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Leonard SH, Chin-Yee I, Delport J, Crozier A, Abdulsatar F. Improving wound swab collection in paediatric patients: a quality improvement project. BMJ Open Qual 2023; 12:e002170. [PMID: 37612047 PMCID: PMC10450052 DOI: 10.1136/bmjoq-2022-002170] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 08/15/2023] [Indexed: 08/25/2023] Open
Abstract
Microbiology sample swabs may be unsuccessful or rejected for a variety of reasons. Typically, errors occur in the preanalytical phase of sample collection. Errors with collection, handling and transport can lead to the need to repeat specimen collection. Unsuccessful specimens contribute to delays in diagnosis, increased patient stress and increased healthcare costs. An audit of sample swabs from London Health Sciences Centre Children's Hospital from August through October 2021 yielded complete success rates of 100% for ear and eye culture swabs, 98.1% for methicillin-resistant Staphylococcus aureus swabs and 88.9% for wound swabs. This project aimed to improve wound swab success to 95% on the paediatric inpatient and paediatric emergency departments by May 2022.Stakeholders from paediatric clinical services including physicians, nurses and the laboratory medicine team at our centre were engaged to guide quality improvement interventions to improve specimen success rate. Based on feedback, we implemented visual aids to our electronic laboratory test information guide. Additionally, visual reminders of correct sample collection equipment were placed in high traffic areas for nursing staff.After the interventions were implemented, a three-month follow-up showed that wound swab success rate rose to 95.3%. This study achieved its aim of improving wound swab success rate to 95%. It adds to the growing pool of evidence that preanalytical phase intervention such as visual aids can increase swab success rates, in healthcare settings.
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Affiliation(s)
- Sean H Leonard
- Department of Paediatrics, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada
| | - Ian Chin-Yee
- Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada
- Department of Hematology, Western University, London, Ontario, Canada
| | - Johan Delport
- Department Medical Microbiology, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada
| | - Abby Crozier
- Division of Microbiology, London Health Sciences Centre, London, Ontario, Canada
| | - Farah Abdulsatar
- Department of Paediatrics, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada
- Department of Paediatrics, London Health Sciences Centre, London, Ontario, Canada
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2
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Röhr F, Uellner F, Deckert A, Anders S, Burk R, Knop M, Brugnara L, Bärnighausen T, Jahn A, McMahon S, Souares A. From disgusting and complicated to simple and brilliant: Implementation perspectives and lessons learned from users and rejectors of mail-in SARS-CoV-2 gargle tests. Front Public Health 2023; 10:1024525. [PMID: 36684995 PMCID: PMC9850099 DOI: 10.3389/fpubh.2022.1024525] [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: 08/21/2022] [Accepted: 11/17/2022] [Indexed: 01/07/2023] Open
Abstract
Background Despite the important role of testing as a measure against the COVID-19 pandemic, user perspectives on SARS-CoV-2 tests remain scarce, inhibiting an improvement of testing approaches. As the world enters the third year of the pandemic, more nuanced perspectives of testing, and opportunities to expand testing in a feasible and affordable manner merit consideration. Methods Conducted amid the second pandemic wave (late 2020-early 2021) during and after a multi-arm trial evaluating SARS-CoV-2 surveillance strategies in the federal state Baden-Württemberg, Germany, this qualitative sub-study aimed to gain a deeper understanding of how test users and test rejectors perceived mail-in SARS-CoV-2 gargle tests. We conducted 67 semi-structured in-depth interviews (mean duration: 60 min) via telephone or video call. Interviews were audio-recorded, transcribed verbatim and analyzed inductively using thematic analysis. The Consolidated Framework for Implementation Research guided the findings' presentation. Results Respondents generally described gargle sampling as simple and comfortable. However, individual perceptions of the testing method and its feasibility varied widely from disgusting and complicated to simple and brilliant. Self-sampling was appreciated for lowering infection risks during testing, but also considered more complex. Gargle-sampling increased participants' self-efficacy to sample correctly. Communication (first contact, quantity and content of information, reminders, support system) and trust (in the study, its institutional affiliation and test method) decisively influenced the intervention's acceptability. Conclusion User-driven insights on how to streamline testing include: consider communication, first impressions of tests and information as key for successful mail-in testing; pay attention to the role of mutual trust between those taking and administering tests; implement gargle self-sampling as a pleasant alternative to swab testing; offer multiple test methods to increase test up-take.
