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McCracken GR, Patriquin G, Hatchette TF, Davidson RJ, Goodall B, Barrett L, MacDonald J, Heinstein C, Pettipas J, Ross J, LeBlanc JJ. Taqman PACMAN: a simple molecular approach for positive rapid antigen test confirmation during periods of low prevalence. Microbiol Spectr 2024; 12:e0407323. [PMID: 38567975 DOI: 10.1128/spectrum.04073-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/13/2024] [Indexed: 05/03/2024] Open
Abstract
Antigen-based rapid diagnostic tests (Ag-RDTs) were widely deployed to enhance SARS-CoV-2 testing capacity during the COVID-19 pandemic. Consistent with national guidance for low prevalence settings, positive Ag-RDTs were confirmed using nucleic acid amplification tests (NAATs) to avoid false positive results. However, increasing demands for positive Ag-RDT confirmation competed with other testing priorities in clinical laboratories. This work hypothesized that real-time RT-PCR without nucleic acid extraction (NAE) would be sufficiently sensitive to support positive Ag-RDT confirmation. Ag-RDT and NAAT results from community-based asymptomatic testing sites prior to the omicron variant wave were compared to calculate the weekly false positive rate (FPR) and false detection rate (FDR). Real-time RT-PCR was compared with and without NAE using 752 specimens previously tested positive for SARS-CoV-2 using commercial NAATs and 344 specimens from Ag-RDT-positive individuals. The impact of SARS-CoV-2 prevalence on laboratory resources required to sustain Ag-RDT confirmation was modeled for the RT-PCR with and without NAE. Overall, FPR was low [0.07% (222/330,763)] in asymptomatic testing sites, but FDR was high [30.7% (222/724)]. When RT-PCR was compared with and without NAE, 100% concordance was obtained with NAAT-positive specimens, including those from Ag-RDT-positive individuals. NAE-free RT-PCR significantly reduced time to results, human resources, and overall costs. A 30.7% FDR reaffirms the need for NAAT-based confirmation of positive Ag-RDT results during low SARS-CoV-2 prevalence. NAE-free RT-PCR was shown to be a simple and cost-sparing NAAT-based solution for positive Ag-RDT confirmation, and its implementation supported data-driven broader Ag-RDT deployment into communities, workplaces, and households. IMPORTANCE Rapid antigen testing for SARS-CoV-2 was widely deployed during the COVID-19 pandemic. In settings of low prevalence, national guidance recommends that positive antigen test results be confirmed with molecular testing. Given the high testing burden on clinical laboratories during the COVID-19 pandemic, the high volume of positive antigen tests submitted for confirmatory testing posed challenges for laboratory workflow. This study demonstrated that a simple PCR method without prior nucleic acid purification is an accurate and cost-effective solution for positive rapid antigen test confirmation. Implementing this method allowed molecular confirmatory testing for positive antigen tests to be sustained as antigen testing was expanded into large populations such as workplaces, schools, and households.
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Affiliation(s)
- Gregory R McCracken
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Glenn Patriquin
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Todd F Hatchette
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ross J Davidson
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Barbara Goodall
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lisa Barrett
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - James MacDonald
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Charles Heinstein
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Janice Pettipas
- Nova Scotia Provincial Public Health Laboratory Network (PPHLN), Halifax, Nova Scotia, Canada
| | - John Ross
- Praxes Medical Group, Halifax, Nova Scotia, Canada
| | - Jason J LeBlanc
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Simms E, McCracken GR, Hatchette TF, McNeil SA, Davis I, Whelan N, Keenan A, LeBlanc JJ, Patriquin G. Real-world evaluation of the Lucira Check-It COVID-19 loop-mediated amplification (LAMP) test. Microbiol Spectr 2023; 11:e0277223. [PMID: 37962351 PMCID: PMC10714936 DOI: 10.1128/spectrum.02772-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/29/2023] [Indexed: 11/15/2023] Open
Abstract
IMPORTANCE In hospitals during the COVID-19 pandemic, laboratory testing was important to reduce SARS-CoV-2 transmissions, while facilitating patient flow in the emergency department and pre-operative settings, and allowing for the safe return to work of exposed healthcare workers. Delayed test results from laboratory nucleic acid amplification tests (NAATs) posed a barrier to maximizing efficient patient flow and minimizing staffing shortages. This quality improvement project sought to evaluate the analytical and clinical performance of the Lucira Check-It COVID-19 Test, a point-of-care test that used NAAT technology, in the perioperative setting, emergency department, and community testing sites. We found the Lucira Check-It to have comparable performance to laboratory NAATs. It can be employed with little training for specimen collection, processing, and interpretation, and at a cost justifiable from the resources saved from avoiding sample transport and laboratory testing.
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Affiliation(s)
- Elizabeth Simms
- Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Gregory R. McCracken
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Todd F. Hatchette
- Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Shelly A. McNeil
- Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ian Davis
- Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Noella Whelan
- COVID-19 Implementation and Planning, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Angela Keenan
- Occupational Health Safety & Wellness, People Services, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Jason J. LeBlanc
- Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Glenn Patriquin
- Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
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McCracken GR, Gaston D, Pettipas J, Loder A, Majer A, Grudeski E, Labbé G, Joy BK, Patriquin G, LeBlanc JJ. Neglected SARS-CoV-2 variants and potential concerns for molecular diagnostics: a framework for nucleic acid amplification test target site quality assurance. Microbiol Spectr 2023; 11:e0076123. [PMID: 37815347 PMCID: PMC10715164 DOI: 10.1128/spectrum.00761-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/02/2023] [Indexed: 10/11/2023] Open
Abstract
IMPORTANCE Molecular tests like polymerase chain reaction were widely used during the COVID-19 pandemic but as the pandemic evolved, so did SARS-CoV-2. This virus acquired mutations, prompting concerns that mutations could compromise molecular test results and be falsely negative. While some manufacturers may have in-house programs for monitoring mutations that could impact their assay performance, it is important to promptly report mutations in circulating viral strains that could adversely impact a diagnostic test result. However, commercial test target sites are proprietary, making independent monitoring difficult. In this study, SARS-CoV-2 test target sites were sequenced to monitor and assess mutations impact, and 29 novel mutations impacting SARS-CoV-2 detection were identified. This framework for molecular test target site quality assurance could be adapted to any molecular test, ensuring accurate diagnostic test results and disease diagnoses.
