1
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Hakre S, Maljkovic-Berry I, Hang J, Conte MA, Pollio AR, Fung CK, Gandhi J, Peel SA, Lidl GM, Huhtanen ME, Hall TL, Modjarrad K, Friberg HL, O’Connell RJ, Scott PT. Transmission of SARS-CoV-2 among recruits in a US Army training environment: a brief report. J Public Health (Oxf) 2023; 45:748-752. [PMID: 37132356 PMCID: PMC10470341 DOI: 10.1093/pubmed/fdad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/10/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND In 2020, preventive measures were implemented to mitigate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among 600-700 recruits arriving weekly at a basic combat training (BCT) facility in the southern United States. Trainees were sorted into companies and platoons (cocoons) at arrival, tested, quarantined for 14 days with daily temperature and respiratory-symptom monitoring and retested before release into larger groups for training where symptomatic testing was conducted. Nonpharmaceutical measures, such as masking, and social distancing, were maintained throughout quarantine and BCT. We assessed for SARS-CoV-2 transmission in the quarantine milieu. METHODS Nasopharyngeal (NP) swabs were collected at arrival and at the end of quarantine and blood specimens at both timepoints and at the end of BCT. Epidemiological characteristics were analyzed for transmission clusters identified from whole-genome sequencing of NP samples. RESULTS Among 1403 trainees enrolled from 25 August to 7 October 2020, epidemiological analysis identified three transmission clusters (n = 20 SARS-CoV-2 genomes) during quarantine, which spanned five different cocoons. However, SARS-CoV-2 incidence decreased from 2.7% during quarantine to 1.5% at the end of BCT; prevalence at arrival was 3.3%. CONCLUSIONS These findings suggest layered SARS-CoV-2 mitigation measures implemented during quarantine minimized the risk of further transmission in BCT.
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Affiliation(s)
- Shilpa Hakre
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Irina Maljkovic-Berry
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Cherokee Nation Technology Solutions, Tulsa, OK, USA
| | - Jun Hang
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Matthew A Conte
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Cherokee Nation Technology Solutions, Tulsa, OK, USA
| | - Adam R Pollio
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Cherokee Nation Technology Solutions, Tulsa, OK, USA
| | - Christian K Fung
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Cherokee Nation Technology Solutions, Tulsa, OK, USA
| | - Jaykumar Gandhi
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Cherokee Nation Technology Solutions, Tulsa, OK, USA
| | - Sheila A Peel
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Grace M Lidl
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Mark E Huhtanen
- Moncrief Army Health Clinic, Fort Jackson, Columbia, SC, USA
| | - Tara L Hall
- Moncrief Army Health Clinic, Fort Jackson, Columbia, SC, USA
| | - Kayvon Modjarrad
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Heather L Friberg
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | - Paul T Scott
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
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2
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Regina de Oliveira T, Oliveira Leite TH, Miranda WN, Manuli ER, Leal F, Sabino E, Pott-Junior H, Melendez M, Faria RC. Molecular test for COVID-19 diagnosis based on a colorimetric genomagnetic assay. Anal Chim Acta 2023; 1257:341167. [PMID: 37062564 PMCID: PMC10066033 DOI: 10.1016/j.aca.2023.341167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/10/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023]
Abstract
The world is in a long pandemic period caused by the SARS-CoV-2 virus and massive diagnostic tests to assist efforts to control the spread of the disease and also to avoid new coronavirus variants are still needed. Herein, we propose a simple and accurate saliva-based colorimetric test for the diagnosis of COVID-19. Magnetic beads (MBs) modified with a sequence of single-strand DNA (ssDNA) complementary to the N gene of the SARS-CoV-2 RNA were developed and used for magnetic capture and separation from a complex saliva sample. A second biotinylated ssDNA sequence was applied, and the colorimetric detection was carried out by adding streptavidin-horseradish peroxidase conjugate, H2O2, and tetramethylbenzidine (TMB) as chromogenic substrate. The test does not require viral RNA isolation, transcription, or amplification steps and can be performed at room temperature. The molecular assay test can be run using 96-well microplates, allowing the diagnosis of a large number of samples in 90 min. A simple support for magnets was designed and constructed using a 3D printer that allows the magnetic separations directly in the 96-well microplate. The colorimetric test showed an excellent ability to discriminate between healthy individuals and patients infected with SARS-CoV-2, with 92% and 100% of clinical sensitivity and specificity, respectively. This performance was similar to that achieved using the gold standard RT-PCR technique. The proposed genomagnetic assay offers an opportunity to greatly increase population testing, contribute to controlling the spread of the virus, and improve health equity in testing for COVID-19.
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Affiliation(s)
| | | | - Wyllian Neves Miranda
- Department of Chemistry, Federal University of São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Erika Regina Manuli
- Municipal University of São Caetano do Sul, São Caetano do Sul, SP, 09521-160, Brazil
| | - Fábio Leal
- Municipal University of São Caetano do Sul, São Caetano do Sul, SP, 09521-160, Brazil
| | - Ester Sabino
- Institute of Tropical Medicine, University of São Paulo, São Paulo, SP, 05403-000, Brazil
| | - Henrique Pott-Junior
- Department of Medicine, Federal University of São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Matias Melendez
- Cloning Solutions Ltda, Barretos, SP, 14780-459, Brazil; Molecular Carcinogenesis Program, National Cancer Institute, Rio de Janeiro, RJ, 20231-050, Brazil
| | - Ronaldo Censi Faria
- Department of Chemistry, Federal University of São Carlos, São Carlos, SP, 13565-905, Brazil.