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Affiliation(s)
- Freda Röhr
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Ferdinand Uellner
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Andreas Deckert
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Simon Anders
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Heidelberg, Germany
- Bioquant Center, University of Heidelberg, Heidelberg, Germany
| | - Robin Burk
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Heidelberg, Germany
| | - Michael Knop
- Center for Molecular Biology Heidelberg (ZMBH), University of Heidelberg, Heidelberg, Germany
- German Cancer Research Center (DKFZ)-ZMBH Alliance, Heidelberg, Germany
| | - Lucia Brugnara
- Evaplan Ltd. at the University Hospital Heidelberg, Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Albrecht Jahn
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Shannon McMahon
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
- International Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Aurélia Souares
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
- German Center for Infection Research Heidelberg Site, Heidelberg, Germany
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3
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Uršič T, Kogoj R, Šikonja J, Jevšnik Virant M, Petrovec M. A simplified nasopharyngeal swab collection procedure for minimizing patient discomfort while retaining sample quality. Front Public Health 2023; 11:1066934. [PMID: 37033037 PMCID: PMC10076767 DOI: 10.3389/fpubh.2023.1066934] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
A nasopharyngeal swab (NPS) is the most frequently collected sample type when molecular diagnosis of respiratory viruses, including SARS CoV-2, is required. An optimal collection technique would provide sufficient sample quality for the diagnostic process and would minimize the discomfort felt by the patient. This study compares a simplified NPS collection procedure with only one rotation of the swab to a more standard procedure with five rotations. Swabs were collected from 76 healthy volunteers by the same healthcare professional on 2 consecutive days at a similar hour to minimize variability. The number of Ubiquitin C copy number per sample was measured by real-time quantitative PCR and patient discomfort was assessed by questionnaire. No statistically significant difference (p = 0.15) was observed in the Ubiquitin C copy number per sample between a NPS collected with one rotation (5.2 ± 0.6 log UBC number copies/sample) or five rotations (5.3 ± 0.5 log UBC number copies/sample). However, a statistically significant difference was observed in discomfort between these two procedures, the second being much more uncomfortable. Additional analysis of the results showed a weak correlation between discomfort and the number of human cells recovered (Spearman's rho = 0.202) and greater discomfort in younger people. The results of this study show that a NPS collected with one slow rotation has the same quality as a NPS collected with five rotations. However, the collection time is shorter and, most importantly, less unpleasant for patients.
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4
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Cheong SHR, Ng YJX, Lau Y, Lau ST. Wearable technology for early detection of COVID-19: A systematic scoping review. Prev Med 2022; 162:107170. [PMID: 35878707 PMCID: PMC9304072 DOI: 10.1016/j.ypmed.2022.107170] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/29/2022] [Accepted: 07/17/2022] [Indexed: 11/23/2022]
Abstract
Wearable technology is an emerging method for the early detection of coronavirus disease 2019 (COVID-19) infection. This scoping review explored the types, mechanisms, and accuracy of wearable technology for the early detection of COVID-19. This review was conducted according to the five-step framework of Arksey and O'Malley. Studies published between December 31, 2019 and December 15, 2021 were obtained from 10 electronic databases, namely, PubMed, Embase, Cochrane, CINAHL, PsycINFO, ProQuest, Scopus, Web of Science, IEEE Xplore, and Taylor & Francis Online. Grey literature, reference lists, and key journals were also searched. All types of articles describing wearable technology for the detection of COVID-19 infection were included. Two reviewers independently screened the articles against the eligibility criteria and extracted the data using a data charting form. A total of 40 articles were included in this review. There are 22 different types of wearable technology used to detect COVID-19 infections early in the existing literature and are categorized as smartwatches or fitness trackers (67%), medical devices (27%), or others (6%). Based on deviations in physiological characteristics, anomaly detection models that can detect COVID-19 infection early were built using artificial intelligence or statistical analysis techniques. Reported area-under-the-curve values ranged from 75% to 94.4%, and sensitivity and specificity values ranged from 36.5% to 100% and 73% to 95.3%, respectively. Further research is necessary to validate the effectiveness and clinical dependability of wearable technology before healthcare policymakers can mandate its use for remote surveillance.
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Affiliation(s)
- Shing Hui Reina Cheong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Yu Jie Xavia Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Siew Tiang Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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5
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Wang Y, Wang G, Zhang L, Ren L, Wang J. The sampling efficiencies of commercial nasopharyngeal swabs. Biosaf Health 2022; 4:66-69. [PMID: 35291338 PMCID: PMC8912975 DOI: 10.1016/j.bsheal.2022.03.007] [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: 12/04/2021] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
Upper respiratory tract samples are the most commonly used samples for coronavirus disease 2019 (COVID-19) diagnosis. The samples collected from the nasopharynx are preferred for viral nucleic acids detection. Commercial nasopharyngeal swabs (NPSs) are the major factor that influences the sampling quality. We here evaluated the acceptability and efficiency of NPSs from five manufacturers by examining the concentration of glyceraldehyde-3-phosphate dehydrogenase gene (GAPDH) retrieved from the swabs using the RT-PCR method. Significant different concentrations of GAPDH were detected, ranged from 4.36 × 108 copies/mL to 6.98 × 1010 copies/mL among the five swabs (p < 0.05). The designation of the swab head, with or without tip expansion, had limited influence on the collection efficiency. The discrepancy among the NPSs emphasized the improvement of the swab head material.