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Affiliation(s)
- Gregory R. McCracken
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health (NSH), Halifax, Nova Scotia, Canada
| | - Daniel Gaston
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Hematopathology, Department of Pathology and Laboratory Medicine, Nova Scotia Health (NSH), Halifax, Nova Scotia, Canada
| | - Janice Pettipas
- Nova Scotia Provincial Public Health Laboratory Network (PPHLN), Halifax, Nova Scotia, Canada
| | - Allana Loder
- National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - Anna Majer
- National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - Elsie Grudeski
- National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - Geneviève Labbé
- National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - Bryn K. Joy
- Medical Sciences Program, Faculty of Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Glenn Patriquin
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health (NSH), Halifax, Nova Scotia, Canada
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jason J. LeBlanc
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health (NSH), Halifax, Nova Scotia, Canada
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine (Infectious Diseases), Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Joy BK, Donovan AL, McCracken GR, Pettipas J, Grudeski E, Majer A, Mandes R, Booth TF, Hatchette TF, Patriquin G, LeBlanc JJ. Hunting for mpox (monkeypox) mimickers: Use of the Biofire meningitis/encephalitis panel on lesion swabs to support alternative viral diagnoses. J Clin Virol 2023; 159:105356. [PMID: 36608619 PMCID: PMC9789924 DOI: 10.1016/j.jcv.2022.105356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/08/2022] [Accepted: 12/18/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND Mpox (formerly monkeypox) is an emerging zoonotic disease of public health concern that presents as a rash mimicking other common viral exanthems. Unlike traditional testing algorithms relying on several assays, the BioFire FilmArray meningitis/encephalitis (ME) panel simultaneously detects common viruses causing rashes; however, Biofire ME is only licensed for testing on cerebral spinal fluid. OBJECTIVES This study evaluated use of the Biofire ME panel for detection and discrimination of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), varicella zoster virus (VZV), human herpesviruses type 6 (HHV-6), enteroviruses (EVs), and human paraechoviruses (HPeVs) from a dermal or mucocutaneous swabs collected in universal transport media (UTM). STUDY DESIGN Results of the BioFire ME panel were compared against methods used during clinical testing. Ten-fold serial dilutions in UTM of cultured viruses were used to compare analytical sensitivity, and analytical specificity was assessed using panels of microorganisms in UTM. Clinical sensitivity and specificity were assessed using 20 positive specimens each for HHV-1, HHV-2, HHV-6, VZV, EVs, and HPeV, as well as 35 known negative specimens that included 15 mpox-positive specimens. RESULTS Biofire ME was as sensitive as comparator methods, and correctly discriminated all HSV-1, HSV-2, VZV, HHV-6, EVs, and HPeVs from mpox and mpox-mimickers. Cross-reaction between EV and rhinoviruses A, B, and C were noted in the specificity panel. CONCLUSIONS Swabs in UTM collected for mpox testing are suitable for use on the Biofire ME panel, allowing more streamlined diagnostic testing for viral exanthems in patients under investigation for mpox infection.
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Affiliation(s)
- Bryn K. Joy
- Medical Sciences Program, Faculty of Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Alexis L. Donovan
- School of Medicine, Royal College of Surgeons in Ireland (RSCI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Gregory R. McCracken
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Janice Pettipas
- Nova Scotia Provincial Public Health Laboratory Network (PPHLN), Halifax, Nova Scotia, Canada
| | - Elsie Grudeski
- Enteroviruses and Enteric Viruses Laboratory, National Microbiology Laboratory (NML), Winnipeg, Manitoba, Canada
| | - Anna Majer
- Enteroviruses and Enteric Viruses Laboratory, National Microbiology Laboratory (NML), Winnipeg, Manitoba, Canada
| | - Russell Mandes
- Enteroviruses and Enteric Viruses Laboratory, National Microbiology Laboratory (NML), Winnipeg, Manitoba, Canada
| | - Tim F. Booth
- Enteroviruses and Enteric Viruses Laboratory, National Microbiology Laboratory (NML), Winnipeg, Manitoba, Canada
| | - Todd F. Hatchette
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada,Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada,Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Glenn Patriquin
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada,Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jason J. LeBlanc
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada,Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada,Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada.,Corresponding author at: Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health (NSH), Room 404B, MacKenzie Building, 5788 University Avenue, Halifax, Nova Scotia, B3H 1V8, Canada
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Tosif S, Lee LY, Nguyen J, McMinn A, Selman C, Grobler AC, Daley A, Crawford NW. Stick with the nose…Saliva rapid antigen testing is not a viable method for testing children under 5 years old. J Paediatr Child Health 2023; 59:258-263. [PMID: 36401338 PMCID: PMC10100334 DOI: 10.1111/jpc.16277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/21/2022]
Abstract
AIM Respiratory testing with rapid antigen tests (RATs) in children under 5 years of age may be uncomfortable and presents specific challenges to testing due to compliance and procedural distress. The aim of this study was to investigate sensitivity and feasibility of self-collected nasal and saliva RAT tests compared with a combined nose and throat (CTN) swab PCR in children under 5. METHODS Children aged between 1 month and 5 years, with confirmed COVID-19 or who were a household contact within 7 days were included. A saliva RAT, nasal RAT and CTN swab were collected by the parent. SARS-CoV-2 cycle threshold (Ct) values for CTN tested by PCR were compared with saliva and nasal RAT results. Parent preference for method of sample was recorded. RESULTS Forty-one children were recruited with median age of 1.5 (interquartile range 0.7-4.0) years. Only 22/41 (54%) of parents were able to successfully collect a saliva RAT from their child. Sensitivity of the nasal RAT and saliva RAT was 0.889 (95% confidence interval (CI) 0.739-0.969) and 0.158 (95% CI 0.034-0.396), respectively. Upper limit of nasal RAT detection by CTN Ct value was higher than saliva (36.05 vs. 27.29). While saliva RAT was rated most comfortable, nasal RAT was rated the preferred specimen by parents for future testing, due to saliva collection difficulties and time taken. CONCLUSIONS Rapid antigen testing with nasal RAT is a more feasible and sensitive method for SARS-CoV-2 detection in young children compared with saliva RAT.