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3
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Campos-Aguirre E, Martínez-Álvarez JC, Arrazola-García MA, Arroyo-García OD, Delgado-Colín MG, Chávez-Durán MÁ, Galván-Bobadilla AI, Benítez-Arvizu G. [PCR for COVID in the transplant protocol]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2023; 61:S33-S36. [PMID: 36378084 PMCID: PMC10395893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/25/2022] [Indexed: 06/16/2023]
Abstract
Background Since the beginning of the SARS-CoV-2 pandemic, identifying the COVID-19 pathophysiology not only has been addressed to applying diagnostic tests or preventing through vaccines, but also to the timely detection, especially of patients in risk groups such as those in transplants areas (renal, hematology, etcetera). In the case of these patients, using RT-PCR tests avoids putting them at risk by subjecting them to states of immunosuppression that could aggravate their situation if they were faced with an onset of a COVID-19 infection. Objective To present the results of patients of a transplant unit tested for SARS-CoV-2. Material and methods Descriptive, observational, cross-sectional, and retrolective study. Data of results of RT-PCR tests of patients who underwent transplantation from June 2021 to April 2022 in a third level hospital were collected. Results 755 tests were done to patients who underwent transplantation. 384 (50.8%) were women. Out of all patients, only 73 (9.7%) were positive to SARS-CoV-2. Conclusions Implementing RT-PCR tests as a transplant protocol to detect SARS-CoV-2 prevents fatal complications due to COVID infection to donors and receptors.
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Affiliation(s)
- Esmeralda Campos-Aguirre
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Unidad Complementaria Banco de Sangre. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Julio César Martínez-Álvarez
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Unidad Complementaria Banco de Sangre. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - María Araceli Arrazola-García
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Unidad Complementaria Banco de Sangre. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Oscar David Arroyo-García
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Unidad Complementaria Banco de Sangre. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - María Guadalupe Delgado-Colín
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Unidad Complementaria Banco de Sangre. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Miguel Ángel Chávez-Durán
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Unidad Complementaria Banco de Sangre. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Alexis Ignacio Galván-Bobadilla
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Unidad Complementaria Banco de Sangre. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Gamaliel Benítez-Arvizu
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Unidad Complementaria Banco de Sangre. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
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4
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Montolio Breva S, Molina Clavero C, Gómez Bertomeu F, Picó-Plana E, Serrat Orús N, Palau Sánchez I, Mestre-Prad MT, Sans-Mateu MT. Evaluation of five immunoassays and one lateral flow immunochromatography for anti-SARS-CoV-2 antibodies detection. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:489-494. [PMID: 36336378 PMCID: PMC9631337 DOI: 10.1016/j.eimce.2020.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/06/2020] [Indexed: 06/16/2023]
Abstract
INTRODUCTION In order to deal with the current pandemic caused by the novel SARS-CoV-2 coronavirus several serological immunoassays have been recently developed with the objective of being used as a complementary diagnostic tool and to support the RT-PCR technique currently considered the "gold-standard" method. However, these new assays need to be evaluated and validated. The purpose of this study was to assess the performance of five immunoassays (two ELISA and three CLIA assays) and one rapid immunochromatographic test for the detection of anti-SARS-CoV-2 antibodies. METHODS Five semiquantitative immunoassays (MENARINI®, PALEX®, VIRCLIA®, ROCHE® and SIEMENS®) and one lateral flow rapid test (WONDFO®) were performed. A total of 124 samples were studied. Case serum samples (n=78) were obtained from COVID-19 patients confirmed by real-time RT-PCR/epidemiological-clinical-radiological criteria, and control non-SARS-CoV-2 samples (n=46) belonged to healthy healthcare workers involved in a seroprevalence study. RESULTS Overall, the tests showed sensitivities around 70-90% and specificities greater than 95%, including the immunochromatographic test. In addition, we observed very good agreements among them, being better for the detection of IgG than for IgM antibodies (Cohen's kappa index of 0.95 for VIRCLIA® IgG with ROCHE®), as well as good diagnostic power of the tests as determined by the ROC curves. CONCLUSIONS This study demonstrates the proper performance of the different immunoassays in order to be applied in the clinical practice as support in the diagnostic approach and in the development of vaccines and seroepidemiological studies of COVID-19.
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Affiliation(s)
- Silvia Montolio Breva
- Laboratori Clínic ICS Camp de Tarragona - Terres de l'Ebre - Hospital Universitari Joan XXIII, Tarragona, Spain.
| | - Carmen Molina Clavero
- Laboratori Clínic ICS Camp de Tarragona - Terres de l'Ebre - Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Frederic Gómez Bertomeu
- Laboratori Clínic ICS Camp de Tarragona - Terres de l'Ebre - Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Ester Picó-Plana
- Laboratori Clínic ICS Camp de Tarragona - Terres de l'Ebre - Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Núria Serrat Orús
- Laboratori Clínic ICS Camp de Tarragona - Terres de l'Ebre - Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Inmaculada Palau Sánchez
- Laboratori Clínic ICS Camp de Tarragona - Terres de l'Ebre - Hospital Universitari Joan XXIII, Tarragona, Spain
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5
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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] [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.
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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
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6
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Parmar H, Montovano M, Banada P, Pentakota SR, Shiau S, Ma Z, Saibire K, Chopoorian A, O’Shaughnessy M, Hirsch M, Jain P, Demirdjian G, Karagueuzian M, Robin T, Salvati M, Patel B, Alland D, Xie YL. RT-PCR negative COVID-19. BMC Infect Dis 2022; 22:149. [PMID: 35152885 PMCID: PMC8841043 DOI: 10.1186/s12879-022-07095-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/24/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
COVID-19 is a multi-system infection with emerging evidence-based antiviral and anti-inflammatory therapies to improve disease prognosis. However, a subset of patients with COVID-19 signs and symptoms have repeatedly negative RT-PCR tests, leading to treatment hesitancy. We used comparative serology early in the COVID-19 pandemic when background seroprevalence was low to estimate the likelihood of COVID-19 infection among RT-PCR negative patients with clinical signs and/or symptoms compatible with COVID-19.
