentina
- Consorcio Argentino de Genómica de SARS-CoV-2 (Proyecto PAIS), Ministerio de Ciencia, Tecnología e Innovación, Ciudad Autónoma de Buenos Aires, Argentina
| | - Dolores Acuña
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Ciudad Autónoma de Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Argentina
- Consorcio Argentino de Genómica de SARS-CoV-2 (Proyecto PAIS), Ministerio de Ciencia, Tecnología e Innovación, Ciudad Autónoma de Buenos Aires, Argentina
| | - Melina Salvatori
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), CONICET-Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
- Facultad de Medicina, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Laura Álvarez
- División Promoción y Protección de la Salud, Hospital General de Agudos Dr. Carlos G. Durand, Ciudad Autónoma de Buenos Aires, Argentina
| | - María Eugenia Langan
- División Promoción y Protección de la Salud, Hospital General de Agudos Dr. Carlos G. Durand, Ciudad Autónoma de Buenos Aires, Argentina
| | - Gabriela Turk
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), CONICET-Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
- Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Ricardo Del Olmo
- Hospital Municipal de Rehabilitación Respiratoria María Ferrer, Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariana Viegas
- Laboratorio de Virología, Hospital de Niños Dr. Ricardo Gutiérrez, Ciudad Autónoma de Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Argentina
- Consorcio Argentino de Genómica de SARS-CoV-2 (Proyecto PAIS), Ministerio de Ciencia, Tecnología e Innovación, Ciudad Autónoma de Buenos Aires, Argentina
| | - Miriam Bruno
- División Promoción y Protección de la Salud, Hospital General de Agudos Dr. Carlos G. Durand, Ciudad Autónoma de Buenos Aires, Argentina
| | - Vivian Bokser
- División Promoción y Protección de la Salud, Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires, Argentina
| |
Collapse
|
12
|
Kang SW, Park H, Kim JY, Park S, Lim SY, Lee S, Bae JY, Kim J, Bae S, Jung J, Kim MJ, Chong YP, Lee SO, Choi SH, Kim YS, Yun SC, Park MS, Kim SH. Clinical scoring system to predict viable viral shedding in patients with COVID-19. J Clin Virol 2022; 157:105319. [PMID: 36223658 DOI: 10.1016/j.jcv.2022.105319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/27/2022] [Accepted: 10/01/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The Centers for Disease Control and Prevention (CDC) recommends 5-10 days of isolation for patients with COVID-19, depending on symptom duration and severity. However, in clinical practice, an individualized approach is required. We thus developed a clinical scoring system to predict viable viral shedding. METHODS We prospectively enrolled adult patients with SARS-CoV-2 infection admitted to a hospital or community isolation facility between February 2020 and January 2022. Daily dense respiratory samples were obtained, and genomic RNA viral load assessment and viral culture were performed. Clinical predictors of negative viral culture results were identified using survival analysis and multivariable analysis. RESULTS Among 612 samples from 121 patients including 11 immunocompromised patients (5 organ transplant recipients, 5 with hematologic malignancy, and 1 receiving immunosuppressive agents) with varying severity, 154 (25%) revealed positive viral culture results. Multivariable analysis identified symptom onset day, viral copy number, disease severity, organ transplant recipient, and vaccination status as independent predictors of culture-negative rate. We developed a 4-factor predictive model based on viral copy number (-3 to 3 points), disease severity (1 point for moderate to critical disease), organ transplant recipient (2 points), and vaccination status (-2 points for fully vaccinated). Predicted culture-negative rates were calculated through the symptom onset day and the score of the day the sample was collected. CONCLUSIONS Our clinical scoring system can provide the objective probability of a culture-negative state in a patient with COVID-19 and is potentially useful for implementing personalized de-isolation policies beyond the simple symptom-based isolation strategy.
Collapse
|
13
|
Grumiro L, Brandolini M, Gatti G, Scalcione A, Taddei F, Dirani G, Mancini A, Denicolò A, Manera M, Zannoli S, Marino MM, Morotti M, Arfilli V, Battisti A, Cricca M, Sambri V. Evaluation of STANDARDTM M10 SARS-CoV-2, a Novel Cartridge-Based Real-Time PCR Assay for the Rapid Identification of Severe Acute Respiratory Syndrome Coronavirus 2. Appl Microbiol 2022; 2:873-881. [DOI: 10.3390/applmicrobiol2040067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Since the beginning of the pandemic, SARS-CoV-2 has caused problems for all of world’s population, not only in terms of deaths but also in terms of overloading healthcare facilities in all countries. Diagnosis is one of the key aspects of controlling the spread of SARS-CoV-2, and among the current molecular techniques, real-time PCR is considered as the gold standard. The availability of tests that allow for the rapid and accurate identification of SARS-CoV-2 is therefore of considerable importance. Moreover, if these tests allow for even minimal intervention by the operator, any risk of contamination is reduced. In this study, the performances of the new STANDARDTM M10 SARS-CoV-2 (SD Biosensor Inc., Suwon, Korea) rapid molecular test, which incorporates the above-mentioned features, were characterized. The clinical and analytical performances measured by testing different variants circulating in Italy of STANDARDTM M10 SARS-CoV-2 were compared to the test already on the market and recognized as the gold standard: Xpert Xpress SARS-CoV-2 (Cepheid, Sunnyvale, CA, USA). The results obtained between the two tests are largely comparable, suggesting that STANDARDTM M10 SARS-CoV-2 can be used with excellent results in the fight against the global spread of SARS-CoV-2.
Collapse
|
14
|
Zhu X, Zhou F, Zhou Q, Xu J. Evaluating the role of SARS-CoV-2 target genes based on two nucleic acid assay kits. Front Public Health 2022; 10:982171. [PMID: 36249245 PMCID: PMC9554243 DOI: 10.3389/fpubh.2022.982171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/12/2022] [Indexed: 01/25/2023] Open
Abstract
Background Effective isolation and early treatment of coronavirus disease 2019 (COVID-19) relies on rapid, accurate, and straightforward diagnostic tools. In response to the rapidly increasing number of cases, reverse transcription-quantitative polymerase chain reaction (RT-qPCR) assays for multiple target genes have become widely available in the market. Methods In total, 236 COVID-19 patients with positive results in both RT-qPCR and rapid antigen diagnosis (Ag-RDT) were enrolled in the study. The cycle threshold (Ct) was compared with different onset times and target genes. Comparison between groups was evaluated with the Kruskal-Wallis test and Dunn test. The correlation between target genes was analyzed by Spearman. Results In samples of Ct ≤ 21, Ct was different for the nucleocapsid (N), open reading frame 1ab (ORF1ab), and envelope (E) genes (P < 0.05). Mild COVID-19 patients within 7 days of onset accounted for 67.80% of all enrolled patients. At the above stage, all target genes reached the trough of Ct, and N genes showed lower values than the other target genes. The Ct of the ORF1ab and N gene in asymptomatic patients differed from those of mild patients within 7 days and more than 14 days of onset. The kits used in the study showed strong consistency among target genes, with all correlation coefficients >0.870. Conclusion RT-qPCR confirmed that the N gene performed well in Ct ≤ 21 and samples within 7 days of onset. Ag-RDT was discriminatory for patients within 7 days of onset. This study facilitated early identification and control of COVID-19 prevalence among patients.
Collapse
Affiliation(s)
- Xuetong Zhu
- Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China,Department of Laboratory Medicine, The First Hospital of Jilin University, Changchun, China
| | - Fengyan Zhou
- Department of Infectious Disease Control, Jilin City Center for Disease Control and Prevention, Jilin, China
| | - Qi Zhou
- Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China,Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Jiancheng Xu
- Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China,Department of Laboratory Medicine, The First Hospital of Jilin University, Changchun, China,*Correspondence: Jiancheng Xu
| |
Collapse
|
15
|
Basile K, Rockett RJ, McPhie K, Fennell M, Johnson-Mackinnon J, Agius JE, Fong W, Rahman H, Ko D, Donavan L, Hueston L, Lam C, Arnott A, Chen SCA, Maddocks S, O’Sullivan MV, Dwyer DE, Sintchenko V, Kok J. Improved Neutralisation of the SARS-CoV-2 Omicron Variant following a Booster Dose of Pfizer-BioNTech (BNT162b2) COVID-19 Vaccine. Viruses 2022; 14:v14092023. [PMID: 36146829 PMCID: PMC9501619 DOI: 10.3390/v14092023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/02/2022] [Accepted: 09/08/2022] [Indexed: 11/20/2022] Open
Abstract
In late November 2021, the World Health Organization declared the SARS-CoV-2 lineage B.1.1.529 the fifth variant of concern, Omicron. This variant has acquired over 30 mutations in the spike protein (with 15 in the receptor-binding domain), raising concerns that Omicron could evade naturally acquired and vaccine-derived immunity. We utilized an authentic virus, multicycle neutralisation assay to demonstrate that sera collected one, three, and six months post-two doses of Pfizer-BioNTech BNT162b2 had a limited ability to neutralise SARS-CoV-2. However, four weeks after a third dose, neutralising antibody titres were boosted. Despite this increase, neutralising antibody titres were reduced fourfold for Omicron compared to lineage A.2.2 SARS-CoV-2.
Collapse
Affiliation(s)
- Kerri Basile
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
- Correspondence: (K.B.); (J.K.)
| | - Rebecca J. Rockett
- Centre for Infectious Diseases and Microbiology—Public Health, Westmead Hospital, Sydney, NSW 2145, Australia
- Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, NSW 2006, Australia
| | - Kenneth McPhie
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
- The Westmead Institute for Medical Research, Westmead, Sydney, NSW 2145, Australia
| | - Michael Fennell
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
| | - Jessica Johnson-Mackinnon
- Centre for Infectious Diseases and Microbiology—Public Health, Westmead Hospital, Sydney, NSW 2145, Australia
| | - Jessica E. Agius
- Centre for Infectious Diseases and Microbiology—Public Health, Westmead Hospital, Sydney, NSW 2145, Australia
| | - Winkie Fong
- Centre for Infectious Diseases and Microbiology—Public Health, Westmead Hospital, Sydney, NSW 2145, Australia
| | - Hossinur Rahman
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
| | - Danny Ko
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
| | - Linda Donavan
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
| | - Linda Hueston
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD 4222, Australia
| | - Connie Lam
- Centre for Infectious Diseases and Microbiology—Public Health, Westmead Hospital, Sydney, NSW 2145, Australia
| | - Alicia Arnott
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
| | - Sharon C.-A. Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
- Centre for Infectious Diseases and Microbiology—Public Health, Westmead Hospital, Sydney, NSW 2145, Australia
- Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, NSW 2006, Australia
| | - Susan Maddocks
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
| | - Matthew V. O’Sullivan
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
- Centre for Infectious Diseases and Microbiology—Public Health, Westmead Hospital, Sydney, NSW 2145, Australia
- Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, NSW 2006, Australia
| | - Dominic E. Dwyer
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
- Centre for Infectious Diseases and Microbiology—Public Health, Westmead Hospital, Sydney, NSW 2145, Australia
- Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, NSW 2006, Australia
| | - Vitali Sintchenko
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
- Centre for Infectious Diseases and Microbiology—Public Health, Westmead Hospital, Sydney, NSW 2145, Australia
- Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, NSW 2006, Australia
| | - Jen Kok
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
- Centre for Infectious Diseases and Microbiology—Public Health, Westmead Hospital, Sydney, NSW 2145, Australia
- Correspondence: (K.B.); (J.K.)
| |
Collapse
|
16
|
Gans JS. Test sensitivity for infection versus infectiousness of SARS-CoV-2. MDE Manage Decis Econ 2022; 43:1880-1887. [PMID: 34908630 PMCID: PMC8662307 DOI: 10.1002/mde.3496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/18/2021] [Accepted: 10/25/2021] [Indexed: 06/07/2023]
Abstract
The most commonly used test for the presence of SARS-CoV-2 is a PCR test that is able to detect very low viral loads and inform on treatment decisions. Medical research has confirmed that many individuals might be infected with SARS-CoV-2 but not infectious. Knowing whether an individual is infectious is the critical piece of information for a decision to isolate an individual or not. This paper examines the value of different tests from an information-theoretic approach and shows that applying treatment-based approval standards for tests for infection will lower the value of those tests and likely causes decisions based on them to have too many false positives (i.e., individuals isolated who are not infectious). The conclusion is that test scoring be tailored to the decision being made.
Collapse
Affiliation(s)
- Joshua S. Gans
- Rotman School of ManagementUniversity of Toronto and NBERTorontoCanada
| |
Collapse
|
17
|
Pham D, Maddocks S, Dwyer DE, Sintchenko V, Kok J, Rockett RJ. Development and Validation of an In-House Real-Time Reverse-Transcriptase Polymerase Chain Reaction Assay for SARS-CoV-2 Omicron Lineage Subtyping between BA.1 and BA.2. Viruses 2022; 14:v14081760. [PMID: 36016382 PMCID: PMC9416591 DOI: 10.3390/v14081760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 11/18/2022] Open
Abstract
In order to rapidly differentiate sublineages BA.1 and BA.2 of the SARS-CoV-2 variant of concern Omicron, we developed a real-time reverse-transcriptase polymerase chain reaction to target the discriminatory spike protein deletion at amino acid position 69–70 (S:del69–70). Compared to the gold standard of whole genome sequencing, the candidate assay was 100% sensitive and 99.4% specific. Sublineage typing by RT-PCR can provide a rapid, high throughput and cost-effective method to enhance surveillance as well as potentially guiding treatment and infection control decisions.