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Affiliation(s)
- Shidan Tosif
- Department of General Medicine & Immunisation Service, Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.,Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lai-Yang Lee
- Department of Microbiology, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Jill Nguyen
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Alissa McMinn
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Chris Selman
- Clinical Epidemiology & Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Anneke C Grobler
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,Clinical Epidemiology & Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Andrew Daley
- Department of Microbiology, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Nigel W Crawford
- Department of General Medicine & Immunisation Service, Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.,Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
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Cooper L, Eckert K, Mann J, Montalvo R, Castillo L, Fellows D, Young S. Accuracy of an antigen-detecting SARS-CoV-2 assay with self- and provider-collected specimens interpreted visually and with BD Veritor™ Plus analyzer. J Clin Virol Plus 2023; 3:100140. [PMID: 36683609 PMCID: PMC9846876 DOI: 10.1016/j.jcvp.2023.100140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023] Open
Abstract
Background SARS-CoV-2 rapid antigen tests (RATs) are in high demand for reducing the spread of SARS-CoV-2. Reduced involvement from health care professionals (HCPs) for collection and interpretation could significantly foster the wide-spread implementation of RATs, but data evaluating RATs, when used by lay people, is limited. Objective To valuate agreement between BD Veritor test results for self- and HCP-collected specimens, and visually- and analyzer-interpreted results. Methods Individuals with onset of COVID-19 symptoms within five days of enrollment had three nasal swabs collected; one self-collected and the other two HCP-collected. One HCP-collected swab was stored for future testing while the order of the other two (self and HCP) was randomized before testing. with the BD Veritor System for Rapid Detection of SARS-CoV-2. Results were first assessed visually, followed by interpretation with the analyzer. Results When self-collection was compared to HCP collection for SARS-CoV-2 detection, interpretation by analyzer resulted in positive percent agreement (PPA) of 94.7% (95% CI 82.7, 98.5) and negative percent agreement (NPA) of 99.0% (95% CI 97.5, 99.6). When visual interpretation was compared to analyzer-read results, collection by HCPs had a PPA of 97.4% (95% CI 86.5, 99.5) and NPA of 99.8% (95% CI 98.6, 100.0) while self-collection resulted in PPA of 94.9% (95% CI 83.1, 98.6) and NPA of 99.8% (95% CI 98.6, 100). Conclusions Similar PPA and NPA were observed for self- and HCP-collected specimens as well as visually- and analyzer-interpreted tests. The equivalence in performance supports the use of expanded collection and testing methods.
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Affiliation(s)
- Lauren Cooper
- Becton Dickinson and Company, Integrated Diagnostic Solutions, 7 Loveton Circle, Sparks, MD, USA,Corresponding author at: Scientific Affairs, Becton, Dickinson and Company, BD Life Sciences, Integrated Diagnostic Solutions (IDS), 7 Loveton Circle, Sparks, MD 21152, USA
| | - Karen Eckert
- Becton Dickinson and Company, Integrated Diagnostic Solutions, 7 Loveton Circle, Sparks, MD, USA
| | - Joseph Mann
- Becton Dickinson and Company, Integrated Diagnostic Solutions, 7 Loveton Circle, Sparks, MD, USA
| | - Rossmeri Montalvo
- CTMD Research, 2328 S. Congress Ave, Suite 1-C, Palm Springs, FL, USA
| | - Luis Castillo
- CTMD Research, 2328 S. Congress Ave, Suite 1-C, Palm Springs, FL, USA
| | - Dwan Fellows
- Fellows Research Alliance, Inc., 1 Oglethorpe Professional Blvd #204, Savannah, GA, USA
| | - Stephen Young
- TriCore Reference Laboratories, 1001 Woodward Place NE, Albuquerque, NM, USA
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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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Lübke N, Repges K, Menne C, Walker A, Jensen BO, Freise NF, Gliga S, Eickhoff SB, Bosse HM, Adams O, Timm J. Quantitative analysis of different respiratory specimens on two automated test systems for detection of SARS-CoV-2 RNA. Diagn Microbiol Infect Dis 2023; 105:115800. [PMID: 36252283 DOI: 10.1016/j.diagmicrobio.2022.115800] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/12/2022] [Accepted: 08/20/2022] [Indexed: 12/04/2022]
Abstract
Molecular testing of SARS-CoV-2 RNA is essential during the pandemic. Here, we compared the results of different respiratory specimens including anterior nasal swabs, pharyngeal swabs, saliva swabs, and gargle lavage samples to nasopharyngeal swabs on two automated SARS-CoV-2 test systems. Samples were collected and tested simultaneously from a total of 36 hospitalized symptomatic COVID-19 patients. Detection and quantification of SARS-CoV-2 was performed on cobas®6800 (Roche) and NeuMoDx™ (Qiagen) systems. Both assays showed reliable detection and quantification of SARS-CoV-2 RNA, with nasopharyngeal swabs showing the highest sensitivity. SARS-CoV-2 RNA concentrations in other respiratory specimens were lower (mean 2.5 log10 copies/ml) or even undetectable in up to 20%. These data clearly indicate that not all respiratory materials are equally suitable for the management of hospitalized patients, especially, in the late phase of COVID-19, when the viral phase subsides and inflammation becomes the predominant factor, making detection of even lower viral loads increasingly important.
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Bouska O, Jaworek H, Koudelakova V, Kubanova K, Dzubak P, Slavkovsky R, Siska B, Pavlis P, Vrbkova J, Hajduch M. Evaluation of Non-Invasive Gargle Lavage Sampling for the Detection of SARS-CoV-2 Using rRT-PCR or Antigen Assay. Viruses 2022; 14. [PMID: 36560833 DOI: 10.3390/v14122829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/09/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused considerable disruption worldwide. For efficient SARS-CoV-2 detection, new methods of rapid, non-invasive sampling are needed. This study aimed to investigate the stability of SARS-CoV-2 in a novel medium for gargle-lavage (GL) self-sampling and to compare the performance of SARS-CoV-2 detection in paired self-collected GL and clinician-obtained nasopharyngeal swab (NPS) samples. The stability study for SARS-CoV-2 preservation in a novel medium was performed over 14 days (4 °C, 24-27 °C, and 37 °C). In total, 494 paired GL and NPS samples were obtained at the University Hospital in Olomouc in April 2021. SARS-CoV-2 detection in paired samples was performed with a SARS-CoV-2 Nucleic Acid Detection Kit (Zybio, Chongqing Municipality, Chongqing, China), an Elecsys® SARS-CoV-2 Antigen assay (Roche Diagnostics, Mannheim, Germany), and a SARS-CoV-2 Antigen ELISA (EUROIMMUN, Lübeck, Germany). The stability study demonstrated excellent SARS-CoV-2 preservation in the novel medium for 14 days. SARS-CoV-2 was detected in 55.7% of NPS samples and 55.7% of GL samples using rRT-PCR, with an overall agreement of 91.9%. The positive percent agreement (PPA) of the rRT-PCR in the GL samples was 92.7%, and the negative percent agreement (NPA) was 90.9%, compared with the NPS samples. The PPA of the rRT-PCR in the NPS and GL samples was 93.2% when all positive tests were used as the reference standard. Both antigen detection assays showed poor sensitivity compared to rRT-PCR (33.2% and 36.0%). rRT-PCR SARS-CoV-2 detection in self-collected GL samples had a similar PPA and NPA to that of NPSs. GL self-sampling offers a suitable and more comfortable alternative for SARS-CoV-2 detection.