Methods
Between April and October 2020, we conducted serologic testing of patients with (i) signs and symptoms of COVID-19 who were repeatedly negative by RT-PCR (‘Probables’; N = 20), (ii) signs and symptoms of COVID-19 but with a potential alternative diagnosis (‘Suspects’; N = 15), (iii) no signs and symptoms of COVID-19 (‘Non-suspects’; N = 43), (iv) RT-PCR confirmed COVID-19 patients (N = 40), and (v) pre-pandemic samples (N = 55).
Results
Probables had similar seropositivity and levels of IgG and IgM antibodies as propensity-score matched RT-PCR confirmed COVID-19 patients (60.0% vs 80.0% for IgG, p-value = 0.13; 50.0% vs 72.5% for IgM, p-value = 0.10), but multi-fold higher seropositivity rates than Suspects and matched Non-suspects (60.0% vs 13.3% and 11.6% for IgG; 50.0% vs 0% and 4.7% for IgM respectively; p-values < 0.01). However, Probables were half as likely to receive COVID-19 treatment than the RT-PCR confirmed COVID-19 patients with similar disease severity.
Conclusions
Findings from this study indicate a high likelihood of acute COVID-19 among RT-PCR negative with typical signs/symptoms, but a common omission of COVID-19 therapies among these patients. Clinically diagnosed COVID-19, independent of RT-PCR positivity, thus has a potential vital role in guiding treatment decisions.
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7
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Saad Menezes MC, Santinelli Pestana DV, Ferreira JC, Ribeiro de Carvalho CR, Felix MC, Marcilio IO, da Silva KR, Junior VC, Marchini JF, Alencar JC, Gomez LMG, Mauá DD, Souza HP. Distinct Outcomes in COVID-19 Patients with Positive or Negative RT-PCR Test. Viruses 2022; 14:v14020175. [PMID: 35215772 PMCID: PMC8874612 DOI: 10.3390/v14020175] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/08/2022] [Accepted: 01/15/2022] [Indexed: 02/01/2023] Open
Abstract
Identification of the SARS-CoV-2 virus by RT-PCR from a nasopharyngeal swab sample is a common test for diagnosing COVID-19. However, some patients present clinical, laboratorial, and radiological evidence of COVID-19 infection with negative RT-PCR result(s). Thus, we assessed whether positive results were associated with intubation and mortality. This study was conducted in a Brazilian tertiary hospital from March to August of 2020. All patients had clinical, laboratory, and radiological diagnosis of COVID-19. They were divided into two groups: positive (+) RT-PCR group, with 2292 participants, and negative (−) RT-PCR group, with 706 participants. Patients with negative RT-PCR testing and an alternative most probable diagnosis were excluded from the study. The RT-PCR(+) group presented increased risk of intensive care unit (ICU) admission, mechanical ventilation, length of hospital stay, and 28-day mortality, when compared to the RT-PCR(−) group. A positive SARS-CoV-2 RT-PCR result was independently associated with intubation and 28 day in-hospital mortality. Accordingly, we concluded that patients with a COVID-19 diagnosis based on clinical data, despite a negative RT-PCR test from nasopharyngeal samples, presented more favorable outcomes than patients with positive RT-PCR test(s).
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Affiliation(s)
- Maria Clara Saad Menezes
- Emergency Medicine Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, Brazil; (D.V.S.P.); (L.M.G.G.); (H.P.S.)
- Correspondence:
| | - Diego Vinicius Santinelli Pestana
- Emergency Medicine Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, Brazil; (D.V.S.P.); (L.M.G.G.); (H.P.S.)
| | - Juliana Carvalho Ferreira
- Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903l, Brazil; (J.C.F.); (C.R.R.d.C.); (M.C.F.); (I.O.M.); (K.R.d.S.); (V.C.J.); (J.F.M.); (J.C.A.)
| | - Carlos Roberto Ribeiro de Carvalho
- Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903l, Brazil; (J.C.F.); (C.R.R.d.C.); (M.C.F.); (I.O.M.); (K.R.d.S.); (V.C.J.); (J.F.M.); (J.C.A.)
| | - Marcelo Consorti Felix
- Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903l, Brazil; (J.C.F.); (C.R.R.d.C.); (M.C.F.); (I.O.M.); (K.R.d.S.); (V.C.J.); (J.F.M.); (J.C.A.)
| | - Izabel Oliva Marcilio
- Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903l, Brazil; (J.C.F.); (C.R.R.d.C.); (M.C.F.); (I.O.M.); (K.R.d.S.); (V.C.J.); (J.F.M.); (J.C.A.)
| | - Katia Regina da Silva
- Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903l, Brazil; (J.C.F.); (C.R.R.d.C.); (M.C.F.); (I.O.M.); (K.R.d.S.); (V.C.J.); (J.F.M.); (J.C.A.)
| | - Vilson Cobello Junior
- Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903l, Brazil; (J.C.F.); (C.R.R.d.C.); (M.C.F.); (I.O.M.); (K.R.d.S.); (V.C.J.); (J.F.M.); (J.C.A.)
| | - Julio Flavio Marchini
- Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903l, Brazil; (J.C.F.); (C.R.R.d.C.); (M.C.F.); (I.O.M.); (K.R.d.S.); (V.C.J.); (J.F.M.); (J.C.A.)