Collapse
Affiliation(s)
- David Pham
- Centre for Infectious Diseases & Microbiology Laboratory Services, New South Wales Health, Pathology—Institute of Clinical Pathology & Medical Research, Westmead Hospital, Westmead, NSW 2145, Australia
- Correspondence:
| | - Susan Maddocks
- Centre for Infectious Diseases & Microbiology Laboratory Services, New South Wales Health, Pathology—Institute of Clinical Pathology & Medical Research, Westmead Hospital, Westmead, NSW 2145, Australia
- Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia
| | - Dominic E. Dwyer
- Centre for Infectious Diseases & Microbiology Laboratory Services, New South Wales Health, Pathology—Institute of Clinical Pathology & Medical Research, Westmead Hospital, Westmead, NSW 2145, Australia
- Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia
- Centre for Infectious Diseases & Microbiology—Public Health, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Vitali Sintchenko
- Centre for Infectious Diseases & Microbiology Laboratory Services, New South Wales Health, Pathology—Institute of Clinical Pathology & Medical Research, Westmead Hospital, Westmead, NSW 2145, Australia
- Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia
- Centre for Infectious Diseases & Microbiology—Public Health, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Jen Kok
- Centre for Infectious Diseases & Microbiology Laboratory Services, New South Wales Health, Pathology—Institute of Clinical Pathology & Medical Research, Westmead Hospital, Westmead, NSW 2145, Australia
- Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia
- Centre for Infectious Diseases & Microbiology—Public Health, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Rebecca J. Rockett
- Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia
- Centre for Infectious Diseases & Microbiology—Public Health, Westmead Hospital, Westmead, NSW 2145, Australia
| |
Collapse
|
18
|
Agard A, Elsheikh O, Bell D, Relich RF, Schmitt BH, Sadowski J, Fadel W, Webb DH, Dbeibo L, Kelley K, Carozza M, Lei GS, Calkins P, Beeler C. Clinical comparison and agreement of PCR, antigen, and viral culture for the diagnosis of COVID-19. Journal of Clinical Virology Plus 2022; 2:100099. [PMID: 35880110 PMCID: PMC9300048 DOI: 10.1016/j.jcvp.2022.100099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/12/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study is to compare the COVID-19 nasopharyngeal PCR (NP PCR) to antigen, nasal PCR, and viral culture. One-hundred-and-fourteen risk-stratified patients were tested by culture, nasal PCR, NP PCR, and Ag testing. Twenty (48%) of the high risk and 23 (32%) of the low risk were NP PCR positive. Compared with NP PCR, the sensitivity of nasal PCR, Sofia Ag, BinaxNOW Ag, and culture were 44%, 31%, 37%, and 15%. In the high risk group, the sensitivity of these tests improved to 71%, 37%, 50%, and 22%. Agreement between tests was highest between nasal PCR and both antigen tests. Patients who were NP PCR positive but antigen negative were more likely to have remote prior COVID-19 infection (p<0.01). Nasal PCR and antigen positive patients were more likely to have symptoms (p = 0.01).
Collapse
Affiliation(s)
| | | | - Drew Bell
- Indiana University School of Medicine
| | | | | | | | - William Fadel
- Indiana University Richard M. Fairbanks School of Public Health
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Affiliation(s)
- Claire Johnston
- Infectious Diseases, Public Health Wales, Cardiff, UK
- Department of Microbiology, Morriston Hospital, Swansea, UK
| | | | - Sion Lingard
- Health Protection Team, Public Health Wales, Swansea
| | - Stephen Hailey
- Medical Directorate - General Practice & Revalidation, NHS Wales Health Education and Improvement Wales, Nantgarw, Rhondda Cynon Taff, UK
| | - Brendan Healy
- Cardiff and Vale University Health Board, Public Health Wales, Cardiff
- Department of Microbiology, Morriston Hospital, Swansea, UK
| |
Collapse
|
20
|
Chu VT, Schwartz NG, Donnelly MAP, Chuey MR, Soto R, Yousaf AR, Schmitt-Matzen EN, Sleweon S, Ruffin J, Thornburg N, Harcourt JL, Tamin A, Kim G, Folster JM, Hughes LJ, Tong S, Stringer G, Albanese BA, Totten SE, Hudziec MM, Matzinger SR, Dietrich EA, Sheldon SW, Stous S, McDonald EC, Austin B, Beatty ME, Staples JE, Killerby ME, Hsu CH, Tate JE, Kirking HL, Matanock A. Comparison of Home Antigen Testing With RT-PCR and Viral Culture During the Course of SARS-CoV-2 Infection. JAMA Intern Med 2022; 182:701-709. [PMID: 35486394 PMCID: PMC9055515 DOI: 10.1001/jamainternmed.2022.1827] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE As self-collected home antigen tests become widely available, a better understanding of their performance during the course of SARS-CoV-2 infection is needed. OBJECTIVE To evaluate the diagnostic performance of home antigen tests compared with reverse transcription-polymerase chain reaction (RT-PCR) and viral culture by days from illness onset, as well as user acceptability. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study was conducted from January to May 2021 in San Diego County, California, and metropolitan Denver, Colorado. The convenience sample included adults and children with RT-PCR-confirmed infection who used self-collected home antigen tests for 15 days and underwent at least 1 nasopharyngeal swab for RT-PCR, viral culture, and sequencing. EXPOSURES SARS-CoV-2 infection. MAIN OUTCOMES AND MEASURES The primary outcome was the daily sensitivity of home antigen tests to detect RT-PCR-confirmed cases. Secondary outcomes included the daily percentage of antigen test, RT-PCR, and viral culture results that were positive, and antigen test sensitivity compared with same-day RT-PCR and cultures. Antigen test use errors and acceptability were assessed for a subset of participants. RESULTS This study enrolled 225 persons with RT-PCR-confirmed infection (median [range] age, 29 [1-83] years; 117 female participants [52%]; 10 [4%] Asian, 6 [3%] Black or African American, 50 [22%] Hispanic or Latino, 3 [1%] Native Hawaiian or Other Pacific Islander, 145 [64%] White, and 11 [5%] multiracial individuals) who completed 3044 antigen tests and 642 nasopharyngeal swabs. Antigen test sensitivity was 50% (95% CI, 45%-55%) during the infectious period, 64% (95% CI, 56%-70%) compared with same-day RT-PCR, and 84% (95% CI, 75%-90%) compared with same-day cultures. Antigen test sensitivity peaked 4 days after illness onset at 77% (95% CI, 69%-83%). Antigen test sensitivity improved with a second antigen test 1 to 2 days later, particularly early in the infection. Six days after illness onset, antigen test result positivity was 61% (95% CI, 53%-68%). Almost all (216 [96%]) surveyed individuals reported that they would be more likely to get tested for SARS-CoV-2 infection if home antigen tests were available over the counter. CONCLUSIONS AND RELEVANCE The results of this cohort study of home antigen tests suggest that sensitivity for SARS-CoV-2 was moderate compared with RT-PCR and high compared with viral culture. The results also suggest that symptomatic individuals with an initial negative home antigen test result for SARS-CoV-2 infection should test again 1 to 2 days later because test sensitivity peaked several days after illness onset and improved with repeated testing.
Collapse
Affiliation(s)
- Victoria T Chu
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Noah G Schwartz
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marisa A P Donnelly
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meagan R Chuey
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia.,County of San Diego Health and Human Services Agency, San Diego, California
| | - Raymond Soto
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Anna R Yousaf
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emily N Schmitt-Matzen
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sadia Sleweon
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jasmine Ruffin
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natalie Thornburg
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer L Harcourt
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Azaibi Tamin
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gimin Kim
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer M Folster
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Laura J Hughes
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Suxiang Tong
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ginger Stringer
- Colorado Department of Public Health and Environment, Denver
| | | | - Sarah E Totten
- Colorado Department of Public Health and Environment, Denver
| | | | | | - Elizabeth A Dietrich
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah W Sheldon
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah Stous
- County of San Diego Health and Human Services Agency, San Diego, California
| | - Eric C McDonald
- County of San Diego Health and Human Services Agency, San Diego, California
| | - Brett Austin
- County of San Diego Health and Human Services Agency, San Diego, California
| | - Mark E Beatty
- County of San Diego Health and Human Services Agency, San Diego, California
| | - J Erin Staples
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marie E Killerby
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christopher H Hsu
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jacqueline E Tate
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hannah L Kirking
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Almea Matanock
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | | |
Collapse
|
21
|
Cuypers L, Bode J, Beuselinck K, Laenen L, Dewaele K, Janssen R, Capron A, Lafort Y, Paridaens H, Bearzatto B, Cauchie M, Huwart A, Degosserie J, Fagnart O, Overmeire Y, Rouffiange A, Vandecandelaere I, Deffontaine M, Pilate T, Yin N, Micalessi I, Roisin S, Moons V, Reynders M, Steyaert S, Henin C, Lazarova E, Obbels D, Dufrasne FE, Pirenne H, Schepers R, Collin A, Verhasselt B, Gillet L, Jonckheere S, Van Lint P, Van den Poel B, Van der Beken Y, Stojkovic V, Garrino MG, Segers H, Vos K, Godefroid M, Pede V, Nollet F, Claes V, Verschraegen I, Bogaerts P, Van Gysel M, Leurs J, Saegeman V, Soetens O, Vanhee M, Schiettekatte G, Huyghe E, Martens S, Lemmens A, Nailis H, Laffineur K, Steensels D, Vanlaere E, Gras J, Roussel G, Gijbels K, Boudewijns M, Sion C, Achtergael W, Maurissen W, Iliano L, Chantrenne M, Vanheule G, Flies R, Hougardy N, Berth M, Verbeke V, Morent R, Vankeerberghen A, Bontems S, Kehoe K, Schallier A, Ho G, Bafort K, Raymaekers M, Pypen Y, Heinrichs A, Schuermans W, Cuigniez D, Lali SE, Drieghe S, Ory D, Le Mercier M, Van Laethem K, Thoelen I, Vandamme S, Mansoor I, Vael C, De Sloovere M, Declerck K, Dequeker E, Desmet S, Maes P, Lagrou K, André E. Nationwide Harmonization Effort for Semi-Quantitative Reporting of SARS-CoV-2 PCR Test Results in Belgium. Viruses 2022; 14:1294. [PMID: 35746765 PMCID: PMC9230955 DOI: 10.3390/v14061294] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 02/05/2023] Open
Abstract
From early 2020, a high demand for SARS-CoV-2 tests was driven by several testing indications, including asymptomatic cases, resulting in the massive roll-out of PCR assays to combat the pandemic. Considering the dynamic of viral shedding during the course of infection, the demand to report cycle threshold (Ct) values rapidly emerged. As Ct values can be affected by a number of factors, we considered that harmonization of semi-quantitative PCR results across laboratories would avoid potential divergent interpretations, particularly in the absence of clinical or serological information. A proposal to harmonize reporting of test results was drafted by the National Reference Centre (NRC) UZ/KU Leuven, distinguishing four categories of positivity based on RNA copies/mL. Pre-quantified control material was shipped to 124 laboratories with instructions to setup a standard curve to define thresholds per assay. For each assay, the mean Ct value and corresponding standard deviation was calculated per target gene, for the three concentrations (107, 105 and 103 copies/mL) that determine the classification. The results of 17 assays are summarized. This harmonization effort allowed to ensure that all Belgian laboratories would report positive PCR results in the same semi-quantitative manner to clinicians and to the national database which feeds contact tracing interventions.
Collapse
Affiliation(s)
- Lize Cuypers
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
| | - Jannes Bode
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
| | - Kurt Beuselinck
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
| | - Lies Laenen
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
| | - Klaas Dewaele
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
| | - Reile Janssen
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
| | - Arnaud Capron
- Epidemiology of Infectious Diseases and Quality Service Unit, Scientific Directorate of Epidemiology and Public Health, Sciensano, 1000 Brussels, Belgium; (A.C.); (Y.L.)
| | - Yves Lafort
- Epidemiology of Infectious Diseases and Quality Service Unit, Scientific Directorate of Epidemiology and Public Health, Sciensano, 1000 Brussels, Belgium; (A.C.); (Y.L.)