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Affiliation(s)
- Ying Wang
- NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, Beijing 100730, China
| | - Geng Wang
- NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, Beijing 100730, China
| | - Lulu Zhang
- NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, Beijing 100730, China
| | - Lili Ren
- NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, Beijing 100730, China,Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China,Corresponding author: Chinese Academy of Medical Sciences & Peking Union Medical College, No.9 Dong Dan San Tiao, Dongcheng District, Beijing 100730, China
| | - Jianwei Wang
- NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, Beijing 100730, China,Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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6
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Nyaruaba R, Mwaliko C, Dobnik D, Neužil P, Amoth P, Mwau M, Yu J, Yang H, Wei H. Digital PCR Applications in the SARS-CoV-2/COVID-19 Era: a Roadmap for Future Outbreaks. Clin Microbiol Rev 2022;:e0016821. [PMID: 35258315 DOI: 10.1128/cmr.00168-21] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [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] [Indexed: 12/15/2022] Open
Abstract
The ongoing coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a global public health disaster. The current gold standard for the diagnosis of infected patients is real-time reverse transcription-quantitative PCR (RT-qPCR). As effective as this method may be, it is subject to false-negative and -positive results, affecting its precision, especially for the detection of low viral loads in samples. In contrast, digital PCR (dPCR), the third generation of PCR, has been shown to be more effective than the gold standard, RT-qPCR, in detecting low viral loads in samples. In this review article, we selected publications to show the broad-spectrum applications of dPCR, including the development of assays and reference standards, environmental monitoring, mutation detection, and clinical diagnosis of SARS-CoV-2, while comparing it analytically to the gold standard, RT-qPCR. In summary, it is evident that the specificity, sensitivity, reproducibility, and detection limits of RT-dPCR are generally unaffected by common factors that may affect RT-qPCR. As this is the first time that dPCR is being tested in an outbreak of such a magnitude, knowledge of its applications will help chart a course for future diagnosis and monitoring of infectious disease outbreaks.
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7
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Esteves E, Mendes AK, Barros M, Figueiredo C, Andrade J, Capelo J, Novais A, Rebelo C, Soares R, Nunes A, Ferreira A, Lemos J, Duarte AS, Silva RM, Inácio Bernardino L, Correia MJ, Esteves AC, Rosa N. Population wide testing pooling strategy for SARS-CoV-2 detection using saliva. PLoS One 2022; 17:e0263033. [PMID: 35089942 PMCID: PMC8797214 DOI: 10.1371/journal.pone.0263033] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 10/05/2021] [Accepted: 01/10/2022] [Indexed: 12/24/2022] Open
Abstract
SARS-CoV-2 pandemic has forced frequent testing of populations. It is necessary to identify the most cost-effective strategies for the detection of COVID-19 outbreaks. Nasopharyngeal samples have been used for SARS-CoV-2 detection but require a healthcare professional to collect the sample and cause discomfort and pain to the individual. Saliva has been suggested as an appropriate fluid for the diagnosis of COVID-19. We have investigated the possibility of using pools of saliva samples to detect SARS-CoV-2 in symptomatic and asymptomatic patients. Two hundred and seventy-nine saliva samples were analyzed through RT-PCR of Envelope, Nucleocapsid and Open Reading Frame 1ab genes. Reproducibility assays showed an almost perfect agreement as well as high sensitivity (96.6%), specificity (96.8%), positive predicted value (96.6%), and negative predicted value (96.8%). The average Cycle Threshold of the genes detected was 29.7. No significant differences (p > 0.05) were detected when comparing the cycle threshold average of two consecutive reactions on the same positive saliva samples. Saliva samples have a higher median viral load (32.6) than in nasopharyngeal samples (28.9), although no significant differences were detected (p > 0.05). Saliva-pool samples allowed effective SARS-CoV-2 screening, with a higher sensibility (96.9%) on 10-sample pools than in 20-sample pools (87.5%). Regardless of pools size specificity was high (99.9%) and an almost perfect agreement was observed. Our strategy was successfully applied in population wide testing of more than 2000 individuals, showing that it is possible to use pooled saliva as diagnostic fluid for SARS-CoV-2 infection.