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10
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Moser C, Li JZ, Eron JJ, Aga E, Daar ES, Wohl DA, Coombs RW, Javan AC, Bender Ignacio RA, Jagannathan P, Ritz J, Sieg SF, Parikh UM, Hughes MD, Currier JS, Smith DM, Chew KW. Predictors of SARS-CoV-2 RNA From Nasopharyngeal Swabs and Concordance With Other Compartments in Nonhospitalized Adults With Mild to Moderate COVID-19. Open Forum Infect Dis 2022; 9:ofac618. [PMID: 36467293 PMCID: PMC9709705 DOI: 10.1093/ofid/ofac618] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background Identifying characteristics associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA shedding may be useful to understand viral compartmentalization, disease pathogenesis, and risks for viral transmission. Methods Participants were enrolled August 2020 to February 2021 in ACTIV-2/A5401, a placebo-controlled platform trial evaluating investigational therapies for mild-to-moderate coronavirus disease 2019 (COVID-19), and underwent quantitative SARS-CoV-2 RNA testing on nasopharyngeal and anterior nasal swabs, oral wash/saliva, and plasma at entry (day 0, pretreatment) and days 3, 7, 14, and 28. Concordance of RNA levels (copies/mL) across compartments and predictors of nasopharyngeal RNA levels were assessed at entry (n = 537). Predictors of changes over time were evaluated among placebo recipients (n = 265) with censored linear regression models. Results Nasopharyngeal and anterior nasal RNA levels at study entry were highly correlated (r = 0.84); higher levels of both were associated with greater detection of RNA in plasma and oral wash/saliva. Older age, White non-Hispanic race/ethnicity, lower body mass index (BMI), SARS-CoV-2 immunoglobulin G seronegativity, and shorter prior symptom duration were associated with higher nasopharyngeal RNA at entry. In adjusted models, body mass index and race/ethnicity associations were attenuated, but the association with age remained (for every 10 years older, mean nasopharyngeal RNA was 0.27 log10 copies/mL higher; P < .001). Examining longitudinal viral RNA levels among placebo recipients, women had faster declines in nasopharyngeal RNA than men (mean change, -2.0 vs -1.3 log10 copies/mL, entry to day 3; P < .001). Conclusions SARS-CoV-2 RNA shedding was concordant across compartments. Age was strongly associated with viral shedding, and men had slower viral clearance than women, which could explain sex differences in acute COVID-19 outcomes.
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Affiliation(s)
- Carlee Moser
- Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jonathan Z Li
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Joseph J Eron
- Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Evgenia Aga
- Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Eric S Daar
- Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California, USA
| | - David A Wohl
- Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Robert W Coombs
- Department of Laboratory Medicine and Pathology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | | | - Rachel A Bender Ignacio
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Vaccine and Infectious Disease Division, Fred Hutch Cancer Center, Seattle, Washington, USA
| | | | - Justin Ritz
- Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Scott F Sieg
- Department of Medicine, Case Western University, Cleveland, Ohio, USA
| | - Urvi M Parikh
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael D Hughes
- Department of Biostatistics and Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Judith S Currier
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
| | - Davey M Smith
- Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Kara W Chew
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
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11
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McCallum MK, Patriquin G, Davis IR, MacDonald T, Gaston D, LeBlanc JJ, Shabi Y, Johnston BL. Factors contributing to a coronavirus disease 2019 (COVID-19) outbreak on a mixed medical-surgical unit in a Canadian acute-care hospital. Antimicrob Steward Healthc Epidemiol 2022; 2:e151. [PMID: 36483428 PMCID: PMC9726552 DOI: 10.1017/ash.2022.288] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To identify preventable factors that contribute to the cross transmission of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) to patients in healthcare facilities. DESIGN A case-control study was conducted among inpatients on a coronavirus disease 2019 (COVID-19) outbreak unit. SETTING This study was conducted in a medical-surgical unit of a tertiary-care hospital in Nova Scotia in May 2021. PATIENTS Patients hospitalized on the unit for at least 12 hours and healthcare workers (HCW) working on the unit within 2 weeks of outbreak declaration were included. METHODS Risk factors for SARS-CoV-2 infection were analyzed using simple and multiple logistic regression. Whole-genome sequencing (WGS) was performed to identify SARS-CoV-2 strain relatedness. Network analysis was used to describe patient accommodation. RESULTS SARS-CoV-2 infections were identified in 21 patients (29.6%) and 11 HCWs (6.6%). WGS data revealed 4 distinct clades of related sequences. Several factors likely contributed to the outbreak, including failure to identify SARS-CoV-2, a largely incomplete or unvaccinated population, and patient wandering behaviors. The most significant risk factor for SARS-CoV-2 infection was room sharing with an infectious patient, which was the only factor that remained statistically significant following multivariate analysis (odds ratio [OR], 9.2l; 95% confidence interval [CI], 2.04-41.67; P = .004). CONCLUSIONS This outbreak likely resulted from admission of 2 patients with COVID-19, with subsequent transmissions to 17 patients and 11 staff. WGS and bioinformatics analyses were critical to identifying previously unrecognized nosocomial transmissions of SARS-CoV-2. This study supports strategies to reduce nosocomial transmissions of SARS-CoV-2, such as single-patient rooms, promotion of COVID-19 vaccination, and infection prevention and control measures including management of wandering behaviors.