| | - Henry Paridaens
- Clinical Laboratory, Centre Hospitalier Régional de la Citadelle, 4000 Liège, Belgium;
| | - Bertrand Bearzatto
- Federal Testing Platform COVID-19, Centre des Technologies Moléculaires Appliquées (CTMA), Institute of Experimental and Clinical Research (IREC), Cliniques Universitaires Saint-Luc and Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium;
| | | | | | - Jonathan Degosserie
- Federal Testing Platform COVID-19, Department of Laboratory Medicine, CHU UCL Namur, 5530 Yvoir, Belgium;
| | - Olivier Fagnart
- Saint-Jean Hospital Laboratory, Cebiodi, 1000 Brussels, Belgium;
| | - Yarah Overmeire
- Microbiology, Labo Nuytinck, Anacura, 9940 Evergem, Belgium;
| | | | | | - Marine Deffontaine
- Laboratory of Clinical Biology, Centre Hopsitalier de Mouscron, 7700 Mouscron, Belgium;
| | - Thomas Pilate
- Clinical Laboratory, Laboratory Medicine, AZ Diest, 3290 Diest, Belgium;
| | - Nicolas Yin
- Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles—Universitair Laboratorium Brussel (LHUB-ULB), Université de Bruxelles (ULB), 1000 Brussels, Belgium;
| | - Isabel Micalessi
- Clinical Reference Laboratory, Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Sandrine Roisin
- Microbiology, Centre Hospitalier Universitaire de Tivoli, 7100 La Louvière, Belgium;
| | - Veronique Moons
- Microbiology, LKO-LMC Medical Laboratory, 3800 Sint-Truiden, Belgium;
| | - Marijke Reynders
- Laboratory Medicine, AZ Sint-Jan Brugge-Oostende AV, 8000 Brugge, Belgium;
| | - Sophia Steyaert
- Clinical Laboratory, AZ Maria Middelares, 9000 Gent, Belgium;
| | - Coralie Henin
- Federal Testing Platform COVID-19, Université Libre de Bruxelles, 1070 Brussels, Belgium;
| | - Elena Lazarova
- Centre Hospitalier Régional de la Haute Senne, Department of Clinical Biology, 7060 Soignies, Belgium;
| | - Dagmar Obbels
- Imelda, Clinical Laboratory, 2820 Bonheiden, Belgium;
| | | | - Hendri Pirenne
- Synlab Belgium, Synlab Laboratory Collard, 4020 Liège, Belgium;
| | - Raf Schepers
- Synlab Belgium, Synlab Laboratory Heppignies, 6220 Heppignies, Belgium;
| | | | - Bruno Verhasselt
- Federal Testing Platform COVID-19, Department of Laboratory Medicine, Ghent University and Ghent University Hospital, 9000 Gent, Belgium;
| | - Laurent Gillet
- Federal Testing Platform COVID-19, University of Liège, 4000 Liège, Belgium;
| | - Stijn Jonckheere
- Jan Yperman Hospital, Laboratory of Clinical Biology, 8900 Ieper, Belgium;
| | | | - Bea Van den Poel
- Clinical Laboratory, General Hospital Jan Portaels, 1800 Vilvoorde, Belgium;
| | - Yolien Van der Beken
- Military Medicine Lab Capacity, Military Hospital Queen Astrid, 1120 Brussels, Belgium;
| | - Violeta Stojkovic
- Centre Hospitalier Bois de l’Abbaye, Laboratory Service, 4100 Seraing, Belgium;
| | | | | | - Kevin Vos
- RZ Heilig Hart Tienen, Clinical Biology, 3300 Tienen, Belgium;
| | | | - Valerie Pede
- AZ Sint-Elisabeth Zottegem, Laboratory of Clinical Biology, 9600 Zottegem, Belgium;
| | - Friedel Nollet
- Biogazelle NV, Diagnostic Testing, 9052 Zwijnaarde, Belgium;
| | - Vincent Claes
- Institute of Clinical Biology ULB-IBC, 1170 Brussels, Belgium;
| | | | - Pierre Bogaerts
- CHU UCL Namur, Department of Laboratory Medicine, Molecular Diagnostics Center, 5530 Yvoir, Belgium;
| | | | | | | | - Oriane Soetens
- Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 1090 Brussels, Belgium;
| | - Merijn Vanhee
- Clinical Laboratory, Laboratory Medicine, AZ Delta, 8800 Roeselare, Belgium;
| | | | - Evelyne Huyghe
- ZNA Middelheim, Clinical Laboratory, 2020 Antwerp, Belgium;
| | | | - Ann Lemmens
- AZ Sint-Maarten, Laboratory of Clinical Biology, 2800 Mechelen, Belgium;
| | | | | | - Deborah Steensels
- Clinical Laboratory, Campus Sint-Jan, Hospital Oost-Limburg, 3600 Genk, Belgium;
| | - Elke Vanlaere
- Clinical Laboratory, AZ Sint-Lucas Hospital, 9000 Gent, Belgium;
| | - Jérémie Gras
- Institute of Pathology and Genetics, 6041 Gosselies, Belgium;
| | - Gatien Roussel
- Clinique Saint Pierre, Laboratory, 1340 Ottignies, Belgium;
| | | | - Michael Boudewijns
- Clinical Laboratory, Campus Kennedylaan, AZ Groeninge, 8500 Kortrijk, Belgium;
| | - Catherine Sion
- Grand Hôpital de Charleroi, Clinical Biology and Microbiology, 6060 Gilly, Belgium;
| | - Wim Achtergael
- Clinical Laboratory, Algemeen Stedelijk Ziekenhuis Aalst, 9300 Aalst, Belgium;
| | | | - Luc Iliano
- Laboratory for Medical Biology Iliano, 9070 Destelbergen, Belgium;
| | | | | | | | - Nicolas Hougardy
- Clinical Biology Unit, Vivalia Clinique du Sud-Luxembourg, 6700 Arlon, Belgium;
| | - Mario Berth
- Clinical Laboratory, AZ Alma, 9900 Eeklo, Belgium;
| | | | - Robin Morent
- Department of Laboratory Medicine, Campus Henri Serruys, AZ Sint-Jan Brugge, 8400 Oostende, Belgium;
| | - Anne Vankeerberghen
- Laboratory of Molecular Biology, Campus Aalst-Asse-Ninove, Onze-Lieve-Vrouwziekenhuis, 9300 Aalst, Belgium;
| | - Sébastien Bontems
- Clinical Laboratory, Unit of Clinical Microbiology, CHU Liège, 4000 Liège, Belgium;
| | - Kaat Kehoe
- Microbiology, Algemeen Medisch Laboratorium, 2020 Antwerp, Belgium;
| | | | - Giang Ho
- Laboratory, Clinique du MontLégia, Groupe Santé CHC, 4000 Liège, Belgium;
| | - Kristof Bafort
- Clinical Laboratory, Mariaziekenhuis Noorderhart, 3900 Pelt, Belgium;
| | - Marijke Raymaekers
- Laboratory for Molecular Diagnostics, Jessa Hospital, 3500 Hasselt, Belgium;
| | - Yolande Pypen
- Microbiology, Laboratory Somedi, 2220 Heist-op-den-Berg, Belgium;
| | - Amelie Heinrichs
- Laboratory of Clinical Biology, Hospital Arlon—Vivalia, 6700 Arlon, Belgium;
| | - Wim Schuermans
- Clinical Laboratory, Ziekenhuis Geel, 2440 Geel, Belgium;
| | | | | | - Stefanie Drieghe
- Microbiology, Algemeen Medisch Laboratorium West, 8850 Ardooie, Belgium;
| | - Dieter Ory
- Clinical Laboratory, Heilig Hart Ziekenhuis Mol, 2400 Mol, Belgium;
| | - Marie Le Mercier
- Federal Testing Platform COVID-19, University Hospitals Antwerp, 2650 Edegem, Belgium;
| | - Kristel Van Laethem
- Federal Testing Platform COVID-19, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium;
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Rega Institute for Medical Research, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium;
| | - Inge Thoelen
- Clinical Laboratory, AZ Vesalius Tongeren, 3700 Tongeren, Belgium;
| | - Sarah Vandamme
- Microbiology Laboratory, University Hospitals Antwerp, 2650 Edegem, Belgium;
| | - Iqbal Mansoor
- Clinical Laboratory, Hospital Hornu Epicura, 7301 Boussu, Belgium;
| | - Carl Vael
- Clinical Laboratory, AZ Klina, 2930 Brasschaat, Belgium;
| | | | | | - Elisabeth Dequeker
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
| | - Stefanie Desmet
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Piet Maes
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Rega Institute for Medical Research, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium;
| | - Katrien Lagrou
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Emmanuel André
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
- Federal Testing Platform COVID-19, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium;
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| |
Collapse
|
22
|
Sefik E, Qu R, Junqueira C, Kaffe E, Mirza H, Zhao J, Brewer JR, Han A, Steach HR, Israelow B, Blackburn HN, Velazquez SE, Chen YG, Halene S, Iwasaki A, Meffre E, Nussenzweig M, Lieberman J, Wilen CB, Kluger Y, Flavell RA. Inflammasome activation in infected macrophages drives COVID-19 pathology. Nature 2022; 606:585-593. [PMID: 35483404 PMCID: PMC9288243 DOI: 10.1038/s41586-022-04802-1] [Citation(s) in RCA: 225] [Impact Index Per Article: 112.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 04/25/2022] [Indexed: 01/18/2023]
Abstract
Severe COVID-19 is characterized by persistent lung inflammation, inflammatory cytokine production, viral RNA and a sustained interferon (IFN) response, all of which are recapitulated and required for pathology in the SARS-CoV-2-infected MISTRG6-hACE2 humanized mouse model of COVID-19, which has a human immune system1-20. Blocking either viral replication with remdesivir21-23 or the downstream IFN-stimulated cascade with anti-IFNAR2 antibodies in vivo in the chronic stages of disease attenuates the overactive immune inflammatory response, especially inflammatory macrophages. Here we show that SARS-CoV-2 infection and replication in lung-resident human macrophages is a critical driver of disease. In response to infection mediated by CD16 and ACE2 receptors, human macrophages activate inflammasomes, release interleukin 1 (IL-1) and IL-18, and undergo pyroptosis, thereby contributing to the hyperinflammatory state of the lungs. Inflammasome activation and the accompanying inflammatory response are necessary for lung inflammation, as inhibition of the NLRP3 inflammasome pathway reverses chronic lung pathology. Notably, this blockade of inflammasome activation leads to the release of infectious virus by the infected macrophages. Thus, inflammasomes oppose host infection by SARS-CoV-2 through the production of inflammatory cytokines and suicide by pyroptosis to prevent a productive viral cycle.
Collapse
Affiliation(s)
- Esen Sefik
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Rihao Qu
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
- Computational Biology and Bioinformatics Program, Yale University, New Haven, CT, USA
| | - Caroline Junqueira
- Program in Cellular and Molecular Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Eleanna Kaffe
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Haris Mirza
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - Jun Zhao
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - J Richard Brewer
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Ailin Han
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Holly R Steach
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Benjamin Israelow
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Holly N Blackburn
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Sofia E Velazquez
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Y Grace Chen
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Stephanie Halene
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
- Section of Hematology, Yale Cancer Center and Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Akiko Iwasaki
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
- Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, CT, USA
| | - Eric Meffre
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Michel Nussenzweig
- Laboratory of Molecular Immunology, The Rockefeller University, New York, NY, USA
- Howard Hughes Medical Institute, The Rockefeller University, New York, NY, USA
| | - Judy Lieberman
- Program in Cellular and Molecular Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Craig B Wilen
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Yuval Kluger
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
- Program of Applied Mathematics, Yale University, New Haven, CT, USA
| | - Richard A Flavell
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA.
- Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, CT, USA.
| |
Collapse
|
23
|
Kim DY, Lin MY, Jennings C, Li H, Jung JH, Moore NM, Ghinai I, Black SR, Zaccaro DJ, Brofman J, Hayden MK. Duration of Replication-Competent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Shedding Among Patients With Severe or Critical Coronavirus Disease 2019 (COVID-19). Clin Infect Dis 2022; 76:e416-e425. [PMID: 35607802 PMCID: PMC9213867 DOI: 10.1093/cid/ciac405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/05/2022] [Accepted: 05/18/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Patterns of shedding replication-competent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in severe or critical COVID-19 are not well characterized. We investigated the duration of replication-competent SARS-CoV-2 shedding in upper and lower airway specimens from patients with severe or critical coronavirus disease 2019 (COVID-19). METHODS We enrolled patients with active or recent severe or critical COVID-19 who were admitted to a tertiary care hospital intensive care unit (ICU) or long-term acute care hospital (LTACH) because of COVID-19. Respiratory specimens were collected at predefined intervals and tested for SARS-CoV-2 using viral culture and reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Clinical and epidemiologic metadata were reviewed. RESULTS We collected 529 respiratory specimens from 78 patients. Replication-competent virus was detected in 4 of 11 (36.3%) immunocompromised patients up to 45 days after symptom onset and in 1 of 67 (1.5%) immunocompetent patients 10 days after symptom onset (P = .001). All culture-positive patients were in the ICU cohort and had persistent or recurrent symptoms of COVID-19. Median time from symptom onset to first specimen collection was 15 days (range, 6-45) for ICU patients and 58.5 days (range, 34-139) for LTACH patients. SARS-CoV-2 RNA was detected in 40 of 50 (80%) ICU patients and 7 of 28 (25%) LTACH patients. CONCLUSIONS Immunocompromise and persistent or recurrent symptoms were associated with shedding of replication-competent SARS-CoV-2, supporting the need for improving respiratory symptoms in addition to time as criteria for discontinuation of transmission-based precautions. Our results suggest that the period of potential infectiousness among immunocompetent patients with severe or critical COVID-19 may be similar to that reported for patients with milder disease.
Collapse
Affiliation(s)
- Do Young Kim
- Correspondence: M. Hayden, Rush University Medical Center, 1653 W. Congress Pkwy, Chicago, IL 60612 ()
| | - Michael Y Lin
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Cheryl Jennings
- Rush Research Cores, Rush University Medical Center, Chicago, Illinois, USA
| | - Haiying Li
- Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA
| | - Jae Hyung Jung
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Nicholas M Moore
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA,Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA,Department of Medical Laboratory Science, Rush University Medical Center, Chicago, Illinois, USA
| | - Isaac Ghinai
- Chicago Department of Public Health, Chicago, Illinois, USA
| | | | - Daniel J Zaccaro
- Social & Scientific Systems, Inc, a DLH Holdings Corporation, Durham, North Carolina, USA
| | | | - Mary K Hayden
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | | |
Collapse
|
24
|
Wong G, Rowlandson M, Sabanayagam D, Ginn AN, Kable K, Sciberras F, Au E, Draper J, Arnott A, Sintchenko V, Dwyer DE, Chen SCA, Kok J. COVID-19 Infection With the Omicron SARS-CoV-2 Variant in a Cohort of Kidney and Kidney Pancreas Transplant Recipients: Clinical Features, Risk Factors, and Outcomes. Transplantation 2022. [PMID: 35675438 DOI: 10.1097/TP.0000000000004203] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Since November 2021, a new variant of concern (VOC), the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lineage B.1.1.529 (Omicron) has emerged as the dominant coronavirus disease 2019 (COVID-19) infection worldwide. We describe the clinical presentation, risk factors, and outcomes in a cohort of kidney and kidney pancreas transplant recipients with COVID-19 caused by Omicron infection. METHODS We included all kidney and kidney pancreas transplant recipients diagnosed with SARS-CoV-2 Omicron infections between December 26, 2021, and January 14, 2022, in a single transplant center in Australia. Identification of the VOC Omicron was confirmed using phylogenetic analysis of SARS-CoV-2 sequences. RESULTS Forty-one patients with kidney (6 living and 33 deceased) and kidney pancreas transplants were diagnosed with the VOC Omicron (lineage B.1.1.529/BA.1) infection during the study period. The mean age (SD) at the time of diagnosis was 52 (11.1) y; 40 (out of 41) (98%) had received at least 2 doses of COVID-19 vaccine. Cough was the most frequent symptom (80.5%), followed by myalgia (70.7%), sore throat (63.4%), and fever (58.5%). After a follow-up time of 30 d, 1 (2.4%) patient died, 2 (4.9%) experienced multiorgan failure, and 5 (12.2%) had respiratory failure; 11 (26.8%) patients developed other superimposed infections. Compared with recipients who did not receive sotrovimab antibody therapy, the odds ratio (95% confidence interval) for hospitalization among patients who received sotrovimab was 0.05 (0.005-0.4). CONCLUSIONS Despite double or triple dose vaccination, VOC Omicron infections in kidney and kidney pancreas transplant recipients are not necessarily mild. Hospitalization rates remained high (around 56%), and sotrovimab use may prevent hospitalization.
Collapse
|
25
|
Rockett RJ, Draper J, Gall M, Sim EM, Arnott A, Agius JE, Johnson-Mackinnon J, Fong W, Martinez E, Drew AP, Lee C, Ngo C, Ramsperger M, Ginn AN, Wang Q, Fennell M, Ko D, Hueston L, Kairaitis L, Holmes EC, O'Sullivan MN, Chen SCA, Kok J, Dwyer DE, Sintchenko V. Co-infection with SARS-CoV-2 Omicron and Delta variants revealed by genomic surveillance. Nat Commun 2022; 13:2745. [PMID: 35585202 PMCID: PMC9117272 DOI: 10.1038/s41467-022-30518-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/21/2022] [Indexed: 12/02/2022] Open
Abstract
Co-infections with different variants of SARS-CoV-2 are a key precursor to recombination events that are likely to drive SARS-CoV-2 evolution. Rapid identification of such co-infections is required to determine their frequency in the community, particularly in populations at-risk of severe COVID-19, which have already been identified as incubators for punctuated evolutionary events. However, limited data and tools are currently available to detect and characterise the SARS-CoV-2 co-infections associated with recognised variants of concern. Here we describe co-infection with the SARS-CoV-2 variants of concern Omicron and Delta in two epidemiologically unrelated adult patients with chronic kidney disease requiring maintenance haemodialysis. Both variants were co-circulating in the community at the time of detection. Genomic surveillance based on amplicon- and probe-based sequencing using short- and long-read technologies identified and quantified subpopulations of Delta and Omicron viruses in respiratory samples. These findings highlight the importance of integrated genomic surveillance in vulnerable populations and provide diagnostic pathways to recognise SARS-CoV-2 co-infection using genomic data. Here, using genomic approaches, Rockett et al. identify Omicron and Delta SARS-CoV-2 co-infections in two adults, highlighting the usefulness of genomic surveillance for the timely recognition of co-infections in situations when different variants of the virus are circulating in the community.