| | - Julio Cesar Alencar
- Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903l, Brazil; (J.C.F.); (C.R.R.d.C.); (M.C.F.); (I.O.M.); (K.R.d.S.); (V.C.J.); (J.F.M.); (J.C.A.)
| | - Luz Marina Gomez Gomez
- Emergency Medicine Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, Brazil; (D.V.S.P.); (L.M.G.G.); (H.P.S.)
| | - Denis Deratani Mauá
- Institute of Mathematics and Statistics, Universidade de São Paulo, São Paulo 05508-090, Brazil;
| | - Heraldo Possolo Souza
- Emergency Medicine Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, Brazil; (D.V.S.P.); (L.M.G.G.); (H.P.S.)
| | - Emergency USP COVID-19 Group
- Emergency Medicine Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, Brazil; (D.V.S.P.); (L.M.G.G.); (H.P.S.)
| | - HCFMUSP COVID-19 Study Group
- Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903l, Brazil; (J.C.F.); (C.R.R.d.C.); (M.C.F.); (I.O.M.); (K.R.d.S.); (V.C.J.); (J.F.M.); (J.C.A.)
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8
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Barrera-Avalos C, Luraschi R, Vallejos-Vidal E, Figueroa M, Arenillas E, Barría D, Hernández F, Mateluna C, Mena J, Rioseco C, Torrent C, Vergara C, Gutiérrez G, Quiroz J, Alarcón J, Cartagena J, Cayunao J, Mella-Torres A, Santibañez Á, Tapia S, Undurraga A, Vargas D, Wong V, Inostroza-Molina A, Valdés D, Imarai M, Acuña-Castillo C, Reyes-López FE, Sandino AM. Analysis by real-time PCR of five transport and conservation mediums of nasopharyngeal swab samples to COVID-19 diagnosis in Santiago of Chile. J Med Virol 2021; 94:1167-1174. [PMID: 34755352 PMCID: PMC8662110 DOI: 10.1002/jmv.27446] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/02/2021] [Accepted: 11/08/2021] [Indexed: 12/23/2022]
Abstract
Due to the COVID-19 pandemic, many transport kits have been manufactured to preserve and transport nasopharyngeal swab samples (NPSs) from patients. However, there is no information on the performance of the different virus transport media (VTM) used in COVID-19 diagnosis in the population of Santiago de Chile. We compared the RT-qPCR amplification profile of five different viral transport kit mediums, including DNA/RNA Shield™, NAT, VTM-N, Ezmedlab™, and phosphate-buffered saline (PBS), for NPSs from Central Metropolitan Health Service, Santiago, Chile. The DNA/RNA Shield™ medium showed a better performance in terms of Cq and RFU values for the internal reference RNase P and viral ORF1ab probes. By contrast, the PBS transport medium registered higher Cq values for the viral and reference gene, compared to the other VTM. DNA/RNA Shield™ shows higher relative fluorescence units (RFUs) and lower Cq values for the reference gene. Collectively, our results suggest that the PBS medium could compromise the sample diagnosis because of its lower RT-qPCR performance. The NAT, Ezmedlab and VTM-N, and DNA/RNA Shield™ media show acceptable RT-qPCR parameters and, consequently, seem suitable for use in COVID-19 diagnosis.
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Affiliation(s)
- Carlos Barrera-Avalos
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Roberto Luraschi
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Eva Vallejos-Vidal
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile.,Centro de Nanociencia y Nanotecnología CEDENNA, Universidad de Santiago de Chile, Santiago, Chile
| | - Maximiliano Figueroa
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Esteban Arenillas
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Daniela Barría
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Felipe Hernández
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Carlos Mateluna
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Javier Mena
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Claudia Rioseco
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Claudia Torrent
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Claudio Vergara
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Gaby Gutiérrez
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Javiera Quiroz
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Javiera Alarcón
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Julio Cartagena
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Javiera Cayunao
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Andrea Mella-Torres
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Álvaro Santibañez
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Sebastián Tapia
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Alejandro Undurraga
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Deborah Vargas
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Valentina Wong
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Ailen Inostroza-Molina
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Daniel Valdés
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile.,Departamento de Biología, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Mónica Imarai
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile.,Departamento de Biología, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Claudio Acuña-Castillo
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile.,Departamento de Biología, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Felipe E Reyes-López
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile.,Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Facultad de Medicina Veterinaria y Agronomía, Universidad de Las Américas, Santiago, Chile
| | - Ana M Sandino
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile.,Departamento de Biología, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
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9
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Gadwal A, Roy D, Khokhar M, Modi A, Sharma P, Purohit P. CRISPR/Cas-New Molecular Scissors in Diagnostics and Therapeutics of COVID-19. Indian J Clin Biochem 2021; 36:459-467. [PMID: 33879980 PMCID: PMC8050156 DOI: 10.1007/s12291-021-00977-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/03/2021] [Indexed: 12/12/2022]
Abstract
The current pandemic of COVID-19, with its climbing number of cases and deaths, has us searching for tools for rapid, reliable, and affordable methods of detection on one hand, and novel, improved therapeutic strategies on the other. The currently employed RT-PCR method, despite its all-encompassing utility, has its shortcomings. Newer diagnostic tools, based on the Clustered Regularly Interspaced Short Palindromic Repeats/Cas(CRISPR-Cas) system, with its better diagnostic accuracy measures, have come up to fill that void. These assay platforms are expected to slowly take up the place of COVID-19 diagnostics. Further, the current therapeutic options focus mainly on counteracting the viral proteins and components and their entry into host cells. The CRISPR-based system, especially through the RNA-guided Cas13 approach, can identify the genomic characteristics of SARS-CoV-2 and provide a novel inhibition strategy for coronaviruses. In this mini-review, we have discussed the available and upcoming CRISPR-based diagnostic assays and the potential of the CRISPR/Cas system as a therapeutic or prevention strategy in COVID-19. CRISPR-Cas system shows promise in both diagnostics as well as therapeutics and may as well change the face of molecular diagnosis and precision medicine.