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Affiliation(s)
- Eduardo Esteves
- Universidade Católica Portuguesa, Faculty of Dental Medicine (FMD), Center for Interdisciplinary Research in Health (CIIS), Viseu, Portugal
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Ana Karina Mendes
- Universidade Católica Portuguesa, Faculty of Dental Medicine (FMD), Center for Interdisciplinary Research in Health (CIIS), Viseu, Portugal
| | - Marlene Barros
- Universidade Católica Portuguesa, Faculty of Dental Medicine (FMD), Center for Interdisciplinary Research in Health (CIIS), Viseu, Portugal
| | | | | | - Joana Capelo
- Centro Hospitalar Tondela Viseu, Viseu, Portugal
| | | | - Carla Rebelo
- Centro Hospitalar Tondela Viseu, Viseu, Portugal
| | - Rita Soares
- Centro Hospitalar Tondela Viseu, Viseu, Portugal
| | - Ana Nunes
- Centro Hospitalar Tondela Viseu, Viseu, Portugal
| | | | - Joana Lemos
- Centro Hospitalar Tondela Viseu, Viseu, Portugal
| | - Ana Sofia Duarte
- Universidade Católica Portuguesa, Faculty of Dental Medicine (FMD), Center for Interdisciplinary Research in Health (CIIS), Viseu, Portugal
| | - Raquel M. Silva
- Universidade Católica Portuguesa, Faculty of Dental Medicine (FMD), Center for Interdisciplinary Research in Health (CIIS), Viseu, Portugal
| | | | - Maria José Correia
- Universidade Católica Portuguesa, Faculty of Dental Medicine (FMD), Center for Interdisciplinary Research in Health (CIIS), Viseu, Portugal
| | | | - Nuno Rosa
- Universidade Católica Portuguesa, Faculty of Dental Medicine (FMD), Center for Interdisciplinary Research in Health (CIIS), Viseu, Portugal
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8
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Paulose AK, Huang C, Chen P, Tripathi A, Chen P, Huang Y, Wang Y. A Rapid Detection of COVID-19 Viral RNA in Human Saliva Using Electrical Double Layer-Gated Field-Effect Transistor-Based Biosensors. Adv Mater Technol 2022; 7:2100842. [PMID: 34901383 PMCID: PMC8646907 DOI: 10.1002/admt.202100842] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/11/2021] [Indexed: 05/15/2023]
Abstract
In light of the swift outspread and considerable mortality, coronavirus disease 2019 (COVID-19) necessitates a rapid screening tool and a precise diagnosis. Saliva is considered as an alternative specimen to detect the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since the viral load is comparable to what are found in a throat and a nasal cavity. The electrical double layer (EDL)-gated field-effect transistor-based biosensor (BioFET) emerges as a promising candidate for salivary COVID-19 tests due to a high sensitivity, a portable configuration, a label-free operation, and a matrix insensitivity. In this work, the authors utilize EDL-gated BioFETs to detect complementary DNAs (cDNAs) and viral RNAs with various testing conditions such as switches of probes, temperature treatments, and matrices. The selectivity is confirmed with cDNA and noncomplementary DNA (ncDNA), exhibiting an eightfold difference in electrical signals. The matrix insensitivity is evaluated, and BioFETs successfully validate the detection of SARS-CoV-2 N-gene RNA down to 1 fm in diluted human saliva with a 95°C- and a 25°C-treatment, respectively. This proposed system has a high potential to be deployed for an on-site COVID-19 screening, improving the disease control and benefitting frontline healthcare system.
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Affiliation(s)
- Akhil K. Paulose
- Institute of Nanoengineering and MicrosystemsNational Tsing Hua UniversityHsinchu30013Taiwan
| | - Chih‐Cheng Huang
- Institute of Nanoengineering and MicrosystemsNational Tsing Hua UniversityHsinchu30013Taiwan
| | - Po‐Hsuan Chen
- Institute of Nanoengineering and MicrosystemsNational Tsing Hua UniversityHsinchu30013Taiwan
| | - Adarsh Tripathi
- Institute of Molecular MedicineNational Tsing Hua UniversityHsinchu30013Taiwan
| | - Pin‐Hsuan Chen
- Department of Power Mechanical EngineeringNational Tsing Hua UniversityHsinchu30013Taiwan
| | - Yu‐Shan Huang
- Institute of Nanoengineering and MicrosystemsNational Tsing Hua UniversityHsinchu30013Taiwan
| | - Yu‐Lin Wang
- Institute of Nanoengineering and MicrosystemsNational Tsing Hua UniversityHsinchu30013Taiwan
- Department of Power Mechanical EngineeringNational Tsing Hua UniversityHsinchu30013Taiwan
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9
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Campos-Ferreira D, Visani V, Córdula C, Nascimento G, Montenegro L, Schindler H, Cavalcanti I. COVID-19 challenges: From SARS-CoV-2 infection to effective point-of-care diagnosis by electrochemical biosensing platforms. Biochem Eng J 2021; 176:108200. [PMID: 34522158 PMCID: PMC8428033 DOI: 10.1016/j.bej.2021.108200] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 04/14/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 12/25/2022]
Abstract
In January 2020, the World Health Organization (WHO) identified a new zoonotic virus, SARS-CoV-2, responsible for causing the COVID-19 (coronavirus disease 2019). Since then, there has been a collaborative trend between the scientific community and industry. Multidisciplinary research networks try to understand the whole SARS-CoV-2 pathophysiology and its relationship with the different grades of severity presented by COVID-19. The scientific community has gathered all the data in the quickly developed vaccines that offer a protective effect for all variants of the virus and promote new diagnostic alternatives able to have a high standard of efficiency, added to shorter response analysis time and portability. The industry enters in the context of accelerating the path taken by science until obtaining the final product. In this review, we show the principal diagnostic methods developed during the COVID-19 pandemic. However, when we observe the diagnostic tools section of an efficient infection outbreak containment report and the features required for such tools, we could observe a highlight of electrochemical biosensing platforms. Such devices present a high standard of analytical performance, are low-cost tools, easy to handle and interpret, and can be used in the most remote and low-resource regions. Therefore, probably, they are the ideal point-of-care diagnostic tools for pandemic scenarios.