Collapse
Affiliation(s)
- Rebecca J Rockett
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia.,Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, NSW, Australia
| | - Jenny Draper
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia.,Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Mailie Gall
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia.,Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Eby M Sim
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia.,Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, NSW, Australia.,Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Alicia Arnott
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia.,Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, NSW, Australia.,Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Jessica E Agius
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia
| | - Jessica Johnson-Mackinnon
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia.,Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, NSW, Australia
| | - Winkie Fong
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia.,Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, NSW, Australia
| | - Elena Martinez
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia.,Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, NSW, Australia.,Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Alexander P Drew
- Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Clement Lee
- Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Christine Ngo
- Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Marc Ramsperger
- Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Andrew N Ginn
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia.,Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Qinning Wang
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia.,Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, NSW, Australia.,Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Michael Fennell
- Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Danny Ko
- Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Linda Hueston
- Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Lukas Kairaitis
- Renal Services Blacktown Hospital, Western Sydney Local Health District, Sydney, NSW, Australia
| | - Edward C Holmes
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia.,School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia.,School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
| | - Matthew N O'Sullivan
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia.,Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, NSW, Australia.,Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Sharon C-A Chen
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia.,Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, NSW, Australia.,Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Jen Kok
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia.,Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, NSW, Australia.,Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Dominic E Dwyer
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia.,Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, NSW, Australia.,Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia
| | - Vitali Sintchenko
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia. .,Centre for Infectious Diseases and Microbiology-Public Health, Westmead Hospital, Westmead, NSW, Australia. .,Institute for Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead, NSW, Australia. .,School of Medical Sciences, University of Sydney, Sydney, NSW, Australia.
| |
Collapse
|
26
|
Liu LT, Tsai JJ, Chang K, Chen CH, Lin PC, Tsai CY, Tsai YY, Hsu MC, Chuang WL, Chang JM, Hwang SJ, Chong IW. Identification and Analysis of SARS-CoV-2 Alpha Variants in the Largest Taiwan COVID-19 Outbreak in 2021. Front Med (Lausanne) 2022; 9:869818. [PMID: 35547225 PMCID: PMC9081839 DOI: 10.3389/fmed.2022.869818] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 03/23/2022] [Indexed: 12/23/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is believed to have originated in Wuhan City, Hubei Province, China, in December 2019. Infection with this highly dangerous human-infecting coronavirus via inhalation of respiratory droplets from SARS-CoV-2 carriers results in coronavirus disease 2019 (COVID-19), which features clinical symptoms such as fever, dry cough, shortness of breath, and life-threatening pneumonia. Several COVID-19 waves arose in Taiwan from January 2020 to March 2021, with the largest outbreak ever having a high case fatality rate (CFR) (5.95%) between May and June 2021. In this study, we identified five 20I (alpha, V1)/B.1.1.7/GR SARS-CoV-2 (KMUH-3 to 7) lineage viruses from COVID-19 patients in this largest COVID-19 outbreak. Sequence placement analysis using the existing SARS-CoV-2 phylogenetic tree revealed that KMUH-3 originated from Japan and that KMUH-4 to KMUH-7 possibly originated via local transmission. Spike mutations M1237I and D614G were identified in KMUH-4 to KMUH-7 as well as in 43 other alpha/B.1.1.7 sequences of 48 alpha/B.1.1.7 sequences deposited in GISAID derived from clinical samples collected in Taiwan between 20 April and July. However, M1237I mutation was not observed in the other 12 alpha/B.1.1.7 sequences collected between 26 December 2020, and 12 April 2021. We conclude that the largest COVID-19 outbreak in Taiwan between May and June 2021 was initially caused by the alpha/B.1.1.7 variant harboring spike D614G + M1237I mutations, which was introduced to Taiwan by China Airlines cargo crew members. To our knowledge, this is the first documented COVID-19 outbreak caused by alpha/B.1.1.7 variant harboring spike M1237I mutation thus far. The largest COVID-19 outbreak in Taiwan resulted in 13,795 cases and 820 deaths, with a high CFR, at 5.95%, accounting for 80.90% of all cases and 96.47% of all deaths during the first 2 years. The high CFR caused by SARS-CoV-2 alpha variants in Taiwan can be attributable to comorbidities and low herd immunity. We also suggest that timely SARS-CoV-2 isolation and/or sequencing are of importance in real-time epidemiological investigations and in epidemic prevention. The impact of G614G + M1237I mutations in the spike gene on the SARS-CoV-2 virus spreading as well as on high CFR remains to be elucidated.
Collapse
Affiliation(s)
- Li-Teh Liu
- Department of Medical Laboratory Science and Biotechnology, College of Medical Technology, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Jih-Jin Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ko Chang
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hong Chen
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Zhunan, Taiwan.,National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Ping-Chang Lin
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ching-Yi Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yan-Yi Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Miao-Chen Hsu
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wan-Long Chuang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Hepatobiliary and Pancreatic, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jer-Ming Chang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shang-Jyh Hwang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Inn-Wen Chong
- Department of Internal Medicine and Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Pulmonary Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| |
Collapse
|
27
|
Hakre S, Lakhal-Naouar I, King DB, Burns JL, Jackson KN, Krauss SW, Chandrasekaran P, McCauley MD, Ober Shepherd BL, McHenry S, Bianchi EJ, Ouellette J, Darden JM, Sanborn AD, Daye SP, Kwon PO, Stubbs J, Brigantti CL, Hall TL, Beagle MH, Pieri JA, Frambes TR, O’Connell RJ, Modjarrad K, Murray CK, Jagodzinski LL, Scott PT, Peel SA. Virological and Serological Assessment of US Army Trainees Isolated for Coronavirus Disease 2019. J Infect Dis 2022; 226:1743-1752. [PMID: 35543272 PMCID: PMC9129211 DOI: 10.1093/infdis/jiac198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 05/09/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Laboratory screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a key mitigation measure to avoid the spread of infection among recruits starting basic combat training in a congregate setting. Because viral nucleic acid can be detected persistently after recovery, we evaluated other laboratory markers to distinguish recruits who could proceed with training from those who were infected. METHODS Recruits isolated for coronavirus disease 2019 (COVID-19) were serially tested for SARS-CoV-2 subgenomic ribonucleic acid (sgRNA), and viral load (VL) by reverse-transcriptase polymerase chain reaction (RT-PCR), and for anti- SARS-CoV-2. Cluster and quadratic discriminant analyses of results were performed. RESULTS Among 229 recruits isolated for COVID-19, those with a RT-PCR cycle threshold >30.49 (sensitivity 95%, specificity 96%) or having sgRNA log10 RNA copies/mL <3.09 (sensitivity and specificity 96%) at entry into isolation were likely SARS-CoV-2 uninfected. Viral load >4.58 log10 RNA copies/mL or anti-SARS-CoV-2 signal-to-cutoff ratio <1.38 (VL: sensitivity and specificity 93%; anti-SARS-CoV-2: sensitivity 83%, specificity 79%) had comparatively lower sensitivity and specificity when used alone for discrimination of infected from uninfected. CONCLUSIONS Orthogonal laboratory assays used in combination with RT-PCR may have utility in determining SARS-CoV-2 infection status for decisions regarding isolation.
Collapse
Affiliation(s)
- Shilpa Hakre
- Correspondence: Shilpa Hakre, DrPH MPH, Emerging Infectious Diseases Branch, Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., 6720-A Rockledge Drive, Suite 400, Bethesda, MD 20817 ()
| | - Ines Lakhal-Naouar
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA,Walter Reed Army Institute of Research, Diagnostics and Countermeasures Branch, Silver Spring, Maryland, USA
| | - David B King
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA
| | - Jennifer L Burns
- Walter Reed Army Institute of Research, Pilot Bioproduction Facility, Silver Spring, Maryland, USA
| | - Kenya N Jackson
- Walter Reed Army Institute of Research, Experimental Therapeutics, Silver Spring, Maryland, USA
| | - Stephen W Krauss
- Walter Reed Army Institute of Research, Center for Military Psychiatry and Neuroscience, Silver Spring, Maryland, USA
| | - Prabha Chandrasekaran
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA,Walter Reed Army Institute of Research, Diagnostics and Countermeasures Branch, Silver Spring, Maryland, USA
| | - Melanie D McCauley
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Branch, Silver Spring, Maryland, USA,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA
| | - Brittany L Ober Shepherd
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Branch, Silver Spring, Maryland, USA,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA
| | - Samantha McHenry
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA
| | - Elizabeth J Bianchi
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Branch, Silver Spring, Maryland, USA,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA
| | - Jason Ouellette
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA,Walter Reed Army Institute of Research, Diagnostics and Countermeasures Branch, Silver Spring, Maryland, USA
| | - Janice M Darden
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA,Walter Reed Army Institute of Research, Diagnostics and Countermeasures Branch, Silver Spring, Maryland, USA
| | - Aaron D Sanborn
- Walter Reed Army Institute of Research, Clinical Trials Center, Silver Spring, Maryland, USA
| | - Sharon P Daye
- Walter Reed Army Institute of Research, One Health Branch, Silver Spring, Maryland, USA
| | - Paul O Kwon
- Program Executive Office for Simulation, Training and Instrumentation, Orlando, Florida, USA
| | | | - Crystal L Brigantti
- DiLorenzo Pentagon Health Clinic, Optometry, Washington, District of Columbia, USA
| | - Tara L Hall
- Moncrief Army Health Clinic, Fort Jackson, South Carolina, USA
| | | | - Jason A Pieri
- United States Army Training Center, Fort Jackson, South Carolina, USA
| | - Timothy R Frambes
- United States Army Training Center, Fort Jackson, South Carolina, USA
| | | | - Kayvon Modjarrad
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Branch, Silver Spring, Maryland, USA
| | | | - Linda L Jagodzinski
- Walter Reed Army Institute of Research, Diagnostics and Countermeasures Branch, Silver Spring, Maryland, USA
| | - Paul T Scott
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Branch, Silver Spring, Maryland, USA
| | | |
Collapse
|
28
|
Lu S, Duplat D, Benitez-Bolivar P, León C, Villota SD, Veloz-Villavicencio E, Arévalo V, Jaenes K, Guo Y, Cicek S, Robinson L, Peidis P, Pearson JD, Woodgett J, Mazzulli T, Ponce P, Restrepo S, González JM, Bernal A, Guevara-Suarez M, Pardee K, Cevallos VE, González C, Bremner R. Multicenter international assessment of a SARS-CoV-2 RT-LAMP test for point of care clinical application. PLoS One 2022; 17:e0268340. [PMID: 35544541 PMCID: PMC9094544 DOI: 10.1371/journal.pone.0268340] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/27/2022] [Indexed: 12/19/2022] Open
Abstract
Continued waves, new variants, and limited vaccine deployment mean that SARS-CoV-2 tests remain vital to constrain the coronavirus disease 2019 (COVID-19) pandemic. Affordable, point-of-care (PoC) tests allow rapid screening in non-medical settings. Reverse-transcription loop-mediated isothermal amplification (RT-LAMP) is an appealing approach. A crucial step is to optimize testing in low/medium resource settings. Here, we optimized RT-LAMP for SARS-CoV-2 and human β-actin, and tested clinical samples in multiple countries. "TTTT" linker primers did not improve performance, and while guanidine hydrochloride, betaine and/or Igepal-CA-630 enhanced detection of synthetic RNA, only the latter two improved direct assays on nasopharygeal samples. With extracted clinical RNA, a 20 min RT-LAMP assay was essentially as sensitive as RT-PCR. With raw Canadian nasopharygeal samples, sensitivity was 100% (95% CI: 67.6% - 100%) for those with RT-qPCR Ct values ≤ 25, and 80% (95% CI: 58.4% - 91.9%) for those with 25 < Ct ≤ 27.2. Highly infectious, high titer cases were also detected in Colombian and Ecuadorian labs. We further demonstrate the utility of replacing thermocyclers with a portable PoC device (FluoroPLUM). These combined PoC molecular and hardware tools may help to limit community transmission of SARS-CoV-2.