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Affiliation(s)
- A. Gadwal
- Dept. of Biochemistry, AIIMS, Jodhpur, Rajasthan India
| | - D. Roy
- Dept. of Biochemistry, AIIMS, Jodhpur, Rajasthan India
| | - M. Khokhar
- Dept. of Biochemistry, AIIMS, Jodhpur, Rajasthan India
| | - A. Modi
- Dept. of Biochemistry, AIIMS, Jodhpur, Rajasthan India
| | - P. Sharma
- Dept. of Biochemistry, AIIMS, Jodhpur, Rajasthan India
| | - P. Purohit
- Dept. of Biochemistry, AIIMS, Jodhpur, Rajasthan India
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10
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Karaca A, Akçimen M, Özen H. Less Exposure for Health Care Workers, More Comfort for Patients During COVID-19 Swab Testing. Workplace Health Saf 2021; 70:37-42. [PMID: 34558368 DOI: 10.1177/21650799211045309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Nasopharyngeal (NP) and oropharyngeal (OP) swab sampling for coronavirus disease 2019 (COVID-19) diagnosis may lead to droplet and/or airborne particle transmission and increase the exposure risk for health care workers (HCWs). However, there is limited evidence for effective methods to reduce occupational exposure from NP and OP swab sampling. This study aimed to reduce droplet-forming responses (DFRs) and the related exposure risk of NP and OP swab sampling by administering 10% lidocaine spray (LS) to the NP and OP areas prior to conducting swab tests. METHODS This quasi-experimental study was conducted with 100 patients who presented to our tertiary care hospital with symptoms of COVID-19 between December 1 and 15, 2020. First, NP and OP swabbings were performed on each patient. Thereafter, LS was applied to the OP and NP regions, and the swab samples were taken once again. Frequency of DFRs and real-time polymerase chain reaction (RT-PCR) test results before and after LS application were recorded for comparison. In addition, the cycle threshold (Ct) was used as a proxy indicator for SARS-CoV-2 viral load in COVID-19 positive cases. FINDINGS Significant differences in OP DFR frequencies before and after LS intervention were found (37% and 9%, respectively), as well as before and after NP DFR (31% and 18%, respectively). The mean Ct values for the positive samples did not differ before and after applying LS. CONCLUSION Our results suggest that applying LS to the OP and NP area prior to swab testing reduces DFR frequencies without affecting (RT-PCR) test results for SARS-CoV-2 and may increase patient and practitioner comfort.
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Affiliation(s)
- Adeviyye Karaca
- University of Health Science Antalya Training and Research Hospital
| | - Mehmet Akçimen
- University of Health Science Antalya Training and Research Hospital
| | - Hatice Özen
- University of Health Science Antalya Training and Research Hospital
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11
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Jindal H, Jain S, Suvvari TK, Kutikuppala LVS, Rackimuthu S, Rocha ICN, Goyal S, Radha. False-Negative RT-PCR Findings and Double Mutant Variant as Factors of an Overwhelming Second Wave of COVID-19 in India: an Emerging Global Health Disaster. SN COMPREHENSIVE CLINICAL MEDICINE 2021; 3:2383-2388. [PMID: 34568761 PMCID: PMC8453462 DOI: 10.1007/s42399-021-01059-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 12/17/2022]
Abstract
RT-PCR is considered to be the standard gold diagnostic test for detecting COVID-19 causing SARS-CoV-2. Recent reports and recent pieces of evidence from scientific literature, however, tell a different story. There have been speculations of SARS-CoV-2 escaping the RT-PCR because of the series of mutations it has gone through. It is possible that host-dependent RNA editing and high person-to-person transmission have equipped the virus with mutations enabling it to spread faster and even evade the RT-PCR. Added to this is burnout among healthcare workers and technicians handling the RT-PCR machines and sampling. All of these factors may be working in unison to result in the deluge of false-negative cases India is facing during the second COVID-19 wave. The mutant strains are spreading to other parts, posing challenges to the whole world. These circumstances warrant supplementary diagnostic tests such as serological and radiological findings to deal with cases of high clinical suspicion. Even one misdiagnosed COVID-19 patient poses a risk to hundreds of others in the vicinity. Healthcare workers' burnout also has to be dealt with. Erroneous staff should be re-trained.
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Affiliation(s)
- Himanshu Jindal
- Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, India
| | | | | | - LVSimhachalam Kutikuppala
- Konaseema Institute of Medical Sciences and Research Foundation (KIMS&RF), Amalapuram, Andhra Pradesh India
| | | | | | | | - Radha
- Kasturba Medical College, Manipal, India
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12
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Diagnostic Properties of Three SARS-CoV-2 Antibody Tests. Diagnostics (Basel) 2021; 11:diagnostics11081441. [PMID: 34441375 PMCID: PMC8393643 DOI: 10.3390/diagnostics11081441] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/22/2021] [Accepted: 07/27/2021] [Indexed: 01/13/2023] Open
Abstract
Serological assays emerged as complementary tools to RT-PCR in the diagnosis of SARS-CoV-2 as well as being needed for epidemiological studies. This study aimed to assess the performance of a rapid test (RT) compared to that of serological tests using finger prick blood samples. A total of 183 samples were evaluated, 88 of which were collected from individuals with negative RT-PCR and 95 from positive RT-PCR individuals. The diagnostic performance of RT (WONDFO®) and LUMIT (PROMEGA®) were compared to that of ELISA (EUROIMMUN®) for detecting antibodies against SARS-CoV-2 according to time from symptoms onset. The IgG antibody tests were detected in 77.4% (LUMIT), 77.9% (RT), and 80.0% (ELISA) of individuals. The detection of antibodies against SARS-CoV-2 increases in accordance with increasing time from symptoms onset. Considering only time from symptoms onset >21 days, the positivity rate ranged from 81.8 to 97.0% between the three tests. The RT and LUMIT showed high agreement with ELISA (agreement = 91.5%, k = 0.83, and agreement = 96.3%, k = 0.9, respectively) in individuals who had symptoms 15 to 21 days before sample collection. Compared to that of the ELISA assay, our results show sensitivity ranged from 95% to 100% for IgG antibody detection in individuals with symptoms onset between 15 and 21 days before sample collection. The specificity was 100% in individuals with symptoms onset >15 days before serological tests. This study shows good performance and high level of agreement of three immunoassays for the detection of SARS-CoV-2 antibodies.