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Affiliation(s)
- D. Campos-Ferreira
- Laboratório de Imunopatologia Keizo Asami – LIKA/ UFPE, Av. Prof. Moraes Rego, s/n, CEP: 506070-901 Recife, PE, Brazil,Corresponding author
| | - V. Visani
- Laboratório de Imunopatologia Keizo Asami – LIKA/ UFPE, Av. Prof. Moraes Rego, s/n, CEP: 506070-901 Recife, PE, Brazil
| | - C. Córdula
- Laboratório de Imunopatologia Keizo Asami – LIKA/ UFPE, Av. Prof. Moraes Rego, s/n, CEP: 506070-901 Recife, PE, Brazil
| | - G.A. Nascimento
- Laboratório de Imunopatologia Keizo Asami – LIKA/ UFPE, Av. Prof. Moraes Rego, s/n, CEP: 506070-901 Recife, PE, Brazil,Centro Acadêmico do Agreste - CAA/UFPE, Av. Marielle Franco, s/n - Km 59 - Bairro Nova Caruaru, CEP: 55.014-900 Caruaru, PE, Brazil
| | - L.M.L. Montenegro
- Fundação Oswaldo Cruz (Fiocruz), Centro de Pesquisas Instituto Aggeu Magalhães (IAM), Av. Professor Moraes Rego s/n, CEP: 50670-901 Recife, PE, Brazil
| | - H.C. Schindler
- Fundação Oswaldo Cruz (Fiocruz), Centro de Pesquisas Instituto Aggeu Magalhães (IAM), Av. Professor Moraes Rego s/n, CEP: 50670-901 Recife, PE, Brazil
| | - I.M.F. Cavalcanti
- Laboratório de Imunopatologia Keizo Asami – LIKA/ UFPE, Av. Prof. Moraes Rego, s/n, CEP: 506070-901 Recife, PE, Brazil,Centro Acadêmico de Vitória – CAV/UFPE, R. Alto do Reservatório, CEP: 55 612-440 Vitória de Santo Antão, PE, Brazil
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10
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De Santi C, Jacob B, Kroich P, Doyle S, Ward R, Li B, Donnelly O, Dykes A, Neelakant T, Neary D, McGuinness R, Cafferkey J, Ryan K, Quadu V, McGrogan K, Garcia Leon A, Mallon P, Fitzpatrick F, Humphreys H, De Barra E, Kerrigan SW, Cavalleri GL. Concordance between PCR-based extraction-free saliva and nasopharyngeal swabs for SARS-CoV-2 testing. HRB Open Res 2021; 4:85. [PMID: 34522839 PMCID: PMC8408542 DOI: 10.12688/hrbopenres.13353.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Accepted: 10/07/2021] [Indexed: 12/29/2022] Open
Abstract
Introduction: Saliva represents a less invasive alternative to nasopharyngeal swab (NPS) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection. SalivaDirect is a nucleic acid extraction-free method for detecting SARS-CoV2 in saliva specimens. Studies evaluating the concordance of gold standard NPS and newly developed SalivaDirect protocols are limited. The aim of our study was to assess SalivaDirect as an alternative method for COVID-19 testing. Methods: Matching NPS and saliva samples were analysed from a cohort of symptomatic (n=127) and asymptomatic (n=181) participants recruited from hospital and university settings, respectively. RNA was extracted from NPS while saliva samples were subjected to the SalivaDirect protocol before RT-qPCR analysis. The presence of SARS-Cov-2 was assessed using RdRp and N1 gene targets in NPS and saliva, respectively. Results: Overall we observed 94.3% sensitivity (95% CI 87.2-97.5%), and 95.9% specificity (95% CI 92.4-97.8%) in saliva when compared to matching NPS samples. Analysis of concordance demonstrated 95.5% accuracy overall for the saliva test relative to NPS, and a very high level of agreement (κ coefficient = 0.889, 95% CI 0.833-0.946) between the two sets of specimens. Fourteen of 308 samples were discordant, all from symptomatic patients. Ct values were >30 in 13/14 and >35 in 6/14 samples. No significant difference was found in the Ct values of matching NPS and saliva sample ( p=0.860). A highly significant correlation (r = 0.475, p<0.0001) was also found between the Ct values of the concordant positive saliva and NPS specimens. Conclusions: Use of saliva processed according to the SalivaDirect protocol represents a valid method to detect SARS-CoV-2. Accurate and less invasive saliva screening is an attractive alternative to current testing methods based on NPS and would afford greater capacity to test asymptomatic populations especially in the context of frequent testing.