Collapse
Affiliation(s)
- Suying Lu
- Lunenfeld Tanenbaum Research Institute, Mt Sinai Hospital, Sinai Health System, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Department of Ophthalmology and Vision Science, University of Toronto, Toronto, ON, Canada
| | - David Duplat
- Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Department of Biological Sciences, Universidad de los Andes, Bogotá, Colombia
| | - Paula Benitez-Bolivar
- Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Department of Biological Sciences, Universidad de los Andes, Bogotá, Colombia
| | - Cielo León
- Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Department of Biological Sciences, Universidad de los Andes, Bogotá, Colombia
| | - Stephany D. Villota
- Centro de Investigación en Enfermedades Infecciosas y Vectoriales (CIREV), Instituto Nacional de Investigación en Salud Pública, Quito, Ecuador
| | - Eliana Veloz-Villavicencio
- Centro de Investigación en Enfermedades Infecciosas y Vectoriales (CIREV), Instituto Nacional de Investigación en Salud Pública, Quito, Ecuador
| | - Valentina Arévalo
- Centro de Investigación en Enfermedades Infecciosas y Vectoriales (CIREV), Instituto Nacional de Investigación en Salud Pública, Quito, Ecuador
| | - Katariina Jaenes
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Yuxiu Guo
- LSK Technologies Inc., Kitchener, Canada
| | | | | | - Philippos Peidis
- Lunenfeld Tanenbaum Research Institute, Mt Sinai Hospital, Sinai Health System, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Department of Ophthalmology and Vision Science, University of Toronto, Toronto, ON, Canada
| | - Joel D. Pearson
- Lunenfeld Tanenbaum Research Institute, Mt Sinai Hospital, Sinai Health System, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Department of Ophthalmology and Vision Science, University of Toronto, Toronto, ON, Canada
| | - Jim Woodgett
- Lunenfeld Tanenbaum Research Institute, Mt Sinai Hospital, Sinai Health System, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Tony Mazzulli
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Department of Microbiology, Sinai Health System/University Health Network, Toronto, Canada
| | - Patricio Ponce
- Centro de Investigación en Enfermedades Infecciosas y Vectoriales (CIREV), Instituto Nacional de Investigación en Salud Pública, Quito, Ecuador
| | - Silvia Restrepo
- Department of Food and Chemical Engineering, Universidad de los Andes, Bogotá, Colombia
| | - John M. González
- Grupo de Ciencias Básicas Médicas, School of Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Adriana Bernal
- Laboratory of Molecular Interactions of Agricultural Microbes (LIMMA), Department of Biological Sciences, Universidad de Los Andes, Bogotá, Colombia
| | - Marcela Guevara-Suarez
- Applied genomics research group, Vicerrectoría de Investigación y Creación, Universidad de los Andes, Bogotá, Colombia
| | - Keith Pardee
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- LSK Technologies Inc., Kitchener, Canada
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada
| | - Varsovia E. Cevallos
- Centro de Investigación en Enfermedades Infecciosas y Vectoriales (CIREV), Instituto Nacional de Investigación en Salud Pública, Quito, Ecuador
| | - Camila González
- Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Department of Biological Sciences, Universidad de los Andes, Bogotá, Colombia
| | - Rod Bremner
- Lunenfeld Tanenbaum Research Institute, Mt Sinai Hospital, Sinai Health System, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Department of Ophthalmology and Vision Science, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
29
|
Kim KW, Wang X, Adhikari A, Yeang M, Jenkins F, Naing Z, Walker GJ, Foster CSP, Stelzer-Braid S, Deveson I, Craig ME, Tedla N, Bull RA, Martinello M, Pinto AN, Chan R, Turville S, Rawlinson WD, van Hal S. Persistent high-level shedding of cultivable SARS-CoV-2 Delta virus 33 days after onset of COVID-19 in a hospitalized patient with pneumonia. J Med Virol 2022; 94:4043-4046. [PMID: 35509147 PMCID: PMC9347799 DOI: 10.1002/jmv.27832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Ki Wook Kim
- Virology Research and Diagnostics Laboratories, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, 2031, Australia.,Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Xinye Wang
- Virology Research and Diagnostics Laboratories, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, 2031, Australia.,School of Medical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Anurag Adhikari
- School of Medical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, 2052, Australia.,The Kirby Institute for Infection and Immunity, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - Malinna Yeang
- Virology Research and Diagnostics Laboratories, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, 2031, Australia
| | - Frances Jenkins
- Department of Microbiology and Infectious Diseases, Royal Prince Alfred Hospital, Sydney, NSW, 2050, Australia
| | - Zin Naing
- Virology Research and Diagnostics Laboratories, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, 2031, Australia
| | - Gregory J Walker
- Virology Research and Diagnostics Laboratories, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, 2031, Australia.,School of Medical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Charles S P Foster
- Virology Research and Diagnostics Laboratories, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, 2031, Australia.,School of Medical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Sacha Stelzer-Braid
- Virology Research and Diagnostics Laboratories, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, 2031, Australia.,School of Medical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Ira Deveson
- Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Sydney, NSW, 2010, Australia.,St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2000, Australia
| | - Maria E Craig
- Virology Research and Diagnostics Laboratories, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, 2031, Australia.,Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, 2052, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, NSW, 2145, Australia
| | - Nicodemus Tedla
- School of Medical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Rowena A Bull
- School of Medical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, 2052, Australia.,The Kirby Institute for Infection and Immunity, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - Marianne Martinello
- School of Medical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, 2052, Australia.,The Kirby Institute for Infection and Immunity, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - Angie N Pinto
- Department of Microbiology and Infectious Diseases, Royal Prince Alfred Hospital, Sydney, NSW, 2050, Australia
| | - Raymond Chan
- Department of Microbiology and Infectious Diseases, Royal Prince Alfred Hospital, Sydney, NSW, 2050, Australia
| | - Stuart Turville
- School of Medical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, 2052, Australia.,The Kirby Institute for Infection and Immunity, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - William D Rawlinson
- Virology Research and Diagnostics Laboratories, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, 2031, Australia.,Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, 2052, Australia.,School of Medical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, 2052, Australia.,School of Biotechnology and Biomolecular Sciences, Faculty of Science, University of New South Wales, Sydney, NSW, 2031, Australia
| | - Sebastiaan van Hal
- Department of Microbiology and Infectious Diseases, Royal Prince Alfred Hospital, Sydney, NSW, 2050, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2000, Australia
| |
Collapse
|
30
|
Rahmani A, Dini G, Leso V, Montecucco A, Kusznir Vitturi B, Iavicoli I, Durando P. Duration of SARS-CoV-2 shedding and infectivity in the working age population: a systematic review and meta-analysis. Med Lav 2022; 113:e2022014. [PMID: 35481581 PMCID: PMC9073762 DOI: 10.23749/mdl.v113i2.12724] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 02/22/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, working age individuals have been implicated in sustaining the resurgence of SARS-CoV-2 infections, and multiple outbreaks have been observed in several occupational settings. In this regard, Occupational Physicians play a crucial role in the management of infected workers, particularly in the safe return-to-work of subjects after clinical resolution. To this end, knowledge of the duration of the infective phase in the working age population is essential, taking into account previous evidence suggesting that PCR positivity does not coincide with virus viability. METHODS A systematic review and meta-analysis, searching major scientific databases, including PubMed/MEDLINE, Scopus and Web of Science, were performed in order to synthesize the available evidence regarding the mean and maximal duration of infectivity compared to the mean and maximal duration of viral RNA shedding. A subgroup analysis of the studies was performed according to the immunocompetent or immunocompromised immune status of the majority of the enrolled individuals. RESULTS Twenty studies were included in the final qualitative and quantitative analysis (866 individuals). Overall, a mean duration of RT-PCR positivity after symptom onset was found equal to 27.9 days (95%CI 23.3-32.5), while the mean duration of replicant competent virus isolation was 7.3 days (95%CI 5.7-8.8). The mean duration of SARS-CoV-2 shedding resulted equal to 26.5 days (95%CI 21.4-31.6) and 36.3 days (95%CI 21.9-50.6), and the mean duration of SARS-CoV-2 infectivity was 6.3 days (95%CI 4.9-7.8) and 29.5 days (95%CI 12.5-46.5), respectively considering immunocompetent and immunocompromised individuals. The maximum duration of infectivity among immunocompetent subjects was reported after 18 days from symptom onset, while in immunocompromised individuals it lasted up to 112 days. CONCLUSIONS These findings suggest that the test-based strategy before return-to-work might not be warranted after 21 days among immunocompetent working age individuals, and could keep many workers out of occupation, reducing their livelihood and productivity.
Collapse
Affiliation(s)
- Alborz Rahmani
- Department of Health Sciences, University of Genoa; Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Guglielmo Dini
- Department of Health Sciences, University of Genoa; Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Veruscka Leso
- Section of Occupational Medicine, Department of Public Health, University of Naples Federico II, Naples, Italy.
| | - Alfredo Montecucco
- Department of Health Sciences, University of Genoa; Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino.
| | | | - Ivo Iavicoli
- Section of Occupational Medicine, Department of Public Health, University of Naples Federico II, Naples, Italy.
| | - Paolo Durando
- Department of Health Sciences, University of Genoa; Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| |
Collapse
|
31
|
Favresse J, Bayart JL, David C, Didembourg M, Gillot C, Dogné JM, Douxfils J. Spike vs. nucleocapsid serum antigens for COVID-19 diagnosis and severity assessment. Clin Chem Lab Med 2022; 60:e97-e100. [PMID: 35007411 DOI: 10.1515/cclm-2021-1244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 01/04/2022] [Indexed: 12/28/2022]
Affiliation(s)
- Julien Favresse
- Department of Laboratory Medicine, Clinique St-Luc Bouge, Namur, Belgium
- Department of Pharmacy, Namur Research Institute for LIfe Sciences, University of Namur, Namur, Belgium
| | - Jean-Louis Bayart
- Department of Laboratory Medicine, Clinique St-Pierre Ottignies, Ottignies-Louvain-la-Neuve, Belgium
| | | | - Marie Didembourg
- Department of Pharmacy, Namur Research Institute for LIfe Sciences, University of Namur, Namur, Belgium
| | - Constant Gillot
- Department of Pharmacy, Namur Research Institute for LIfe Sciences, University of Namur, Namur, Belgium
| | - Jean-Michel Dogné
- Department of Pharmacy, Namur Research Institute for LIfe Sciences, University of Namur, Namur, Belgium
| | - Jonathan Douxfils
- Department of Pharmacy, Namur Research Institute for LIfe Sciences, University of Namur, Namur, Belgium
- Qualiblood sa, Namur, Belgium
| |
Collapse
|
32
|
Morris CP, Luo CH, Sachithanandham J, Li M, Schwartz M, Gaston DC, Gniazdowski V, Giraldo-Castillo N, Amadi A, Norton JM, Wright WF, Klein EY, Pekosz A, Mostafa HH. Large Scale SARS-CoV-2 Molecular Testing and Genomic Surveillance Reveal Prolonged Infections, Protracted RNA shedding, and Viral Reinfections. Front Cell Infect Microbiol 2022; 12:809407. [PMID: 35480235 PMCID: PMC9035932 DOI: 10.3389/fcimb.2022.809407] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/15/2022] [Indexed: 12/22/2022] Open
Abstract
Large-scale SARS-CoV-2 molecular testing coupled with whole genome sequencing in the diagnostic laboratories is instrumental for real-time genomic surveillance. The extensive genomic, laboratory, and clinical data provide a valuable resource for understanding cases of reinfection versus prolonged RNA shedding and protracted infections. In this study, data from a total of 22,292 clinical specimens, positive by SARS-CoV-2 molecular diagnosis at Johns Hopkins clinical virology laboratory between March 11th 2020 to September 23rd 2021, were used to identify patients with two or more positive results. A total of 3,650 samples collected from 1,529 patients who had between 2 and 20 positive results were identified in a time frame that extended up to 403 days from the first positive. Cycle threshold values (Ct) were available for 1,622 samples, the median of which was over 30 by 11 days after the first positive. Extended recovery of infectious virus on cell culture was notable for up to 70 days after the first positive in immunocompromised patients. Whole genome sequencing data generated as a part of our SARS-CoV-2 genomic surveillance was available for 1,027 samples from patients that had multiple positive tests. Positive samples collected more than 10 days after initial positive with high quality sequences (coverage >90% and mean depth >100), were more likely to be from unvaccinated, or immunosuppressed patients. Reinfections with viral variants of concern were found in 3 patients more than 130 days from prior infections with a different viral clade. In 75 patients that had 2 or more high quality sequences, the acquisition of more substitutions or deletions was associated with lack of vaccination and longer time between the recovered viruses. Our study highlights the value of integrating genomic, laboratory, and clinical data for understanding the biology of SARS-CoV-2 as well as for setting a precedent for future epidemics and pandemics.
Collapse
Affiliation(s)
- C. Paul Morris
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, MD, United States
- National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, United States
| | - Chun Huai Luo
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Jaiprasath Sachithanandham
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Maggie Li
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Matthew Schwartz
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - David C. Gaston
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Victoria Gniazdowski
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Nicolas Giraldo-Castillo
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Adannaya Amadi
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Julie M. Norton
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - William F. Wright
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Eili Y. Klein
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
- Center for Disease Dynamics, Economics, and Policy, Washington, DC, United States
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Heba H. Mostafa
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| |
Collapse
|
33
|
Konishi K, Yamaji T, Sakuma C, Kasai F, Endo T, Kohara A, Hanada K, Osada N. Whole-Genome Sequencing of Vero E6 (VERO C1008) and Comparative Analysis of Four Vero Cell Sublines. Front Genet 2022; 13:801382. [PMID: 35391802 PMCID: PMC8981525 DOI: 10.3389/fgene.2022.801382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
The Vero cell line is an immortalized cell line established from kidney epithelial cells of the African green monkey. A variety of Vero sublines have been developed and can be classified into four major cell lineages. In this study, we determined the whole-genome sequence of Vero E6 (VERO C1008), which is one of the most widely used cell lines for the proliferation and isolation of severe acute respiratory syndrome coronaviruses (SARS-CoVs), and performed comparative analysis among Vero JCRB0111, Vero CCL-81, Vero 76, and Vero E6. Analysis of the copy number changes and loss of heterozygosity revealed that these four sublines share a large deletion and loss of heterozygosity on chromosome 12, which harbors type I interferon and CDKN2 gene clusters. We identified a substantial number of genetic differences among the sublines including single nucleotide variants, indels, and copy number variations. The spectrum of single nucleotide variants indicated a close genetic relationship between Vero JCRB0111 and Vero CCL-81, and between Vero 76 and Vero E6, and a considerable genetic gap between the former two and the latter two lines. In contrast, we confirmed the pattern of genomic integration sites of simian endogenous retroviral sequences, which was consistent among the sublines. We identified subline-specific/enriched loss of function and missense variants, which potentially contribute to the differences in response to viral infection among the Vero sublines. In particular, we identified four genes (IL1RAP, TRIM25, RB1CC1, and ATG2A) that contained missense variants specific or enriched in Vero E6. In addition, we found that V739I variants of ACE2, which functions as the receptor for SARS-CoVs, were heterozygous in Vero JCRB0111, Vero CCL-81, and Vero 76; however, Vero E6 harbored only the allele with isoleucine, resulting from the loss of one of the X chromosomes.