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Affiliation(s)
- Megan K. McCallum
- Infection Prevention and Control, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Glenn Patriquin
- Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine, Nova Scotia Health and Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ian R.C. Davis
- Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine, Nova Scotia Health and Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Tammy MacDonald
- Infection Prevention and Control, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Daniel Gaston
- Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jason J. LeBlanc
- Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine, Nova Scotia Health and Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Yahya Shabi
- Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - B. Lynn Johnston
- Department of Medicine, Nova Scotia Health and Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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12
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Goodall BL, LeBlanc JJ, Hatchette TF, Barrett L, Patriquin G. Investigating the Sensitivity of Nasal or Throat Swabs: Combination of Both Swabs Increases the Sensitivity of SARS-CoV-2 Rapid Antigen Tests. Microbiol Spectr 2022; 10:e0021722. [PMID: 35762772 PMCID: PMC9430836 DOI: 10.1128/spectrum.00217-22] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/04/2022] [Indexed: 01/05/2023] Open
Abstract
The COVID-19 pandemic has been hallmarked by several waves of variants of concern (VoCs), each with novel challenges. Currently, the highly transmissible Omicron VoC is predominant worldwide, and sore throat is common, among other cold-like symptoms. Anecdotes on social media have suggested that sampling one's throat can increase the sensitivity for Omicron detection by antigen-based rapid testing devices (Ag-RDTs). This work aimed to improve the local testing strategy and determine whether the sensitivity of Ag-RDTs designed for nasal sampling is altered with the use of self-administered throat swabs in self-perceived asymptomatic individuals. This investigation used a common Ag-RDT (i.e., Abbott Panbio COVID-19 Ag rapid test device) to compare three sampling sites: nasal swab, throat swab, and combined nasal/throat. All Ag-RDT results were confirmed with molecular testing from residual test buffer. Compared to reverse transcriptase PCR (RT-PCR), samples from nasal or throat swabs each detected 64.5% of SARS-CoV-2 cases; however, combining the contributions of each swab increased the positive percent agreement (PPA) with RT-PCR to 88.7%. This trend was also evident with the Rapid Response Ag-RDT (BTNX), which uses more flexible swabs than does the Panbio. When nasal swab collection was compared to paired sampling of the nose/throat using a single swab with the Panbio Ag-RDT, the PPAs were 68.4% and 81.6%, respectively. No false-positive results were observed with nasal, throat, or combined nasal/throat sampling. Self-administered throat and nasal/throat swabs both had >90% acceptability. These findings support the use of self-collected combined nasal/throat sampling for Ag-RDT-based SARS-CoV-2 detection in self-perceived asymptomatic individuals. IMPORTANCE This quality project demonstrates that combining the results of nasal and throat swabs or using a combined single swab of the throat and nares resulted in increased detection of SARS-CoV-2 using a rapid antigen test, in an asymptomatic population. Importantly, no false positives were detected, and over 90% of people were willing to perform the combination swab. These types of projects are instrumental in informing local practices to improve testing strategies. These data support the option of using a combined nasal/throat swab in our local setting to enhance the detection of Omicron.
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Affiliation(s)
- Barbara L. Goodall
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jason J. LeBlanc
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Todd F. Hatchette
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lisa Barrett
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Glenn Patriquin
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
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13
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Kratzer B, Schlax LC, Gattinger P, Waidhofer‐Söllner P, Trapin D, Tauber PA, Sehgal ANA, Körmöczi U, Rottal A, Feichter M, Oberhofer T, Grabmeier‐Pfistershammer K, Borochova K, Dorofeeva Y, Tulaeva I, Weber M, Mühl B, Kropfmüller A, Negrin B, Kundi M, Valenta R, Pickl WF. Combined assessment of S- and N-specific IL-2 and IL-13 secretion and CD69 neo-expression for discrimination of post-infection and post-vaccination cellular SARS-CoV-2-specific immune response. Allergy 2022; 77:3408-3425. [PMID: 35690994 PMCID: PMC9348018 DOI: 10.1111/all.15406] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/20/2022] [Accepted: 05/30/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Antibody-based tests are available for measuring SARS-CoV-2-specific immune responses but fast T-cell assays remain scarce. Robust T cell-based tests are needed to differentiate specific cellular immune responses after infection from those after vaccination. METHODS One hundred seventeen individuals (COVID-19 convalescent patients: n = 40; SARS-CoV-2 vaccinees: n = 41; healthy controls: n = 36) were evaluated for SARS-CoV-2-specific cellular immune responses (proliferation, Th1, Th2, Th17, and inflammatory cytokines, activation-induced marker [AIM] expression) by incubating purified peripheral blood mononuclear cells (PBMC) or whole blood (WB) with SARS-CoV-2 peptides (S, N, or M), vaccine antigens (tetanus toxoid, tick borne encephalitis virus) or polyclonal stimuli (Staphylococcal enterotoxin, phytohemagglutinin). RESULTS N-peptide mix stimulation of WB identified the combination of IL-2 and IL-13 secretion as superior to IFN-γ secretion to discriminate between COVID-19-convalescent patients and healthy controls (p < .0001). Comparable results were obtained with M- or S-peptides, the latter almost comparably recalled IL-2, IFN-γ, and IL-13 responses in WB of vaccinees. Analysis 10 months as opposed to 10 weeks after COVID-19, but not allergic disease status, positively correlated with IL-13 recall responses. WB cytokine responses correlated with cytokine and proliferation responses of PBMC. Antigen-induced neo-expression of the C-type lectin CD69 on CD4+ (p < .0001) and CD8+ (p = .0002) T cells informed best about the SARS-CoV-2 exposure status with additional benefit coming from CD25 upregulation. CONCLUSION Along with N- and S-peptide-induced IL-2 and CD69 neo-expression, we suggest to include the type 2 cytokine IL-13 as T-cellular recall marker for SARS-CoV-2 specific T-cellular immune responses after infection and vaccination.