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Affiliation(s)
- Chiara De Santi
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Benson Jacob
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Patricia Kroich
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Sean Doyle
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Rebecca Ward
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Brian Li
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Owain Donnelly
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Amy Dykes
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Trisha Neelakant
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David Neary
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Ross McGuinness
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Kieran Ryan
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Veronica Quadu
- Mercer's Medical Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Killian McGrogan
- Mercer's Medical Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Alejandro Garcia Leon
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Dublin, Ireland
| | - Patrick Mallon
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Dublin, Ireland
| | - Fidelma Fitzpatrick
- Department of Microbiology, Beaumont Hospital, Dublin, Ireland
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Hilary Humphreys
- Department of Microbiology, Beaumont Hospital, Dublin, Ireland
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Eoghan De Barra
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Infectious Diseases, Beaumont Hospital, Dublin, Ireland
| | - Steve W. Kerrigan
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Gianpiero L. Cavalleri
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
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11
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De Santi C, Jacob B, Kroich P, Doyle S, Ward R, Li B, Donnelly O, Dykes A, Neelakant T, Neary D, McGuinness R, Cafferkey J, Ryan K, Quadu V, McGrogan K, Garcia Leon A, Mallon P, Fitzpatrick F, Humphreys H, De Barra E, Kerrigan SW, Cavalleri GL. Concordance between PCR-based extraction-free saliva and nasopharyngeal swabs for SARS-CoV-2 testing. HRB Open Res 2021; 4:85. [PMID: 34522839 PMCID: PMC8408542 DOI: 10.12688/hrbopenres.13353.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 11/04/2023] Open
Abstract
Introduction: Saliva represents a less invasive alternative to nasopharyngeal swab (NPS) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection. SalivaDirect is a nucleic acid extraction-free method for detecting SARS-CoV2 in saliva specimens. Studies evaluating the concordance of gold standard NPS and newly developed SalivaDirect protocols are limited. The aim of our study was to to assess SalivaDirect as an alternative method for COVID-19 testing. Methods: Matching NPS and saliva samples were analysed from a cohort of symptomatic (n=127) and asymptomatic (n=181) participants recruited from hospital and university settings, respectively. RNA was extracted from NPS while saliva samples were subjected to the SalivaDirect protocol before RT-qPCR analysis. The presence of SARS-Cov-2 was assessed using RdRP and N1 gene targets in NPS and saliva, respectively. Results: Overall we observed 94.3% sensitivity (95% CI 87.2-97.5%), and 95.9% specificity (95% CI 92.4-97.8%) in saliva when compared to matching NPS samples. Analysis of concordance demonstrated 95.5% accuracy overall for the saliva test relative to NPS, and a very high level of agreement (κ coefficient = 0.889, 95% CI 0.833-0.946) between the two sets of specimens. Fourteen of 308 samples were discordant, all from symptomatic patients. Ct values were >30 in 13/14 and >35 in 6/14 samples. No significant difference was found in the Ct values of matching NPS and saliva sample ( p=0.860). A highly significant correlation (r = 0.475, p<0.0001) was also found between the Ct values of the concordant positive saliva and NPS specimens. Conclusions: Use of saliva processed according to the SalivaDirect protocol represents a valid method to detect SARS-CoV-2. Accurate and less invasive saliva screening is an attractive alternative to current testing methods based on NPS and would afford greater capacity to test asymptomatic populations especially in the context of frequent testing.
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Affiliation(s)
- Chiara De Santi
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Benson Jacob
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Patricia Kroich
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Sean Doyle
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Rebecca Ward
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Brian Li
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Owain Donnelly
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Amy Dykes
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Trisha Neelakant
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David Neary
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Ross McGuinness
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Kieran Ryan
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Veronica Quadu
- Mercer's Medical Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Killian McGrogan
- Mercer's Medical Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Alejandro Garcia Leon
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Dublin, Ireland
| | - Patrick Mallon
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Dublin, Ireland
| | - Fidelma Fitzpatrick
- Department of Microbiology, Beaumont Hospital, Dublin, Ireland
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Hilary Humphreys
- Department of Microbiology, Beaumont Hospital, Dublin, Ireland
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Eoghan De Barra
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Infectious Diseases, Beaumont Hospital, Dublin, Ireland
| | - Steve W. Kerrigan
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Gianpiero L. Cavalleri
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
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12
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Abstract
The nasopharyngeal microbiome is a dynamic microbial interface of the aerodigestive tract, and a diagnostic window in the fight against respiratory infections and antimicrobial resistance. As its constituent bacteria, viruses and mycobacteria become better understood and sampling accuracy improves, diagnostics of the nasopharynx could guide more personalized care of infections of surrounding areas including the lungs, ears and sinuses. This review will summarize the current literature from a clinical perspective and highlight its growing importance in diagnostics and infectious disease management.