Collapse
Affiliation(s)
- Kazuhiro Konishi
- Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Japan
| | - Toshiyuki Yamaji
- Department of Biochemistry and Cell Biology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Chisato Sakuma
- Department of Biochemistry and Cell Biology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Fumio Kasai
- Laboratory of Cell Cultures, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Toshinori Endo
- Faculty of Information Science and Technology, Hokkaido University, Sapporo, Japan
| | - Arihiro Kohara
- Laboratory of Cell Cultures, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Kentaro Hanada
- Department of Biochemistry and Cell Biology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Naoki Osada
- Faculty of Information Science and Technology, Hokkaido University, Sapporo, Japan
| |
Collapse
|
34
|
Wertenauer C, Brenner Michael G, Dressel A, Pfeifer C, Hauser U, Wieland E, Mayer C, Mutschmann C, Roskos M, Wertenauer HJ, Moissl AP, Lorkowski S, März W. Diagnostic Performance of Rapid Antigen Testing for SARS-CoV-2: The COVid-19 AntiGen (COVAG) study. Front Med (Lausanne) 2022; 9:774550. [PMID: 35386920 PMCID: PMC8979030 DOI: 10.3389/fmed.2022.774550] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 02/17/2022] [Indexed: 12/19/2022] Open
Abstract
Background Rapid diagnostic testing for SARS-Cov-2 antigens is used to combat the ongoing pandemic. In this study we aimed to compare two RDTs, the SD Biosensor Q SARS-CoV-2 Rapid Antigen Test (Roche) and the Panbio COVID-19 Ag Rapid Test (Abbott), against rRT-PCR. Methods We included 2,215 all-comers at a diagnostic center between February 1 and March 31, 2021. rRT-PCR-positive samples were examined for SARS-CoV-2 variants. Findings Three hundred and thirty eight participants (15%) were rRT-PCR-positive for SARS-CoV-2. The sensitivities of Roche-RDT and Abbott-RDT were 60.4 and 56.8% (P < 0.0001) and specificities 99.7% and 99.8% (P = 0.076). Sensitivity inversely correlated with rRT-PCR-Ct values. The RDTs had higher sensitivities in individuals referred by treating physicians (79.5%, 78.7%) than in those referred by health departments (49.5%, 44.3%) or tested for other reasons (50%, 45.8%), in persons without any comorbidities (74.4%, 71%) compared to those with comorbidities (38.2%, 34.4%), in individuals with COVID-19 symptoms (75.2%, 74.3%) compared to those without (31.9%, 23.3%), and in the absence of SARS-CoV-2 variants (87.7%, 84%) compared to Alpha variant carriers (77.1%, 72.3%). If 10,000 symptomatic individuals are tested of which 500 are truly positive, the RDTs would generate 38 false-positive and 124 false-negative results. If 10,000 asymptomatic individuals are tested, including 50 true positives, 18 false-positives and 34 false-negatives would be generated. Interpretation The sensitivities of the two RDTs for asymptomatic SARS-CoV-2 carriers are unsatisfactory. Their widespread use may not be effective in the ongoing SARS-CoV-2 pandemic. The virus genotype influences the sensitivity of the two RDTs. RDTs should be evaluated for different SARS-CoV-2 variants.
Collapse
Affiliation(s)
- Christoph Wertenauer
- Hausärzte am Schillerplatz, Stuttgart, Germany.,Medical Clinic V, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Faculty of Medicine, Riga Stradins University, Riga, Latvia.,SYNLAB Holding Deutschland GmbH, Augsburg, Germany
| | | | | | | | - Ulrike Hauser
- SYNLAB Medical Care Center Augsburg GmbH, Augsburg, Germany
| | - Eberhard Wieland
- SYNLAB Medical Care Center Leinfelden-Echterdingen GmbH, Leinfelden-Echterdingen, Germany
| | | | | | | | | | - Angela P Moissl
- Medical Clinic V, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, Germany.,Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Jena, Germany
| | - Stefan Lorkowski
- Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, Germany.,Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Jena, Germany
| | - Winfried März
- Medical Clinic V, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,SYNLAB Academy, SYNLAB Holding Deutschland GmbH, Mannheim, Germany.,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| |
Collapse
|
35
|
Fomenko A, Weibel S, Moezi H, Menger K, Schmucker C, Metzendorf MI, Motschall E, Falcone V, Huzly D, Panning M, Rücker G, Hengel H. Assessing severe acute respiratory syndrome coronavirus 2 infectivity by reverse-transcription polymerase chain reaction: A systematic review and meta-analysis. Rev Med Virol 2022; 32:e2342. [PMID: 35366033 PMCID: PMC9111068 DOI: 10.1002/rmv.2342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 12/19/2022]
Abstract
The cornerstone of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) detection is reverse‐transcription polymerase chain reaction (RT‐PCR) of viral RNA. As a surrogate assay SARS‐CoV‐2 RNA detection does not necessarily imply infectivity. Only virus isolation in permissive cell culture systems can indicate infectivity. Here, we review the evidence on RT‐PCR performance in detecting infectious SARS‐CoV‐2. We searched for any studies that used RT‐PCR and cell culture to determine infectious SARS‐CoV‐2 in respiratory samples. We assessed (i) diagnostic accuracy of RT‐PCR compared to cell culture as reference test, (ii) performed meta‐analysis of positive predictive values (PPV) and (iii) determined the virus isolation probabilities depending on cycle threshold (Ct) or log10 genome copies/ml using logistic regression. We included 55 studies. There is substantial statistical and clinical heterogeneity. Seven studies were included for diagnostic accuracy. Sensitivity ranged from 90% to 99% and specificity from 29% to 92%. In meta‐analysis, the PPVs varied across subgroups with different sampling times after symptom onset, with 1% (95% confidence interval [CI], 0%–7%) in sampling beyond 10 days and 27% (CI, 19%–36%) to 46% (CI, 33%–60%) in subgroups that also included earlier samples. Estimates of virus isolation probability varied between 6% (CI, 0%–100%) and 50% (CI, 0%–100%) at a Ct value of 30 and between 0% (CI, 0%–22%) and 63% (CI, 0%–100%) at 5 log10 genome copies/ml. Evidence on RT‐PCR performance in detecting infectious SARS‐CoV‐2 in respiratory samples was limited. Major limitations were heterogeneity and poor reporting. RT‐PCR and cell culture protocols need further standardisation.
Collapse
Affiliation(s)
- Alexey Fomenko
- Institute of Virology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Stephanie Weibel
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Helia Moezi
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Kristina Menger
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Christine Schmucker
- Institute for Evidence in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Maria-Inti Metzendorf
- Cochrane Metabolic and Endocrine Disorders Group, Institute of General Practice, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - Edith Motschall
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Valeria Falcone
- Institute of Virology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Daniela Huzly
- Institute of Virology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Marcus Panning
- Institute of Virology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Gerta Rücker
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Hartmut Hengel
- Institute of Virology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| |
Collapse
|
36
|
Atiya-Nasagi Y, Milrot E, Makdasi E, Schuster O, Shmaya S, Simon I, Ben-Shmuel A, Beth-Din A, Weiss S, Laskar O. Development of an immunofluorescence assay for detection of SARS-CoV-2. Arch Virol 2022; 167:1041-1049. [PMID: 35192015 PMCID: PMC8862410 DOI: 10.1007/s00705-022-05392-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/10/2022] [Indexed: 11/24/2022]
Abstract
SARS-CoV-2, the etiologic agent of the COVID-19 pandemic, emerged as the cause of a global crisis in 2019. Currently, the main method for identification of SARS-CoV-2 is a reverse transcription (RT)-PCR assay designed to detect viral RNA in oropharyngeal (OP) or nasopharyngeal (NP) samples. While the PCR assay is considered highly specific and sensitive, this method cannot determine the infectivity of the sample, which may assist in evaluation of virus transmissibility from patients and breaking transmission chains. Thus, cell-culture-based approaches such as cytopathic effect (CPE) assays are routinely employed for the identification of infectious viruses in NP/OP samples. Despite their high sensitivity, CPE assays take several days and require additional diagnostic tests in order to verify the identity of the pathogen. We have therefore developed a rapid immunofluorescence assay (IFA) for the specific detection of SARS-CoV-2 in NP/OP samples following cell culture infection. Initially, IFA was carried out on Vero E6 cultures infected with SARS-CoV-2 at defined concentrations, and infection was monitored at different time points. This test was able to yield positive signals in cultures infected with 10 pfu/ml at 12 hours postinfection (PI). Increasing the incubation time to 24 hours reduced the detectable infective dose to 1 pfu/ml. These IFA signals occur before the development of CPE. When compared to the CPE test, IFA has the advantages of specificity, rapid detection, and sensitivity, as demonstrated in this work.
Collapse
Affiliation(s)
- Yafit Atiya-Nasagi
- The Department of Infectious Diseases, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Elad Milrot
- The Department of Infectious Diseases, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Efi Makdasi
- The Department of Infectious Diseases, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Ofir Schuster
- The Department of Infectious Diseases, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Shlomo Shmaya
- The Department of Infectious Diseases, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Irit Simon
- The Department of Biotechnology, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Amir Ben-Shmuel
- The Department of Infectious Diseases, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Adi Beth-Din
- The Department of Biochemistry and Molecular Genetics, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Shay Weiss
- The Department of Infectious Diseases, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Orly Laskar
- The Department of Infectious Diseases, Israel Institute for Biological Research, Ness-Ziona, Israel.
| |
Collapse
|
37
|
Henriques A, Mounet N, Aleixo L, Elson P, Devine J, Azzopardi G, Andreini M, Rognlien M, Tarocco N, Tang J. Modelling airborne transmission of SARS-CoV-2 using CARA: risk assessment for enclosed spaces. Interface Focus 2022; 12:20210076. [PMID: 35261732 PMCID: PMC8831086 DOI: 10.1098/rsfs.2021.0076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/19/2021] [Indexed: 12/18/2022] Open
Abstract
The COVID-19 pandemic has highlighted the need for a proper risk assessment of respiratory pathogens in indoor settings. This paper documents the COVID Airborne Risk Assessment methodology, to assess the potential exposure of airborne SARS-CoV-2 viruses, with an emphasis on virological and immunological factors in the quantification of the risk. The model results from a multidisciplinary approach linking physical, mechanical and biological domains, enabling decision makers or facility managers to assess their indoor setting. The model was benchmarked against clinical data, as well as two real-life outbreaks, showing good agreement. A probability of infection is computed in several everyday-life settings and with various mitigation measures. The importance of super-emitters in airborne transmission is confirmed: 20% of infected hosts can emit approximately two orders of magnitude more viral-containing particles. The use of masks provides a fivefold reduction in viral emissions. Natural ventilation strategies are very effective to decrease the concentration of virions, although periodic venting strategies are not ideal in certain settings. Although vaccination is an effective measure against hospitalization, their effectiveness against transmission is not optimal, hence non-pharmaceutical interventions (ventilation, masks) should be actively supported. We also propose a critical threshold to define an acceptable risk level.
Collapse
Affiliation(s)
- Andre Henriques
- CERN (European Organization for Nuclear Research), Geneva, Switzerland
| | - Nicolas Mounet
- CERN (European Organization for Nuclear Research), Geneva, Switzerland
| | - Luis Aleixo
- CERN (European Organization for Nuclear Research), Geneva, Switzerland
| | - Philip Elson
- CERN (European Organization for Nuclear Research), Geneva, Switzerland
| | - James Devine
- CERN (European Organization for Nuclear Research), Geneva, Switzerland
| | | | - Marco Andreini
- CERN (European Organization for Nuclear Research), Geneva, Switzerland
| | - Markus Rognlien
- NTNU (Norwegian University of Science and Technology), Torgarden, Norway
| | - Nicola Tarocco
- CERN (European Organization for Nuclear Research), Geneva, Switzerland
| | - Julian Tang
- Respiratory Sciences, University of Leicester, Leicester, UK
| |
Collapse
|
38
|
Mody L, Akinboyo IC, Babcock HM, Bischoff WE, Cheng VCC, Chiotos K, Claeys KC, Coffey KC, Diekema DJ, Donskey CJ, Ellingson KD, Gilmartin HM, Gohil SK, Harris AD, Keller SC, Klein EY, Krein SL, Kwon JH, Lauring AS, Livorsi DJ, Lofgren ET, Merrill K, Milstone AM, Monsees EA, Morgan DJ, Perri LP, Pfeiffer CD, Rock C, Saint S, Sickbert-Bennett E, Skelton F, Suda KJ, Talbot TR, Vaughn VM, Weber DJ, Wiemken TL, Yassin MH, Ziegler MJ, Anderson DJ. Coronavirus disease 2019 (COVID-19) research agenda for healthcare epidemiology. Infect Control Hosp Epidemiol 2022; 43:156-166. [PMID: 33487199 PMCID: PMC8160487 DOI: 10.1017/ice.2021.25] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 01/07/2021] [Indexed: 02/07/2023]
Abstract
This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to coronavirus disease 2019 (COVID-19) with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplementary materials. This research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research. Research gaps and challenges related to nursing homes and social disparities are included. Collaborations across various disciplines, expertise and across diverse geographic locations will be critical.