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Affiliation(s)
- Bernhard Kratzer
- Medical University of ViennaCenter for PathophysiologyInfectiology and ImmunologyInstitute of ImmunologyViennaAustria
| | - Larissa C. Schlax
- Medical University of ViennaCenter for PathophysiologyInfectiology and ImmunologyInstitute of ImmunologyViennaAustria
| | - Pia Gattinger
- Medical University of ViennaCenter for Pathophysiology, Infectiology and ImmunologyDepartment of Pathophysiology and Allergy ResearchViennaAustria
| | - Petra Waidhofer‐Söllner
- Medical University of ViennaCenter for PathophysiologyInfectiology and ImmunologyInstitute of ImmunologyViennaAustria
| | - Doris Trapin
- Medical University of ViennaCenter for PathophysiologyInfectiology and ImmunologyInstitute of ImmunologyViennaAustria
| | - Peter A. Tauber
- Medical University of ViennaCenter for PathophysiologyInfectiology and ImmunologyInstitute of ImmunologyViennaAustria
| | - Al Nasar Ahmed Sehgal
- Medical University of ViennaCenter for PathophysiologyInfectiology and ImmunologyInstitute of ImmunologyViennaAustria
| | - Ulrike Körmöczi
- Medical University of ViennaCenter for PathophysiologyInfectiology and ImmunologyInstitute of ImmunologyViennaAustria
| | - Arno Rottal
- Medical University of ViennaCenter for PathophysiologyInfectiology and ImmunologyInstitute of ImmunologyViennaAustria
| | - Melanie Feichter
- Medical University of ViennaCenter for PathophysiologyInfectiology and ImmunologyInstitute of ImmunologyViennaAustria
| | - Teresa Oberhofer
- Medical University of ViennaCenter for PathophysiologyInfectiology and ImmunologyInstitute of ImmunologyViennaAustria
| | | | - Kristina Borochova
- Medical University of ViennaCenter for Pathophysiology, Infectiology and ImmunologyDepartment of Pathophysiology and Allergy ResearchViennaAustria
| | - Yulia Dorofeeva
- Medical University of ViennaCenter for Pathophysiology, Infectiology and ImmunologyDepartment of Pathophysiology and Allergy ResearchViennaAustria
| | - Inna Tulaeva
- Medical University of ViennaCenter for Pathophysiology, Infectiology and ImmunologyDepartment of Pathophysiology and Allergy ResearchViennaAustria,I. M. Sechenov First Moscow State Medical University (Sechenov University)Department of Clinical Immunology and AllergologyLaboratory for ImmunopathologyMoscowRussia
| | - Milena Weber
- Medical University of ViennaCenter for Pathophysiology, Infectiology and ImmunologyDepartment of Pathophysiology and Allergy ResearchViennaAustria
| | | | | | - Bettina Negrin
- Österreichische Gesundheitskasse, Klinikum PeterhofBadenAustria
| | - Michael Kundi
- Medical University of ViennaCenter for Public HealthDepartment for Environmental HealthViennaAustria
| | - Rudolf Valenta
- Medical University of ViennaCenter for Pathophysiology, Infectiology and ImmunologyDepartment of Pathophysiology and Allergy ResearchViennaAustria,I. M. Sechenov First Moscow State Medical University (Sechenov University)Department of Clinical Immunology and AllergologyLaboratory for ImmunopathologyMoscowRussia,NRC Institute of Immunology FMBA of RussiaMoscowRussia,Karl Landsteiner University of Health SciencesKremsAustria
| | - Winfried F. Pickl
- Medical University of ViennaCenter for PathophysiologyInfectiology and ImmunologyInstitute of ImmunologyViennaAustria,Karl Landsteiner University of Health SciencesKremsAustria
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14
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Patriquin G, LeBlanc JJ, Gillis HA, McCracken GR, Pettipas JJ, Hatchette TF. Combined oropharyngeal/nares and nasopharyngeal swab sampling remain effective for molecular detection of SARS-CoV-2 Omicron variant. J Med Microbiol 2022; 71. [PMID: 35671206 DOI: 10.1099/jmm.0.001545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The world has experienced several waves of SARS-CoV-2 variants of concern (VoCs) throughout the COVID-19 pandemic since the first cases in December 2019. The Omicron VoC has increased transmission, compared to its predecessors, and can present with sore throat and other cold-like symptoms. Given the predominance of throat symptoms, and previous work demonstrating better sensitivity using antigen-based rapid detection tests when a throat swab is included in the standard nasal sampling, this quality improvement project sought to ensure ongoing suitability of both combined oropharyngeal/nares (OPN) and nasopharyngeal (NP) swab sampling used throughout the pandemic. Consenting participants meeting Public Health testing criteria (mostly symptomatic or a close contact of a known case) were enrolled, and paired NP and OPN swabs were subjected to nucleic acid amplification testing (NAAT). Comparing paired specimens from 392 participants sensitivity of NP swabs was 89.1 % (95 % CI, 78.8-94.9), and that of OPN was 98.4 % (95 % CI: 90.9->99.9) (P-value 0.052). This project demonstrated that both NP and combined OPN swabs detected the Omicron variant with similar sensitivity by NAAT, supporting the continued use of either swab collection for SARS-CoV-2 molecular detection.
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Affiliation(s)
- Glenn Patriquin
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada.,Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jason J LeBlanc
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada.,Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Holly A Gillis
- Public Health, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Gregory R McCracken
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Janice J Pettipas
- Nova Scotia Provincial Public Health Laboratory Network (PPHLN), Halifax, Nova Scotia, Canada
| | - Todd F Hatchette
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada.,Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
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15
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Lévesque S, Beauchemin S, Vallée M, Longtin J, Jacob-Wagner M, Dumaresq J, Dulcey C, Labbé AC. Evaluation of water gargle samples for SARS-CoV-2 detection using Abbott ID NOW COVID-19 assay. J Med Virol 2022; 94:4522-4527. [PMID: 35535382 PMCID: PMC9348367 DOI: 10.1002/jmv.27847] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/24/2022] [Accepted: 05/07/2022] [Indexed: 11/30/2022]
Abstract
The Abbott ID NOW™ COVID‐19 assay has been shown as a reliable and sensitive alternative to reverse transcription‐polymerase chain reaction (RT‐PCR) testing from nasopharyngeal or nasal samples in symptomatic patients. Water gargle is an acceptable noninvasive alternative specimen for severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) detection by RT‐PCR. The objective of this study was to evaluate the performance of water gargle samples for the detection of SARS‐CoV‐2 using the ID NOW. Residual gargle samples were randomly selected among positive standard of care (SOC)‐nucleic acid amplification test (NAAT) samples. For testing on ID NOW, the manufacturer's instructions were followed, except for the specimen addition step: 500 µl of the gargle specimen was added to the blue sample receiver with a pipette and gently mixed. Among the 202 positive samples by SOC‐NAAT, 185 were positive by ID NOW (positive percent agreement [PPA]) = 91.6% (95% confidence interval [CI]: 86.9−95.0). For the 17 discordant samples, cycle threshold (Ct) values were all ≥31.0. The PPA was significantly lower among asymptomatic patients (84.4%; 95% CI: 73.2−92.3) versus symptomatic patients (95.2%; 95% CI: 89.8−98.2). The performance of the ID NOW for the detection of SARS‐CoV‐2 infection on gargle samples is excellent when Ct values are <31.0 and for patients that have COVID‐19 compatible symptoms.