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13
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Patkar N, Rajpal S, Shetty N, Gokarn A, Mirgh S, Munipally S, Nair S, Joshi A, Murthy V, Khattry N, Gupta S. Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is influenced by the type of transport medium: Implications for diagnosis and monitoring. Int J Clin Pract 2021; 75:e14311. [PMID: 33932309 PMCID: PMC8236963 DOI: 10.1111/ijcp.14311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 04/28/2021] [Indexed: 01/08/2023] Open
Abstract
It is unclear if the use of a molecular transport medium (MTM) containing guanidine isothiocyanate (GITC) would be advantageous over the CDC recommended, commonly used viral transport medium (VTM). We retested 70 SARS-CoV2 cases by RT-PCR in varying stages of follow-up using MTM and VTM in parallel and found discrepant results of RNase P, E and N genes. Majority (81%) patients tested positive with MTM as compared with VTM (27.1%). Even patients who were sampled 3 weeks after diagnosis demonstrated a significant discrepancy in the positivity rates between MTM vs VTM raising concerns about the clinical utility of VTM.
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14
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Comparison of SARS-CoV-2 Detection by Rapid Antigen and by Three Commercial RT-qPCR Tests: A Study from Martin University Hospital in Slovakia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137037. [PMID: 34280974 PMCID: PMC8295881 DOI: 10.3390/ijerph18137037] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/10/2021] [Accepted: 06/24/2021] [Indexed: 12/24/2022]
Abstract
The global pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is having a tremendous impact on the global economy, health care systems and the lives of almost all people in the world. The Central European country of Slovakia reached one of the highest daily mortality rates per 100,000 inhabitants in the first 3 months of 2021, despite implementing strong prophylactic measures, lockdowns and repeated nationwide antigen testing. The present study reports a comparison of the performance of the Standard Q COVID-19 antigen test (SD Biosensor) with three commercial RT-qPCR kits (vDetect COVID-19-MultiplexDX, gb SARS-CoV-2 Multiplex-GENERI BIOTECH Ltd. and Genvinset COVID-19 [E]-BDR Diagnostics) in the detection of infected individuals among employees of the Martin University Hospital in Slovakia. Health care providers, such as doctors and nurses, are classified as “critical infrastructure”, and there is no doubt about the huge impact that incorrect results could have on patients. Out of 1231 samples, 14 were evaluated as positive for SARS-CoV-2 antigen presence, and all of them were confirmed by RT-qPCR kit 1 and kit 2. As another 26 samples had a signal in the E gene, these 40 samples were re-isolated and subsequently re-analysed using the three kits, which detected the virus in 22, 23 and 12 cases, respectively. The results point to a divergence not only between antigen and RT-qPCR tests, but also within the “gold standard” RT-qPCR testing. Performance analysis of the diagnostic antigen test showed the positive predictive value (PPV) to be 100% and negative predictive value (NPV) to be 98.10%, indicating that 1.90% of individuals with a negative result were, in fact, positive. If these data are extrapolated to the national level, where the mean daily number of antigen tests was 250,000 in April 2021, it points to over 4700 people per day being misinterpreted and posing a risk of virus shedding. While mean Ct values of the samples that were both antigen and RT-qPCR positive were about 20 (kit 1: 20.47 and 20.16 for Sarbeco E and RdRP, kit 2: 19.37 and 19.99 for Sarbeco E and RdRP and kit 3: 17.47 for ORF1b/RdRP), mean Ct values of the samples that were antigen-negative but RT-qPCR-positive were about 30 (kit 1: 30.67 and 30.00 for Sarbeco E and RdRP, kit 2: 29.86 and 31.01 for Sarbeco E and RdRP and kit 3: 27.47 for ORF1b/RdRP). It confirms the advantage of antigen test in detecting the most infectious individuals with a higher viral load. However, the reporting of Ct values is still a matter of ongoing debates and should not be conducted without normalisation to standardised controls of known concentration.
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van der Toorn W, Oh DY, Bourquain D, Michel J, Krause E, Nitsche A, von Kleist M. An intra-host SARS-CoV-2 dynamics model to assess testing and quarantine strategies for incoming travelers, contact management, and de-isolation. PATTERNS (NEW YORK, N.Y.) 2021; 2:100262. [PMID: 33899034 PMCID: PMC8057735 DOI: 10.1016/j.patter.2021.100262] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/20/2021] [Accepted: 04/14/2021] [Indexed: 12/15/2022]
Abstract
Non-pharmaceutical interventions (NPIs) remain decisive tools to contain SARS-CoV-2. Strategies that combine NPIs with testing may improve efficacy and shorten quarantine durations. We developed a stochastic within-host model of SARS-CoV-2 that captures temporal changes in test sensitivities, incubation periods, and infectious periods. We used the model to simulate relative transmission risk for (1) isolation of symptomatic individuals, (2) contact person management, and (3) quarantine of incoming travelers. We estimated that testing travelers at entry reduces transmission risks to 21.3% ([20.7, 23.9], by PCR) and 27.9% ([27.1, 31.1], by rapid diagnostic test [RDT]), compared with unrestricted entry. We calculated that 4 (PCR) or 5 (RDT) days of pre-test quarantine are non-inferior to 10 days of quarantine for incoming travelers and that 8 (PCR) or 10 (RDT) days of pre-test quarantine are non-inferior to 14 days of post-exposure quarantine. De-isolation of infected individuals 13 days after symptom onset may reduce the transmission risk to <0.2% (<0.01, 6.0).