Collapse
Affiliation(s)
- Lona Mody
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
- Geriatrics Research Education and Clinical Center, Veterans’ Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
| | - Ibukunoluwa C. Akinboyo
- Division of Infectious Diseases, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, United States
| | - Hilary M. Babcock
- Washington University School of Medicine, St. Louis, Missouri, United States
| | - Werner E. Bischoff
- Wake Forest School of Medicine, Winston Salem, North Carolina, United States
| | - Vincent Chi-Chung Cheng
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Kathleen Chiotos
- Division of Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
| | - Kimberly C. Claeys
- University of Maryland School of Pharmacy, Baltimore, Maryland, United States
| | - K. C. Coffey
- University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Daniel J. Diekema
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Curtis J. Donskey
- Infectious Diseases Section, Louis Stokes Cleveland Veterans’ Affairs Medical Center, Cleveland, Ohio, United States
- Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | - Katherine D. Ellingson
- Department of Epidemiology and Biostatistics, College of Public Health, University of Arizona, Tucson, Arizona, United States
| | - Heather M. Gilmartin
- Veterans’ Affairs Eastern Colorado Healthcare System, Aurora, Colorado, United States
- Colorado School of Public Health, University of Colorado, Aurora, Colorado, United States
| | - Shruti K. Gohil
- Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, California, United States
- Epidemiology and Infection Prevention, UC Irvine Health, Irvine, California, United States
| | - Anthony D. Harris
- University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Sara C. Keller
- Division of Infectious Diseases, John Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Eili Y. Klein
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, Unites States
| | - Sarah L. Krein
- Veterans’ Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, United States
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
| | - Jennie H Kwon
- Washington University School of Medicine, St. Louis, Missouri, United States
| | - Adam S. Lauring
- Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
| | - Daniel J. Livorsi
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
- Iowa City Veterans’ Affairs Health Care System, Iowa City, Iowa, United States
| | - Eric T. Lofgren
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, United States
| | | | - Aaron M. Milstone
- Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Elizabeth A. Monsees
- Children’s Mercy Kansas City, Kansas City, Missouri, United States
- University of Missouri–Kansas City School of Medicine, Kansas City, Missouri, United States
| | - Daniel J. Morgan
- University of Maryland School of Medicine, Baltimore, Maryland, United States
- Veterans’ Affairs Maryland Healthcare System, Baltimore, Maryland, United States
| | - Luci P. Perri
- Infection Control Results, Wingate, North Carolina, United States
| | - Christopher D. Pfeiffer
- Veterans’ Affairs Portland Health Care System, Portland, Oregon, United States
- Oregon Health & Science University, Portland, Oregon, United States
| | - Clare Rock
- Division of Infectious Diseases, John Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Sanjay Saint
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
- Veterans’ Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
| | - Emily Sickbert-Bennett
- Department of Infection Prevention, University of North Carolina Medical Center, Chapel Hill, North Carolina, United States
| | - Felicia Skelton
- Michael E. DeBakey Veterans’ Affairs Medical Center, Houston, Texas, United States
- H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, Texas, United States
| | - Katie J. Suda
- Center for Health Equity Research and Promotion, Veterans’ Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, United States
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Thomas R. Talbot
- Vanderbilt University School of Medicine, Nashville, Tennessee, United States
| | - Valerie M. Vaughn
- Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - David J. Weber
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Timothy L. Wiemken
- Division of Infectious Diseases, Allergy, and Immunology, Department of Medicine, Saint Louis University School of Medicine, St Louis, Missouri, United States
| | - Mohamed H. Yassin
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
- Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Matthew J. Ziegler
- Infectious Diseases Division, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Deverick J. Anderson
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University School of Medicine, Durham, North Carolina, United States
| |
Collapse
|
39
|
Li N, Zhao B, Stavins R, Peinetti AS, Chauhan N, Bashir R, Cunningham BT, King WP, Lu Y, Wang X, Valera E. Overcoming the limitations of COVID-19 diagnostics with nanostructures, nucleic acid engineering, and additive manufacturing. Curr Opin Solid State Mater Sci 2022; 26:100966. [PMID: 34840515 PMCID: PMC8604633 DOI: 10.1016/j.cossms.2021.100966] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 05/04/2023]
Abstract
The COVID-19 pandemic revealed fundamental limitations in the current model for infectious disease diagnosis and serology, based upon complex assay workflows, laboratory-based instrumentation, and expensive materials for managing samples and reagents. The lengthy time delays required to obtain test results, the high cost of gold-standard PCR tests, and poor sensitivity of rapid point-of-care tests contributed directly to society's inability to efficiently identify COVID-19-positive individuals for quarantine, which in turn continues to impact return to normal activities throughout the economy. Over the past year, enormous resources have been invested to develop more effective rapid tests and laboratory tests with greater throughput, yet the vast majority of engineering and chemistry approaches are merely incremental improvements to existing methods for nucleic acid amplification, lateral flow test strips, and enzymatic amplification assays for protein-based biomarkers. Meanwhile, widespread commercial availability of new test kits continues to be hampered by the cost and time required to develop single-use disposable microfluidic plastic cartridges manufactured by injection molding. Through development of novel technologies for sensitive, selective, rapid, and robust viral detection and more efficient approaches for scalable manufacturing of microfluidic devices, we can be much better prepared for future management of infectious pathogen outbreaks. Here, we describe how photonic metamaterials, graphene nanomaterials, designer DNA nanostructures, and polymers amenable to scalable additive manufacturing are being applied towards overcoming the fundamental limitations of currently dominant COVID-19 diagnostic approaches. In this paper, we review how several distinct classes of nanomaterials and nanochemistry enable simple assay workflows, high sensitivity, inexpensive instrumentation, point-of-care sample-to-answer virus diagnosis, and rapidly scaled manufacturing.
Collapse
Affiliation(s)
- Nantao Li
- Carle Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, United States
- Holonyak Micro and Nanotechnology Laboratory, University of Illinois at Urbana-Champaign, United States
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, United States
| | - Bin Zhao
- Carle Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, United States
- Holonyak Micro and Nanotechnology Laboratory, University of Illinois at Urbana-Champaign, United States
| | - Robert Stavins
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, United States
| | - Ana Sol Peinetti
- Department of Chemistry, University of Illinois at Urbana-Champaign, United States
| | - Neha Chauhan
- Carle Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, United States
- Holonyak Micro and Nanotechnology Laboratory, University of Illinois at Urbana-Champaign, United States
| | - Rashid Bashir
- Carle Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, United States
- Holonyak Micro and Nanotechnology Laboratory, University of Illinois at Urbana-Champaign, United States
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, United States
- Department of Bioengineering, University of Illinois at Urbana-Champaign, United States
| | - Brian T Cunningham
- Carle Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, United States
- Holonyak Micro and Nanotechnology Laboratory, University of Illinois at Urbana-Champaign, United States
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, United States
- Department of Bioengineering, University of Illinois at Urbana-Champaign, United States
| | - William P King
- Holonyak Micro and Nanotechnology Laboratory, University of Illinois at Urbana-Champaign, United States
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, United States
| | - Yi Lu
- Carle Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, United States
- Department of Chemistry, University of Illinois at Urbana-Champaign, United States
| | - Xing Wang
- Carle Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, United States
- Holonyak Micro and Nanotechnology Laboratory, University of Illinois at Urbana-Champaign, United States
- Department of Chemistry, University of Illinois at Urbana-Champaign, United States
| | - Enrique Valera
- Holonyak Micro and Nanotechnology Laboratory, University of Illinois at Urbana-Champaign, United States
- Department of Bioengineering, University of Illinois at Urbana-Champaign, United States
| |
Collapse
|
40
|
Liu LT, Tsai JJ, Chen CH, Lin PC, Tsai CY, Tsai YY, Hsu MC, Chuang WL, Chang JM, Hwang SJ, Chong IW. Isolation and Identification of a Rare Spike Gene Double-Deletion SARS-CoV-2 Variant From the Patient With High Cycle Threshold Value. Front Med (Lausanne) 2022; 8:822633. [PMID: 35071285 PMCID: PMC8770430 DOI: 10.3389/fmed.2021.822633] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 12/13/2021] [Indexed: 12/18/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an emerging life-threatening pulmonary disease caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which originated in Wuhan, Hubei Province, China, in December 2019. COVID-19 develops after close contact via inhalation of respiratory droplets containing SARS-CoV-2 during talking, coughing, or sneezing by asymptomatic, presymptomatic, and symptomatic carriers. This virus evolved over time, and numerous genetic variants have been reported to have increased disease severity, mortality, and transmissibility. Variants have also developed resistance to antivirals and vaccination and can escape the immune response of humans. Reverse transcription polymerase chain reaction (RT–PCR) is the method of choice among diagnostic techniques, including nucleic acid amplification tests (NAATs), serological tests, and diagnostic imaging, such as computed tomography (CT). The limitation of RT–PCR is that it cannot distinguish fragmented RNA genomes from live transmissible viruses. Thus, SARS-CoV-2 isolation by using cell culture has been developed and makes important contributions in the field of diagnosis, development of antivirals, vaccines, and SARS-CoV-2 virology research. In this research, two SARS-CoV-2 strains were isolated from four RT–PCR-positive nasopharyngeal swabs using VERO E6 cell culture. One isolate was cultured successfully with a blind passage on day 3 post inoculation from a swab with a Ct > 35, while the cells did not develop cytopathic effects without a blind passage until day 14 post inoculation. Our results indicated that infectious SARS-CoV-2 virus particles existed, even with a Ct > 35. Cultivable viruses could provide additional consideration for releasing the patient from quarantine. The results of the whole genome sequencing and bioinformatic analysis suggested that these two isolates contain a spike 68-76del+spike 675-679del double-deletion variation. The double deletion was confirmed by amplification of the regions spanning the spike gene deletion using Sanger sequencing. Phylogenetic analysis revealed that this double-deletion variant was rare (one per million in public databases, including GenBank and GISAID). The impact of this double deletion in the spike gene on the SARS-CoV-2 virus itself as well as on cultured cells and/or humans remains to be further elucidated.
Collapse
Affiliation(s)
- Li-Teh Liu
- Department of Medical Laboratory Science and Biotechnology, College of Medical Technology, Chung-Hwa University of Medical Technology, Tainan, Taiwan
| | - Jih-Jin Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hong Chen
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Zhunan, Taiwan.,National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Ping-Chang Lin
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ching-Yi Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yan-Yi Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Miao-Chen Hsu
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wan-Long Chuang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Hepatobiliary and Pancreatic, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jer-Ming Chang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shang-Jyh Hwang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Inn-Wen Chong
- Department of Internal Medicine and Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Pulmonary Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| |
Collapse
|
41
|
Kim HN, Yoon SY, Lim CS, Yoon J. Comparison of three molecular diagnostic assays for SARS-CoV-2 detection: Evaluation of analytical sensitivity and clinical performance. J Clin Lab Anal 2022; 36:e24242. [PMID: 35019184 PMCID: PMC8842162 DOI: 10.1002/jcla.24242] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/29/2021] [Accepted: 01/02/2022] [Indexed: 12/22/2022] Open
Abstract
Background Currently, SARS‐CoV‐2 RNA detection using real‐time reverse‐transcription PCR (rRT‐PCR) is the standard diagnostic test for COVID‐19 infection. Various rRT‐PCR assays are currently used worldwide, targeting different genes of the SARS‐CoV‐2. Here, we compared the analytical sensitivity and clinical performance (sensitivity and specificity) of Allplex SARS‐CoV‐2/FluA/FluB/RSV assay (Seegene), Standard M nCoV real‐time detection kit (SD Biosensor), and U‐TOP COVID‐19 detection kit (Seasun Biomaterials) for SARS‐CoV‐2 detection. Methods Two hundred and forty‐nine nasopharyngeal swab samples were evaluated to compare the clinical performance of the rRT‐PCR assays. For the analytical performance evaluation, two RNA controls with known viral loads—SARS‐CoV‐2 RNA control and SARS‐COV‐2 B.1.351 RNA control—were used to investigate the potential impact of SARS‐CoV‐2 variants, particularly the B.1.351 lineage. Results Limits of detection ranged from 650 to 1300 copies/ml for rRT‐PCR assays, and the mean differences in cycle threshold (Ct) values of the two RNA controls were within 1.0 for each target in the rRT‐PCR assays (0.05–0.73), without any prominent Ct value shift or dropouts in the SARS‐COV‐2 B.1.351 RNA control. Using the consensus criterion as the reference standard, 89 samples were positive, whereas 160 were negative. The overall clinical performance of rRT‐PCR assays was comparable (sensitivity 98.88%–100%; specificity 99.38%–100%), whereas the sensitivities of each target gene were more variable. Conclusions The three rRT‐PCR assays showed comparable analytical sensitivity and clinical performance. The analytical and clinical sensitivities of each target gene were influenced more by the primer and probe design than the target gene itself.
Collapse
Affiliation(s)
- Ha Nui Kim
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea
| | - Soo-Young Yoon
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea
| | - Chae Seung Lim
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jung Yoon
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea
| |
Collapse
|
42
|
Favresse J, Bayart JL, David C, Dogné JM, Douxfils J. Nucleocapsid Serum Antigen Determination in SARS-CoV-2 Infected Patients Using the Single Molecule Array Technology and Prediction of Disease Severity. J Infect 2022; 84:e4-e6. [PMID: 35074508 PMCID: PMC8779852 DOI: 10.1016/j.jinf.2022.01.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/16/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Julien Favresse
- Department of Laboratory Medicine, Clinique St-Luc Bouge, Namur, Belgium; Department of Pharmacy, Namur Research Institute for LIfe Sciences, University of Namur, Namur, Belgium.
| | - Jean-Louis Bayart
- Department of Laboratory Medicine, Clinique St-Pierre Ottignies, Ottignies-Louvain-la-Neuve, Belgium
| | | | - Jean-Michel Dogné
- Department of Pharmacy, Namur Research Institute for LIfe Sciences, University of Namur, Namur, Belgium
| | - Jonathan Douxfils
- Department of Pharmacy, Namur Research Institute for LIfe Sciences, University of Namur, Namur, Belgium; Qualiblood sa, Namur, Belgium
| |
Collapse
|
43
|
Leitão IDC, Calil PT, Galliez RM, Moreira FRR, Mariani D, Castiñeiras ACP, da Silva GPD, Maia RA, Corrêa IA, Monteiro FLL, de Souza MRM, Gonçalves CCA, Higa LM, de Jesus Ribeiro L, Fonseca VWP, Bastos VC, Voloch CM, Faffe DS, da Costa Ferreira O, Tanuri A, Castiñeiras TMPP, da Costa LJ. Prolonged SARS-CoV-2 Positivity in Immunocompetent Patients: Virus Isolation, Genomic Integrity, and Transmission Risk. Microbiol Spectr 2021; 9:e0085521. [PMID: 34787498 PMCID: PMC8597635 DOI: 10.1128/spectrum.00855-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/21/2021] [Indexed: 12/23/2022] Open
Abstract
Current guidelines for patient isolation in COVID-19 cases recommend a symptom-based approach, averting the use of control real-time reverse transcription PCR (rRT-PCR) testing. However, we hypothesized that patients with persistently positive results by RT-PCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could be potentially infectious for a prolonged time, even if immunocompetent and asymptomatic, which would demand a longer social isolation period than presently recommended. To test this hypothesis, 72 samples from 51 mildly symptomatic immunocompetent patients with long-lasting positive rRT-PCR results for SARS-CoV-2 were tested for their infectiousness in cell culture. The serological response of samples from those patients and virus genomic integrity were also analyzed. Infectious viruses were successfully isolated from 34.38% (22/64) of nasopharynx samples obtained 14 days or longer after symptom onset. Indeed, we observed successful virus isolation up to 128 days. Complete SARS-COV-2 genome integrity was demonstrated, suggesting the presence of replication-competent viruses. No correlation was found between the isolation of infectious viruses and rRT-PCR cycle threshold values or the humoral immune response. These findings call attention to the need to review current isolation guidelines, particularly in scenarios involving high-risk individuals. IMPORTANCE In this study, we evaluated mildly symptomatic immunocompetent patients with long-lasting positive rRT-PCR results for SARS-CoV-2. Infectious viruses were successfully isolated in cell cultures from nasopharynx samples obtained 14 days or longer after symptom onset. Indeed, we observed successful virus isolation for up to 128 days. Moreover, SARS-CoV-2 genome integrity was demonstrated by sequencing, suggesting the presence of replication-competent viruses. These data point out the risk of continuous SARS-CoV-2 transmission from patients with prolonged detection of SARS-CoV-2 in the upper respiratory tract, which has important implications for current precaution guidelines, particularly in settings where vulnerable individuals may be exposed (e.g., nursing homes and hospitals).
