Performance Analysis of Self-Collected Nasal and Oral Swabs for Detection of SARS-CoV-2

Effectiveness of Frequent Point-of-Care Molecular COVID-19 Surveillance in a Rural Workplace: Nonrandomized Controlled Clinical Trial Among Miners

Background

Numerous studies have assessed the risk of SARS-CoV-2 exposure and infection among health care workers during the pandemic. However, far fewer studies have investigated the impact of SARS-CoV-2 on essential workers in other sectors. Moreover, guidance for maintaining a safely operating workplace in sectors outside of health care remains limited. Workplace surveillance has been recommended by the Centers for Disease Control and Prevention, but few studies have examined the feasibility or effectiveness of this approach.

Objective

The objective of this study was to investigate the feasibility and effectiveness of using frequent point-of-care molecular workplace surveillance as an intervention strategy to prevent the spread of SARS-CoV-2 at essential rural workplaces (mining sites) where physical distancing, remote work, and flexible schedules are not possible.

Methods

In this nonrandomized controlled clinical trial conducted from February 2021, to March 2022, 169 miners in New Mexico (intervention cohort) and 61 miners in Wyoming (control cohort) were enrolled. Investigators performed point-of-care rapid antigen testing on midnasal swabs (NSs) self-collected by intervention miners. Our first outcome was the intervention acceptance rate in the intervention cohort. Our second outcome was the rate of cumulative postbaseline seropositivity to SARS-CoV-2 nucleocapsid protein, which was analyzed in the intervention cohort and compared to the control cohort between baseline and 12 months. The diagnostic accuracy of detecting SARS-CoV-2 using rapid antigen testing on NSs was compared to laboratory-based reverse transcriptase polymerase chain reaction (RT-PCR) on nasopharyngeal swabs (NPSs) in a subset of 68 samples.

Results

Our intervention had a mean acceptance rate of 96.4% (11,413/11,842). The intervention miners exhibited a lower cumulative postbaseline incident seropositivity at 12 months compared to control miners (14/97, 14% vs 17/45, 38%; P=.002). Analysis of SARS-CoV-2 antigen detection in self-administered NSs revealed 100% sensitivity and specificity compared to laboratory-based RT-PCR testing on NPSs.

Conclusions

Our findings establish frequent point-of-care molecular workplace COVID-19 surveillance as a feasible option for keeping essential rural workplaces open and preventing SARS-CoV-2 spread. These findings extend beyond this study, providing valuable insights for designing interventions to maintain employees' safety at other essential workplaces during an infectious disease outbreak.

Herpesviruses and SARS-CoV-2: Viral Association with Oral Inflammatory Diseases

The oral cavity is a niche for diverse microbes, including viruses. Members of the Herpesviridae family, comprised of dsDNA viruses, as well as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an ssRNA virus, are among the most prevalent viruses infecting the oral cavity, and they exhibit clinical manifestations unique to oral tissues. Viral infection of oral mucosal epithelia triggers an immune response that results in prolonged inflammation. The clinical and systemic disease manifestations of HHV have been researched extensively, and several recent studies have illuminated the relationship between HHV and oral inflammatory diseases. Burgeoning evidence suggests the oral manifestation of SARS-CoV-2 infection includes xerostomia, dysgeusia, periodontal disease, mucositis, and opportunistic viral and bacterial infections, collectively described as oral post-acute sequelae of COVID-19 (PASC). These diverse sequelae could be a result of intensified immune responses initially due to the copious production of proinflammatory cytokines: the so-called "cytokine storm syndrome", facilitating widespread oral and non-oral tissue damage. This review explores the interplay between HHV, SARS-CoV-2, and oral inflammatory diseases such as periodontitis, endodontic disease, and peri-implantitis. Additionally, the review discusses proper diagnostic techniques for identifying viral infection and how viral diagnostics can lead to improved overall patient health.

Evaluation of Four Rapid Antigen Tests for the Detection of SARS-CoV-2 Infection with Nasopharyngeal Swabs

Owing to the high transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, the capacity of testing systems based on the gold standard real-time reverse transcription–polymerase chain reaction (rRT-PCR) is limited. Rapid antigen tests (RATs) can substantially contribute to the prevention of community transmission, but their further assessment is required. Here, using 1503 nasopharyngeal swabs, we compared the diagnostic performance of four RAT kits (Abbott Panbio™ COVID-19 Ag Rapid Test, SD Biosensor Standard™ Q COVID-19 Ag Test, Humasis COVID-19 Ag Test, and SG Medical Acrosis COVID-19 Ag Test) to the cycle threshold (Ct) values obtained from rRT-PCR. The precision values, area under the curve values, SARS-CoV-2 variant detection ability, and non-SARS-CoV-2 specificity of all four kits were similar. An assay using the Acrosis kit had a significantly better positive detection rate with a higher recall value and cut-off value than that using the other three RAT kits. During the current COVID-19 pandemic, the Acrosis kit is an effective tool to prevent the spread of SARS-CoV-2 in communities.