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Affiliation(s)
- Simon Lévesque
- Service de microbiologie, CIUSSS de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.,Département de microbiologie et infectiologie, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Stéphanie Beauchemin
- Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Maud Vallée
- Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Ste-Anne-de-Bellevue, Québec, Canada
| | - Jean Longtin
- Département de microbiologie et d'infectiologie du centre hospitalier universitaire (CHU) de Québec - Université Laval, Québec, QC, Canada.,Département de microbiologie-infectiologie et d'immunologie, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Mariève Jacob-Wagner
- Département de microbiologie et d'infectiologie du centre hospitalier universitaire (CHU) de Québec - Université Laval, Québec, QC, Canada
| | - Jeannot Dumaresq
- Département de microbiologie et d'infectiologie du centre hospitalier universitaire (CHU) de Québec - Université Laval, Québec, QC, Canada.,Département de Microbiologie et d'Infectiologie, CISSS de Chaudière-Appalaches, Lévis, QC, Canada
| | - Carlos Dulcey
- Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Annie-Claude Labbé
- Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada.,Département de microbiologie, infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada.,Service de maladies infectieuses, CIUSSS de l'Est-de-l'Île-de-Montréal, Montréal, Québec, Canada
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16
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Wang Y, Upadhyay A, Pillai S, Khayambashi P, Tran SD. Saliva as a diagnostic specimen for SARS-CoV-2 detection: a scoping review. Oral Dis 2022; 28 Suppl 2:2362-2390. [PMID: 35445491 PMCID: PMC9115496 DOI: 10.1111/odi.14216] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 03/22/2022] [Accepted: 04/12/2022] [Indexed: 12/03/2022]
Abstract
Objectives This scoping review aims to summarize the diagnostic value of saliva assessed from current studies that (1) compare its performance in reverse transcriptase‐polymerase chain reaction testing to nasopharyngeal swabs, (2) evaluate its performance in rapid and point‐of‐care COVID‐19 diagnostic tests, and (3) explore its use as a specimen for detecting anti‐SARS‐CoV‐2 antibodies. Materials and Methods A systematic search was performed on the following databases: Medline and Embase (Ovid), World Health Organization, Centers for Disease Control and Prevention, and Global Health (Ovid) from January 2019 to September 2021. Of the 657 publications identified from the searches, n = 146 articles were included in the final scoping review. Results Our findings showcase that salivary samples exceed nasopharyngeal swabs in detecting SARS‐CoV‐2 using reverse transcriptase‐polymerase chain reaction testing in several studies. A select number of rapid antigen and point‐of‐care tests from the literature were also identified capable of high detection rates using saliva. Moreover, anti‐SARS‐CoV‐2 antibodies have been shown to be detectable in saliva through biochemical assays. Conclusion We highlight the potential of saliva as an all‐rounded specimen in detecting SARS‐CoV‐2. However, future large‐scale clinical studies will be needed to support its widespread use as a non‐invasive clinical specimen for COVID‐19 testing.
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Kwon J, Ko E, Cho SY, Lee YH, Jun S, Lee K, Hwang E, Vaidya B, Hwang JH, Hwang JH, Kim N, Song MK, Kim HY, Ito D, Lin Y, Jo E, Yang KE, Chung HC, Cha S, Kim DI, Yi YS, Yun SH, Park SC, Lee S, Choi JS, Kim DS, Kim D. Bean Extract-Based Gargle for Efficient Diagnosis of Active COVID-19 Infection Using Rapid Antigen Tests. Microbiol Spectr 2022;:e0161421. [PMID: 35171037 DOI: 10.1128/spectrum.01614-21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 12/13/2022] Open
Abstract
The antigen-based rapid diagnostic test (Ag-RDT) using saliva specimens is fast, noninvasive, and suitable for SARS-CoV-2 self-testing, unlike nasopharyngeal swab (NPS) testing. We evaluated a novel Beanguard gargle (BG)-based virus collection method that can be applied to Ag-RDT as an alternative to the current RT-PCR with an NPS for early diagnosis of COVID-19. This clinical trial comprised 102 COVID-19-positive patients hospitalized after a governmental screening process and 100 healthy individuals. Paired NPS and BG-based saliva specimens from COVID-19 patients and healthy individuals were analyzed using NPS-RT-PCR, BG-RT-PCR, and BG-Ag-RDTs, whose diagnostic performance for detecting SARS-CoV-2 was compared. BG-Ag-RDTs showed high sensitivity (97.8%) and specificity (100%) in 45 patients within 6 days of illness and detected all cases of SARS-CoV-2 Alpha and Delta variants. In 11 asymptomatic active COVID-19 cases, both BG-Ag-RDTs and BG-RT-PCR showed sensitivities and specificities of 100%. Sensitivities of BG-Ag-RDT and BG-RT-PCR toward salivary viral detection were highly concordant, with no discrimination between symptomatic (97.0%), asymptomatic (100%), or SARS-CoV-2 variant (100%) cases. The intermolecular interactions between SARS-CoV-2 spike proteins and truncated canavalin, an active ingredient from the bean extract (BE), were observed in terms of physicochemical properties. The detachment of the SARS-CoV-2 receptor-binding domain from hACE2 increased as the BE concentration increased, allowing the release of the virus from hACE2 for early diagnosis. Using BG-based saliva specimens remarkably enhances the Ag-RDT diagnostic performance as an alternative to NPS and enables noninvasive, rapid, and accurate COVID-19 self-testing and mass screening, supporting efficient COVID-19 management. IMPORTANCE An Ag-RDT is less likely to be accepted as an initial test method for early diagnosis owing to its low sensitivity. However, our self-collection method, Ag-RDT using BG-based saliva specimens, showed significantly enhanced detection sensitivity and specificity toward SARS-CoV-2 including the Alpha and Delta variants in all patients tested within 6 days of illness. The method represents an attractive alternative to nasopharyngeal swabs for the early diagnosis of symptomatic and asymptomatic COVID-19 cases. The evidence suggests that the method could have a potential for mass screening and monitoring of COVID-19 cases.
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18
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Patriquin G, LeBlanc JJ, Williams C, Hatchette TF, Ross J, Barrett L, Davidson R. Comparison between Nasal and Nasopharyngeal Swabs for SARS-CoV-2 Rapid Antigen Detection in an Asymptomatic Population, and Direct Confirmation by RT-PCR from the Residual Buffer. Microbiol Spectr 2022;:e0245521. [PMID: 35171010 DOI: 10.1128/spectrum.02455-21] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 12/27/2022] Open
Abstract
Containment measures employed during the COVID-19 pandemic included prompt recognition of cases, isolation, and contact tracing. Bilateral nasal (NA) swabs applied to a commercial antigen-based rapid diagnostic test (Ag-RDT) offer a simpler and more comfortable alternative to nasopharyngeal (NP) collection; however, little is known about the sensitivity of this method in an asymptomatic population. Participants in community-based asymptomatic testing sites were screened for SARS-CoV-2 using an Ag-RDT with NP sampling. Positive individuals returned for confirmatory molecular testing and consented to repeating the Ag-RDT using a bilateral NA swab for comparison. Residual test buffer (RTB) from Ag-RDTs was subjected to real-time reverse transcription-PCR (RT-PCR). Of 123,617 asymptomatic individuals, 197 NP Ag-RDT-positive participants were included, with 175 confirmed positive by RT-PCR. Of these cases, 154 were identified from the NA swab collection with Ag-RDT, with a sensitivity of 88.0% compared to the NP swab collection. Stratifying results by RT-PCR cycle threshold demonstrated that sensitivity of the nasal collection method varied based on the cycle threshold (CT) value of the paired RT-PCR sample. RT-PCR testing on the RTB from the Ag-RDT using NP and NA swab collections resulted in 100.0% and 98.7% sensitivity, respectively. NA swabs provide an adequate alternative to NP swab collection for use with Ag-RDT, with the recognition that the test is most sensitive in specimens with high viral loads. With the high sensitivity of RT-PCR testing on RTB from Ag-RDT, a more streamlined approach to confirmatory testing is possible without recollection or use of paired collections strategies. IMPORTANCE Nasal swabbing for SARS-CoV-2 (COVID-19) comes with many benefits but is slightly less sensitive than traditional nasopharyngeal swabbing; however, confirmatory lab-based testing could be performed directly from the residual buffer from either sample type.