Collapse
Affiliation(s)
- Isabela de Carvalho Leitão
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Pedro Telles Calil
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Rafael Mello Galliez
- Departamento de Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Filipe Romero Rebello Moreira
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Diana Mariani
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Gustavo Peixoto Duarte da Silva
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Richard Araújo Maia
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Isadora Alonso Corrêa
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Fábio Luís Lima Monteiro
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Marcos Romário Matos de Souza
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Luiza Mendonça Higa
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Liane de Jesus Ribeiro
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Victoria Cortes Bastos
- Departamento de Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Carolina Moreira Voloch
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Débora Souza Faffe
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Orlando da Costa Ferreira
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Amilcar Tanuri
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Luciana Jesus da Costa
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| |
Collapse
|
44
|
Longtin Y, Parkes LO, Charest H, Rajarison S, Zaharatos GJ, Fafard J, Roger M, De Serres G. Persistence of infectivity in elderly individuals diagnosed with severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection 10 days after onset of symptoms: A cross-sectional study. Infect Control Hosp Epidemiol 2021;:1-4. [PMID: 34866565 DOI: 10.1017/ice.2021.502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
We performed viral culture of nasopharyngeal specimens in individuals aged 79 and older, infected with severe acute respiratory coronavirus virus 2 (SARS-CoV-2), 10 days after symptom onset. A positive viral culture was obtained in 10 (45%) of 22 participants, including 4 (33%) of 12 individuals with improving symptoms. The results of this small study suggest that infectivity may be prolonged among older individuals.
Collapse
|
45
|
Chojecka D, Pytlos J, Zawadka M, Andruszkiewicz P, Szarpak Ł, Dzieciątkowski T, Jaguszewski MJ, Filipiak KJ, Gąsecka A. How to Maintain Safety and Maximize the Efficacy of Cardiopulmonary Resuscitation in COVID-19 Patients: Insights from the Recent Guidelines. J Clin Med 2021; 10:jcm10235667. [PMID: 34884368 PMCID: PMC8658351 DOI: 10.3390/jcm10235667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/22/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022] Open
Abstract
Since December 2019, the novel coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has remained a challenge for governments and healthcare systems all around the globe. SARS-CoV-2 infection is associated with increased rates of hospital admissions and significant mortality. The pandemic increased the rate of cardiac arrest and the need for cardiopulmonary resuscitation (CPR). COVID-19, with its pathophysiology and detrimental effects on healthcare, influenced the profile of patients suffering from cardiac arrest, as well as the conditions of performing CPR. To ensure both the safety of medical personnel and the CPR efficacy for patients, resuscitation societies have published modified guidelines addressing the specific reality of the COVID-19 pandemic. In this review, we briefly describe the transmission and pathophysiology of COVID-19, present the challenges of CPR in SARS-CoV-2-infected patients, summarize the current recommendations regarding the algorithms of basic life support (BLS), advanced life support (ALS) and pediatric life support, and discuss other aspects of CPR in COVID-19 patients, which potentially affect the risk-to-benefit ratio of medical procedures and therefore should be considered while formulating further recommendations.
Collapse
Affiliation(s)
- Dominika Chojecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (D.C.); (J.P.)
| | - Jakub Pytlos
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (D.C.); (J.P.)
| | - Mateusz Zawadka
- 2nd Department of Anesthesia and Intensive Care, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.Z.); (P.A.)
| | - Paweł Andruszkiewicz
- 2nd Department of Anesthesia and Intensive Care, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.Z.); (P.A.)
| | - Łukasz Szarpak
- Department of Clinical Sciences, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, Poland;
- Department of Clinical Sciences, Maria Sklodowska-Curie Medical Academy in Warsaw, 00-136 Warsaw, Poland;
| | - Tomasz Dzieciątkowski
- Chair and Department of Medical Microbiology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | | | - Krzysztof Jerzy Filipiak
- Department of Clinical Sciences, Maria Sklodowska-Curie Medical Academy in Warsaw, 00-136 Warsaw, Poland;
| | - Aleksandra Gąsecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (D.C.); (J.P.)
- Correspondence:
| |
Collapse
|
46
|
Puyskens A, Krause E, Michel J, Nübling CM, Scheiblauer H, Bourquain D, Grossegesse M, Valusenko R, Corman VM, Drosten C, Zwirglmaier K, Wölfel R, Lange C, Kramer J, Friesen J, Ignatius R, Müller M, Schmidt-Chanasit J, Emmerich P, Schaade L, Nitsche A. Establishment of a specimen panel for the decentralised technical evaluation of the sensitivity of 31 rapid diagnostic tests for SARS-CoV-2 antigen, Germany, September 2020 to April 2021. Euro Surveill 2021; 26:2100442. [PMID: 34738516 PMCID: PMC8569922 DOI: 10.2807/1560-7917.es.2021.26.44.2100442] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 09/10/2021] [Indexed: 12/23/2022] Open
Abstract
IntroductionThe detection of SARS-CoV-2 with rapid diagnostic tests (RDT) has become an important tool to identify infected people and break infection chains. These RDT are usually based on antigen detection in a lateral flow approach.AimWe aimed to establish a comprehensive specimen panel for the decentralised technical evaluation of SARS-CoV-2 antigen rapid diagnostic tests.MethodsWhile for PCR diagnostics the validation of a PCR assay is well established, there is no common validation strategy for antigen tests, including RDT. In this proof-of-principle study we present the establishment of a panel of 50 pooled clinical specimens that cover a SARS-CoV-2 concentration range from 1.1 × 109 to 420 genome copies per mL of specimen. The panel was used to evaluate 31 RDT in up to six laboratories.ResultsOur results show that there is considerable variation in the detection limits and the clinical sensitivity of different RDT. We show that the best RDT can be applied to reliably identify infectious individuals who present with SARS-CoV-2 loads down to 106 genome copies per mL of specimen. For the identification of infected individuals with SARS-CoV-2 loads corresponding to less than 106 genome copies per mL, only three RDT showed a clinical sensitivity of more than 60%.ConclusionsSensitive RDT can be applied to identify infectious individuals with high viral loads but not to identify all infected individuals.
Collapse
Affiliation(s)
- Andreas Puyskens
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Eva Krause
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Janine Michel
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - C Micha Nübling
- Testing Laboratory for In-vitro Diagnostic Medical Devices, Paul-Ehrlich-Institute, Langen, Germany
| | - Heinrich Scheiblauer
- Testing Laboratory for In-vitro Diagnostic Medical Devices, Paul-Ehrlich-Institute, Langen, Germany
| | - Daniel Bourquain
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Marica Grossegesse
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Roman Valusenko
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Victor M Corman
- Charité - Universitätsmedizin Berlin, Institute of Virology and German Centre for Infection Research (DZIF), Associated Partner Site, Berlin, Germany
- Labor Berlin, Charité - Vivantes GmbH, Berlin, Germany
| | - Christian Drosten
- Charité - Universitätsmedizin Berlin, Institute of Virology and German Centre for Infection Research (DZIF), Associated Partner Site, Berlin, Germany
| | - Katrin Zwirglmaier
- Bundeswehr Institute of Microbiology and German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Roman Wölfel
- Bundeswehr Institute of Microbiology and German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Constanze Lange
- LADR Central Laboratory Dr. Kramer & Colleagues, Geesthacht, Germany
| | - Jan Kramer
- LADR Central Laboratory Dr. Kramer & Colleagues, Geesthacht, Germany
| | | | | | | | - Jonas Schmidt-Chanasit
- Bernhard Nocht Institute for Tropical Medicine, Arbovirology Department, Hamburg, Germany
| | - Petra Emmerich
- Bernhard Nocht Institute for Tropical Medicine, Arbovirology Department, Hamburg, Germany
- Department of Tropical Medicine and Infectious Diseases, Center of Internal Medicine II, University of Rostock, Rostock, Germany
| | - Lars Schaade
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Andreas Nitsche
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| |
Collapse
|
47
|
Bravo MS, Berengua C, Marín P, Esteban M, Rodriguez C, Del Cuerpo M, Miró E, Cuesta G, Mosquera M, Sánchez-Palomino S, Vila J, Rabella N, Marcos MÁ. Viral culture confirmed SARS-CoV-2 subgenomic RNA value as a good surrogate marker of infectivity. J Clin Microbiol 2021;:JCM0160921. [PMID: 34669457 DOI: 10.1128/JCM.01609-21] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Determining SARS-CoV-2 viral infectivity is crucial for patient clinical assessment and isolation decisions. We assessed subgenomic RNA (sgRNA) as a surrogate marker of SARS-CoV-2 infectivity in SARS-CoV-2-positive reverse transcription PCR (RT-PCR) respiratory samples (n = 105) in comparison with viral culture as the reference standard for virus replication. sgRNA and viral isolation results were concordant in 99/105 cases (94%), indicating highly significant agreement between the two techniques (Cohen’s kappa coefficient 0.88, 95% confidence interval [CI] 0.78 to 0.97, P < 0.001). sgRNA RT-PCR showed a sensitivity of 97% and a positive predictive value of 94% to detect replication-competent virus, further supporting sgRNA as a surrogate marker of SARS-CoV-2 infectivity. sgRNA RT-PCR is an accurate, rapid, and affordable technique that can overcome culture and cycle threshold (CT) value limitations and be routinely implemented in hospital laboratories to detect viral infectivity, which is essential for optimizing patient monitoring, the efficacy of treatments/vaccines, and work reincorporation policies, as well as for safely shortening isolation precautions.
Collapse
|
48
|
Koskinen JM, Antikainen P, Hotakainen K, Haveri A, Ikonen N, Savolainen-Kopra C, Sundström K, Koskinen JO. Clinical validation of automated and rapid mariPOC SARS-CoV-2 antigen test. Sci Rep 2021; 11:20363. [PMID: 34645929 DOI: 10.1038/s41598-021-99886-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 10/01/2021] [Indexed: 12/23/2022] Open
Abstract
COVID-19 diagnostics was quickly ramped up worldwide early 2020 based on the detection of viral RNA. However, based on the scientific knowledge for pre-existing coronaviruses, it was expected that the SARS-CoV-2 RNA will be detected from symptomatic and at significant rates also from asymptomatic individuals due to persistence of non-infectious RNA. To increase the efficacy of diagnostics, surveillance, screening and pandemic control, rapid methods, such as antigen tests, are needed for decentralized testing and to assess infectiousness. A novel automated mariPOC SARS-CoV-2 test was developed for the detection of conserved structural viral nucleocapsid proteins. The test utilizes sophisticated optical laser technology for two-photon excitation and individual detection of immunoassay solid-phase particles. We validated the new method against qRT-PCR. Sensitivity of the test was 100.0% (13/13) directly from nasopharyngeal swab specimens and 84.4% (38/45) from swab specimens in undefined transport mediums. Specificity of the test was 100.0% (201/201). The test's limit of detection was 2.7 TCID50/test. It showed no cross-reactions. Our study shows that the new test can detect infectious individuals already in 20 min with clinical sensitivity close to qRT-PCR. The mariPOC is a versatile platform for syndromic testing and for high capacity infection control screening of infectious individuals.
Collapse
|
49
|
Lippi G, Henry BM. Possible drawbacks of relying only on molecular testing for diagnosing SARS-CoV-2 infections. Public Health 2021; 205:e2. [PMID: 34756587 PMCID: PMC8491921 DOI: 10.1016/j.puhe.2021.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022]
Affiliation(s)
- G Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy.
| | - B M Henry
- Clinical Laboratory, Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| |
Collapse
|
50
|
Bouton TC, Lodi S, Turcinovic J, Schaeffer B, Weber SE, Quinn E, Korn C, Steiner J, Schechter-Perkins EM, Duffy E, Ragan EJ, Taylor BP, Miller N, Davidoff R, Hanage WP, Connor J, Pierre C, Jacobson KR. Coronavirus Disease 2019 Vaccine Impact on Rates of Severe Acute Respiratory Syndrome Coronavirus 2 Cases and Postvaccination Strain Sequences Among Health Care Workers at an Urban Academic Medical Center: A Prospective Cohort Study. Open Forum Infect Dis 2021; 8:ofab465. [PMID: 34646910 PMCID: PMC8500299 DOI: 10.1093/ofid/ofab465] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 09/10/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) vaccine trials and post-implementation data suggest that vaccination decreases infections. We examine vaccination's impact on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) case rates and viral diversity among health care workers (HCWs) during a high community prevalence period. METHODS In this prospective cohort study, HCW received 2 doses of BNT162b2 or mRNA-1273. We included confirmed cases among HCWs from 9 December 2020 to 23 February 2021. Weekly SARS-CoV-2 rates per 100,000 person-days and by time from first injection (1-14 and ≥15 days) were compared with surrounding community rates. Viral genomes were sequenced. RESULTS SARS-CoV-2 cases occurred in 1.4% (96/7109) of HCWs given at least a first dose and 0.3% (17/5913) of HCWs given both vaccine doses. Adjusted rate ratios (95% confidence intervals) were 0.73 (.53-1.00) 1-14 days and 0.18 (.10-.32) ≥15 days from first dose. HCW ≥15 days from initial dose compared to 1-14 days were more often older (46 vs 38 years, P = .007), Latinx (10% vs 8%, P = .03), and asymptomatic (48% vs 11%, P = .0002). SARS-CoV-2 rates among HCWs fell below the surrounding community, an 18% vs 11% weekly decrease, respectively (P = .14). Comparison of 50 genomes from post-first dose cases did not indicate selection pressure toward known spike antibody escape mutations. CONCLUSIONS Our results indicate an early positive impact of vaccines on SARS-CoV-2 case rates. Post-vaccination isolates did not show unusual genetic diversity or selection for mutations of concern.
Collapse
Affiliation(s)
- Tara C Bouton
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Sara Lodi
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Jacquelyn Turcinovic
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, USA
| | - Beau Schaeffer
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sarah E Weber
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Emily Quinn
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Cathy Korn
- Department of Infection Control, Boston Medical Center, Boston, Massachusetts, USA
| | - Jacqueline Steiner
- Department of Infection Control, Boston Medical Center, Boston, Massachusetts, USA
| | - Elissa M Schechter-Perkins
- Department of Emergency Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Elizabeth Duffy
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Elizabeth J Ragan
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Bradford P Taylor
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Nancy Miller
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Ravin Davidoff
- Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts, USA
| | - William P Hanage
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - John Connor
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, USA
- Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Cassandra Pierre
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
- Department of Infection Control, Boston Medical Center, Boston, Massachusetts, USA
| | - Karen R Jacobson
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| |
Collapse
|