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Affiliation(s)
- Wiep van der Toorn
- Systems Medicine of Infectious Disease (P5), Robert Koch Institute, Berlin, Germany
- Bioinformatics (MF1), Methodology and Research Infrastructure, Robert Koch Institute, Berlin, Germany
| | - Djin-Ye Oh
- FG17 Influenza and Other Respiratory Viruses, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Daniel Bourquain
- ZBS1 Highly Pathogenic Viruses, Center for Biological Threats and Special Pathogens, Robert Koch Institute, Berlin, Germany
| | - Janine Michel
- ZBS1 Highly Pathogenic Viruses, Center for Biological Threats and Special Pathogens, Robert Koch Institute, Berlin, Germany
| | - Eva Krause
- ZBS1 Highly Pathogenic Viruses, Center for Biological Threats and Special Pathogens, Robert Koch Institute, Berlin, Germany
| | - Andreas Nitsche
- ZBS1 Highly Pathogenic Viruses, Center for Biological Threats and Special Pathogens, Robert Koch Institute, Berlin, Germany
| | - Max von Kleist
- Systems Medicine of Infectious Disease (P5), Robert Koch Institute, Berlin, Germany
- Bioinformatics (MF1), Methodology and Research Infrastructure, Robert Koch Institute, Berlin, Germany
- German COVID Omics Initiative (deCOI), Bonn, Germany
| | - the Working Group on SARS-CoV-2 Diagnostics at RKI
- Systems Medicine of Infectious Disease (P5), Robert Koch Institute, Berlin, Germany
- Bioinformatics (MF1), Methodology and Research Infrastructure, Robert Koch Institute, Berlin, Germany
- FG17 Influenza and Other Respiratory Viruses, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
- ZBS1 Highly Pathogenic Viruses, Center for Biological Threats and Special Pathogens, Robert Koch Institute, Berlin, Germany
- German COVID Omics Initiative (deCOI), Bonn, Germany
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Porto LC, Costa CH, Nunes AS, Bouzas I, Ferreira TF, Porto VM, Secco DA, Vilas Boas S, Faria AC, Rufino R. Clinical and laboratory characteristics in outpatient diagnosis of COVID-19 in healthcare professionals in Rio de Janeiro, Brazil. J Clin Pathol 2021; 75:185-192. [PMID: 33568424 DOI: 10.1136/jclinpath-2020-206797] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 10/09/2020] [Accepted: 12/15/2020] [Indexed: 01/15/2023]
Abstract
AIMS This study aimed to identify the symptoms associated with early stage SARS-CoV-2 (COVID-19) infections in healthcare professionals (HCPs) using both clinical and laboratory data. METHODS A total of 1297 patients, admitted between 18 March and 8 April 2020, were stratified according to their risk of developing COVID-19 using their responses to a questionnaire designed to evaluate symptoms and risk conditions. RESULTS Anosmia/hyposmia (p<0.0001), fever (p<0.0001), body pain (p<0.0001) and chills (p=0.001) were all independent predictors for COVID-19, with a 72% estimated probability for detecting COVID-19 in nasopharyngeal swab samples. Leucopenia, relative monocytosis, decreased eosinophil values, C reactive protein (CRP) and platelets were also shown to be significant independent predictors for COVID-19. CONCLUSIONS The significant clinical features for COVID-19 were identified as anosmia, fever, chills and body pain. Elevated CRP, leucocytes under 5400×109/L and relative monocytosis (>9%) were common among patients with a confirmed COVID-19 diagnosis. These variables may help, in the absence of reverse transcriptase PCR tests, to identify possible COVID-19 infections during pandemic outbreaks. SUMMARY From 19 March to 8 April 2020, 1297 patients attended the Polyclinic Piquet Carneiro for COVID-19 detection. HCP data were analysed, and significant clinical features were anosmia, fever, chills and body pain. Elevated CRP, leucopenia and monocytosis were common in COVID-19.