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Affiliation(s)
- Matthew Flynn
- School of Biomedical Sciences, Ulster University, Coleraine BT52 1SA, UK
- Otolaryngology Department, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
| | - James Dooley
- School of Biomedical Sciences, Ulster University, Coleraine BT52 1SA, UK
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13
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Kinloch NN, Ritchie G, Dong W, Cobarrubias KD, Sudderuddin H, Lawson T, Matic N, Montaner JSG, Leung V, Romney MG, Lowe CF, Brumme CJ, Brumme ZL. SARS-CoV-2 RNA Quantification Using Droplet Digital RT-PCR. J Mol Diagn 2021; 23:907-19. [PMID: 34062285 DOI: 10.1016/j.jmoldx.2021.04.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/29/2021] [Accepted: 04/29/2021] [Indexed: 12/23/2022] Open
Abstract
Quantitative viral load assays have transformed our understanding of viral diseases. They hold similar potential to advance COVID-19 control and prevention, but SARS-CoV-2 viral load tests are not yet widely available. SARS-CoV-2 molecular diagnostic tests, which typically employ real-time RT-PCR, yield semiquantitative results only. Droplet digital RT-PCR (RT-ddPCR) offers an attractive platform for SARS-CoV-2 RNA quantification. Eight primer/probe sets originally developed for real-time RT-PCR–based SARS-CoV-2 diagnostic tests were evaluated for use in RT-ddPCR; three were identified as the most efficient, precise, and sensitive for RT-ddPCR–based SARS-CoV-2 RNA quantification. For example, the analytical efficiency for the E-Sarbeco primer/probe set was approximately 83%, whereas assay precision, measured as the coefficient of variation, was approximately 2% at 1000 input copies/reaction. Lower limits of quantification and detection for this primer/probe set were 18.6 and 4.4 input SARS-CoV-2 RNA copies/reaction, respectively. SARS-CoV-2 RNA viral loads in a convenience panel of 48 COVID-19–positive diagnostic specimens spanned a 6.2log10 range, confirming substantial viral load variation in vivo. RT-ddPCR–derived SARS-CoV-2 E gene copy numbers were further calibrated against cycle threshold values from a commercial real-time RT-PCR diagnostic platform. This log-linear relationship can be used to mathematically derive SARS-CoV-2 RNA copy numbers from cycle threshold values, allowing the wealth of available diagnostic test data to be harnessed to address foundational questions in SARS-CoV-2 biology.
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14
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Deitmer T, Dietz A, Chaberny IF, Pietsch C. [The nasal and pharyngeal swab techniques during the COVID-19-pandemic - the ENT-perspective - SARS-CoV-2, Coronavirus, nasal swab, pharyngeal swab, complications]. Laryngorhinootologie 2021; 100:517-525. [PMID: 34010974 DOI: 10.1055/a-1498-3549] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Since the beginning of the SARS-CoV-2 pandemic, swabs or other samples have increasingly been taken from the upper aero-digestive tract, since high viral loads exist here, especially in the early stages of the disease. As diagnostic options, swabs from the anterior nose, from the nasopharynx, from the oropharynx or the extraction of throat rinse water or saliva are possible. The laboratory methods available are antigen tests that can be read in a few minutes or more lengthy RT-PCR methods in a lab. Swabs are carried out by physicians, medical staff, laypeople and in the self-test, in each case according to prior instructions. Many of these factors therefore have an influence on the informative value and the sensitivity of the entire diagnostic process. The PCR laboratory method is more sensitive than the antigen method; the swabs from the nasopharynx are considered the most valid smear site; correct execution of a test can be achieved even with non-professional individuals with good instructions. Complications with such swabs are reported very rarely, given the assumed number of procedures performed. Short-term nosebleeds after traumatic smears can be assumed without publications about it being found. Broken parts of swabs had to be removed by an ENT doctor. There are only very few reports on injuries to the skullbase with CSF-leaks, including 2 times with anomalies such as meningoceles. The choice of a suitable diagnostic medium depends on many parameters such as availability, the timing of the result, a smear test by knowledgeable staff or a self-test, and a number of other practical considerations.
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Affiliation(s)
- Thomas Deitmer
- Deutsche Gesellschaft für Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie, Bonn
| | - A Dietz
- Hals-Nasen-Ohrenklinik, Universitätsklinikum Leipzig, Leipzig
| | - I F Chaberny
- Institut für Hygiene, Krankenhaushygiene und Umweltmedizin, Universitätsklinikum Leipzig, Leipzig
| | - C Pietsch
- Institut für Medizinische Mikrobiologie und Virologie, Universitätsklinikum Leipzig, Leipzig
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15
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Hilt EE, Boocock J, Trejo M, Le CQ, Guo L, Zhang Y, Sathe L, Arboleda VA, Yin Y, Bloom JS, Wang PC, Elmore JG, Kruglyak L, Shrestha L, Bakhash SAM, Lin M, Xie H, Huang ML, Roychoudhury P, Greninger A, Chandrasekaran S, Yang S, Garner OB. Retrospective Detection of SARS-CoV-2 in Symptomatic Patients prior to Widespread Diagnostic Testing in Southern California. Clin Infect Dis 2021; 74:271-277. [PMID: 33939799 PMCID: PMC8135745 DOI: 10.1093/cid/ciab360] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Indexed: 01/15/2023] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused one of the worst pandemics in recent history. Few reports have revealed that SARS-CoV-2 was spreading in the United States as early as the end of January. In this study, we aimed to determine if SARS-CoV-2 had been circulating in the Los Angeles (LA) area at a time when access to diagnostic testing for coronavirus disease 2019 (COVID-19) was severely limited. Methods We used a pooling strategy to look for SARS-CoV-2 in remnant respiratory samples submitted for regular respiratory pathogen testing from symptomatic patients from November 2019 to early March 2020. We then performed sequencing on the positive samples. Results We detected SARS-CoV-2 in 7 specimens from 6 patients, dating back to mid-January. The earliest positive patient, with a sample collected on January 13, 2020 had no relevant travel history but did have a sibling with similar symptoms. Sequencing of these SARS-CoV-2 genomes revealed that the virus was introduced into the LA area from both domestic and international sources as early as January. Conclusions We present strong evidence of community spread of SARS-CoV-2 in the LA area well before widespread diagnostic testing was being performed in early 2020. These genomic data demonstrate that SARS-CoV-2 was being introduced into Los Angeles County from both international and domestic sources in January 2020.
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Affiliation(s)
- Evann E Hilt
- Department of Pathology & Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles (UCLA), California, USA
| | - James Boocock
- Department of Human Genetics, David Geffen School of Medicine, UCLA, California, USA.,Department of Biological Chemistry, David Geffen School of Medicine, UCLA, California, USA.,Howard Hughes Medical Institute, David Geffen School of Medicine, UCLA, California, USA
| | - Marisol Trejo
- Department of Pathology & Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles (UCLA), California, USA
| | - Catherine Q Le
- Department of Pathology & Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles (UCLA), California, USA
| | - Longhua Guo
- Department of Human Genetics, David Geffen School of Medicine, UCLA, California, USA.,Department of Biological Chemistry, David Geffen School of Medicine, UCLA, California, USA.,Howard Hughes Medical Institute, David Geffen School of Medicine, UCLA, California, USA
| | - Yi Zhang
- Department of Human Genetics, David Geffen School of Medicine, UCLA, California, USA
| | - Laila Sathe
- Department of Pathology & Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles (UCLA), California, USA
| | - Valerie A Arboleda
- Department of Pathology & Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles (UCLA), California, USA.,Department of Human Genetics, David Geffen School of Medicine, UCLA, California, USA
| | - Yi Yin
- Department of Human Genetics, David Geffen School of Medicine, UCLA, California, USA
| | - Joshua S Bloom
- Department of Human Genetics, David Geffen School of Medicine, UCLA, California, USA.,Department of Biological Chemistry, David Geffen School of Medicine, UCLA, California, USA
| | - Pin-Chieh Wang
- Department of Medicine, David Geffen School of Medicine, UCLA, California, USA
| | - Joann G Elmore
- Department of Medicine, David Geffen School of Medicine, UCLA, California, USA
| | - Leonid Kruglyak
- Department of Human Genetics, David Geffen School of Medicine, UCLA, California, USA.,Department of Biological Chemistry, David Geffen School of Medicine, UCLA, California, USA.,Howard Hughes Medical Institute, David Geffen School of Medicine, UCLA, California, USA
| | - Lasata Shrestha
- Department of Laboratory Medicine, University of Washington Medical Center, Seattle, Washington, USA
| | - Shah A Mohamed Bakhash
- Department of Laboratory Medicine, University of Washington Medical Center, Seattle, Washington, USA
| | - Michelle Lin
- Department of Laboratory Medicine, University of Washington Medical Center, Seattle, Washington, USA
| | - Hong Xie
- Department of Laboratory Medicine, University of Washington Medical Center, Seattle, Washington, USA
| | - Meei-Li Huang
- Department of Laboratory Medicine, University of Washington Medical Center, Seattle, Washington, USA
| | - Pavitra Roychoudhury
- Department of Laboratory Medicine, University of Washington Medical Center, Seattle, Washington, USA
| | - Alexander Greninger
- Department of Laboratory Medicine, University of Washington Medical Center, Seattle, Washington, USA
| | - Sukantha Chandrasekaran
- Department of Pathology & Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles (UCLA), California, USA
| | - Shangxin Yang
- Department of Pathology & Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles (UCLA), California, USA
| | - Omai B Garner
- Department of Pathology & Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles (UCLA), California, USA
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16
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Abstract
BACKGROUND As the incidence of new cases of coronavirus disease increased exponentially, the use of viral swabs to collect nasopharyngeal specimens are increasing drastically. Therefore, healthcare workers military staff and uneducated nonprofessional's were ordered to make this swabs. Subsequently case reports reported about basal skull perforation, cerebrospinal fluid fistula and injury due to an incorrect technique. METHODS Search of the literature. RESULTS Only in 44% of the videos (Youtube) nasal swabs were correctly performed. Due to an false technique biological sampling resulted in false-negative COVID-19 tests. CONCLUSION Although professional societies started to report about this unacceptable situation, no publication reported about this health endangerment. In this time of overwhelming information and diversity of opinions, it is necessary to report about this in the hope, all media and TV reports will follow this article to show correctly performed nasal swabs to reduce false-negative COVID-19 tests and injury.
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