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Affiliation(s)
- Luis Cristovao Porto
- Histocompatibility and Cryopreservation Laboratory, Institute of Biology Roberto Alcantara Gomes, UERJ, Rio de Janeiro, Brazil .,Clinical Pathology Service, Polyclinic Piquet Carneiro, UERJ, Rio de Janeiro, Brazil
| | - Claudia H Costa
- Department of Pulmonology and Tisiology, Faculty of Medical Sciences and Service of Pulmonology, Polyclinic Piquet Carneiro, UERJ, Rio de Janeiro, Brazil
| | - Alessandra S Nunes
- Medical Surgical Nursing Department, Nursing Faculty, Polyclinic Piquet Carneiro, UERJ, Rio de Janeiro, Brazil
| | - Isabel Bouzas
- Health Research Support Facility Center (CAPCS), Polyclinic Piquet Carneiro, UERJ, Rio de Janeiro, Brazil
| | - Tiago F Ferreira
- Infectology Service, Polyclinic Piquet Carneiro, UERJ, Rio de Janeiro, Brazil
| | - Vinicius M Porto
- Clinical Pathology Service, Polyclinic Piquet Carneiro, UERJ, Rio de Janeiro, Brazil
| | - Danielle A Secco
- Histocompatibility and Cryopreservation Laboratory, Institute of Biology Roberto Alcantara Gomes, UERJ, Rio de Janeiro, Brazil
| | - Sandra Vilas Boas
- Clinical Pathology Service, Polyclinic Piquet Carneiro, UERJ, Rio de Janeiro, Brazil
| | - Anamelia Costa Faria
- Department of Pulmonology and Tisiology, Faculty of Medical Sciences and Service of Pulmonology, Polyclinic Piquet Carneiro, UERJ, Rio de Janeiro, Brazil
| | - Rogerio Rufino
- Department of Pulmonology and Tisiology, Faculty of Medical Sciences and Service of Pulmonology, Polyclinic Piquet Carneiro, UERJ, Rio de Janeiro, Brazil
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Montolio Breva S, Molina Clavero C, Gómez Bertomeu F, Picó-Plana E, Serrat Orús N, Palau Sánchez I, Mestre-Prad MT, Sans-Mateu MT. Evaluation of five immunoassays and one lateral flow immunochromatography for anti-SARS-CoV-2 antibodies detection. Enferm Infecc Microbiol Clin 2021; 40:S0213-005X(21)00004-5. [PMID: 33558047 PMCID: PMC7816578 DOI: 10.1016/j.eimc.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/26/2020] [Accepted: 12/06/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION In order to deal with the current pandemic caused by the novel SARS-CoV-2 coronavirus several serological immunoassays have been recently developed with the objective of being used as a complementary diagnostic tool and to support the RT-PCR technique currently considered the "gold-standard" method. However, these new assays need to be evaluated and validated. The purpose of this study was to assess the performance of five immunoassays (two ELISA and three CLIA assays) and one rapid immunochromatographic test for the detection of anti-SARS-CoV-2 antibodies. METHODS Five semiquantitative immunoassays (MENARINI®, PALEX®, VIRCLIA®, ROCHE® and SIEMENS®) and one lateral flow rapid test (WONDFO®) were performed. A total of 124 samples were studied. Case serum samples (n=78) were obtained from COVID-19 patients confirmed by real-time RT-PCR/epidemiological-clinical-radiological criteria, and control non-SARS-CoV-2 samples (n=46) belonged to healthy healthcare workers involved in a seroprevalence study. RESULTS Overall, the tests showed sensitivities around 70-90% and specificities greater than 95%, including the immunochromatographic test. In addition, we observed very good agreements among them, being better for the detection of IgG than for IgM antibodies (Cohen's kappa index of 0.95 for VIRCLIA® IgG with ROCHE®), as well as good diagnostic power of the tests as determined by the ROC curves. CONCLUSIONS This study demonstrates the proper performance of the different immunoassays in order to be applied in the clinical practice as support in the diagnostic approach and in the development of vaccines and seroepidemiological studies of COVID-19.
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Affiliation(s)
- Silvia Montolio Breva
- Laboratori Clínic ICS Camp de Tarragona - Terres de l'Ebre - Hospital Universitari Joan XXIII, Tarragona, Spain.
| | - Carmen Molina Clavero
- Laboratori Clínic ICS Camp de Tarragona - Terres de l'Ebre - Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Frederic Gómez Bertomeu
- Laboratori Clínic ICS Camp de Tarragona - Terres de l'Ebre - Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Ester Picó-Plana
- Laboratori Clínic ICS Camp de Tarragona - Terres de l'Ebre - Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Núria Serrat Orús
- Laboratori Clínic ICS Camp de Tarragona - Terres de l'Ebre - Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Inmaculada Palau Sánchez
- Laboratori Clínic ICS Camp de Tarragona - Terres de l'Ebre - Hospital Universitari Joan XXIII, Tarragona, Spain
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Evaluation of two rapid antigen tests to detect SARS-CoV-2 in a hospital setting. Med Microbiol Immunol 2021; 210:65-72. [PMID: 33452927 PMCID: PMC7811156 DOI: 10.1007/s00430-020-00698-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/16/2020] [Indexed: 12/12/2022]
Abstract
Successful containment strategies for the SARS-CoV-2 pandemic will depend on reliable diagnostic assays. Point-of-care antigen tests (POCT) may provide an alternative to time-consuming PCR tests to rapidly screen for acute infections on site. Here, we evaluated two SARS-CoV-2 antigen tests: the STANDARD™ F COVID-19 Ag FIA (FIA) and the SARS-CoV-2 Rapid Antigen Test (RAT). For diagnostic assessment, we used a large set of PCR-positive and PCR-negative respiratory swabs from asymptomatic and symptomatic patients and health care workers in the setting of two University Hospitals in Munich, Germany, i.e. emergency rooms, patient care units or employee test centers. For FIA, overall clinical sensitivity and specificity were 45.4% (n = 381) and 97.8% (n = 360), respectively, and for RAT, 50.3% (n = 445) and 97.7% (n = 386), respectively. For primary diagnosis of asymptomatic and symptomatic individuals, diagnostic sensitivities were 60.9% (FIA) (n = 189) and 64.5% (RAT) (n = 256). This questions these tests' utility for the reliable detection of acute SARS-CoV-2-infected individuals, in particular in high-risk settings. We support the proposal that convincing high-quality outcome data on the impact of false-negative and false-positive antigen test results need to be obtained in a POCT setting. Moreover, the efficacy of alternative testing strategies to complement PCR assays must be evaluated by independent laboratories, prior to widespread implementation in national and international test strategies.
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