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19
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Kohmer N, Eckermann L, Böddinghaus B, Götsch U, Berger A, Herrmann E, Kortenbusch M, Tinnemann P, Gottschalk R, Hoehl S, Ciesek S. Self-Collected Samples to Detect SARS-CoV-2: Direct Comparison of Saliva, Tongue Swab, Nasal Swab, Chewed Cotton Pads and Gargle Lavage. J Clin Med 2021; 10:jcm10245751. [PMID: 34945047 PMCID: PMC8709431 DOI: 10.3390/jcm10245751] [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: 10/26/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 12/20/2022] Open
Abstract
Testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by RT-PCR is a vital public health tool in the pandemic. Self-collected samples are increasingly used as an alternative to nasopharyngeal swabs. Several studies suggested that they are sufficiently sensitive to be a useful alternative. However, there are limited data directly comparing several different types of self-collected materials to determine which material is preferable. A total of 102 predominantly symptomatic adults with a confirmed SARS-CoV-2 infection self-collected native saliva, a tongue swab, a mid-turbinate nasal swab, saliva obtained by chewing a cotton pad and gargle lavage, within 48 h of initial diagnosis. Sample collection was unsupervised. Both native saliva and gargling with tap water had high diagnostic sensitivity of 92.8% and 89.1%, respectively. Nasal swabs had a sensitivity of 85.1%, which was not significantly inferior to saliva (p = 0.092), but 16.6% of participants reported they had difficult in self-collection of this sample. A tongue swab and saliva obtained by chewing a cotton pad had a significantly lower sensitivity of 74.2% and 70.2%, respectively. Diagnostic sensitivity was not related to the presence of clinical symptoms or to age. When comparing self-collected specimens from different material, saliva, gargle lavage or mid-turbinate nasal swabs may be considered for most symptomatic patients. However, complementary experiments are required to verify that differences in performance observed among the five sampling modes were not attributed to collection impairment.
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Affiliation(s)
- Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (L.E.); (A.B.); (M.K.); (R.G.); (S.C.)
| | - Lisa Eckermann
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (L.E.); (A.B.); (M.K.); (R.G.); (S.C.)
| | - Boris Böddinghaus
- Health Protection Authority, City of Frankfurt, 60313 Frankfurt, Germany; (B.B.); (U.G.); (P.T.)
| | - Udo Götsch
- Health Protection Authority, City of Frankfurt, 60313 Frankfurt, Germany; (B.B.); (U.G.); (P.T.)
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (L.E.); (A.B.); (M.K.); (R.G.); (S.C.)
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, 60596 Frankfurt, Germany;
| | - Marhild Kortenbusch
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (L.E.); (A.B.); (M.K.); (R.G.); (S.C.)
| | - Peter Tinnemann
- Health Protection Authority, City of Frankfurt, 60313 Frankfurt, Germany; (B.B.); (U.G.); (P.T.)
| | - Rene Gottschalk
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (L.E.); (A.B.); (M.K.); (R.G.); (S.C.)
- Health Protection Authority, City of Frankfurt, 60313 Frankfurt, Germany; (B.B.); (U.G.); (P.T.)
| | - Sebastian Hoehl
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (L.E.); (A.B.); (M.K.); (R.G.); (S.C.)
- Correspondence: ; Tel.: +49-69-6301-0
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany; (N.K.); (L.E.); (A.B.); (M.K.); (R.G.); (S.C.)
- German Centre for Infection Research, External Partner Site, 60323 Frankfurt, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, 60596 Frankfurt, Germany
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20
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Bui LM, Thi Thu Phung H, Ho Thi TT, Singh V, Maurya R, Khambhati K, Wu CC, Uddin MJ, Trung DM, Chu DT. Recent findings and applications of biomedical engineering for COVID-19 diagnosis: a critical review. Bioengineered 2021; 12:8594-8613. [PMID: 34607509 PMCID: PMC8806999 DOI: 10.1080/21655979.2021.1987821] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 09/28/2021] [Indexed: 12/23/2022] Open
Abstract
COVID-19 is one of the most severe global health crises that humanity has ever faced. Researchers have restlessly focused on developing solutions for monitoring and tracing the viral culprit, SARS-CoV-2, as vital steps to break the chain of infection. Even though biomedical engineering (BME) is considered a rising field of medical sciences, it has demonstrated its pivotal role in nurturing the maturation of COVID-19 diagnostic technologies. Within a very short period of time, BME research applied to COVID-19 diagnosis has advanced with ever-increasing knowledge and inventions, especially in adapting available virus detection technologies into clinical practice and exploiting the power of interdisciplinary research to design novel diagnostic tools or improve the detection efficiency. To assist the development of BME in COVID-19 diagnosis, this review highlights the most recent diagnostic approaches and evaluates the potential of each research direction in the context of the pandemic.
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Affiliation(s)
- Le Minh Bui
- NTT Hi-Tech Institute, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
- Department of Biology, Faculty of Science and Technology, Universitas Airlangga, Surabaya, Indonesia
| | - Huong Thi Thu Phung
- NTT Hi-Tech Institute, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Thuy-Tien Ho Thi
- Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Vietnam
| | - Vijai Singh
- Department of Biosciences, School of Science, Indrashil University, Mehsana, Gujarat, India
| | - Rupesh Maurya
- Department of Biosciences, School of Science, Indrashil University, Mehsana, Gujarat, India
| | - Khushal Khambhati
- Department of Biosciences, School of Science, Indrashil University, Mehsana, Gujarat, India
| | - Chia-Ching Wu
- Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Md Jamal Uddin
- ABEx Bio-Research Center, East Azampur, Dhaka, Bangladesh
- Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Womans University, Seoul, Republic of Korea
| | - Do Minh Trung
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam
| | - Dinh Toi Chu
- Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Vietnam
- Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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21
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Patriquin G, Davidson RJ, Hatchette TF, Head BM, Mejia E, Becker MG, Meyers A, Sandstrom P, Hatchette J, Block A, Smith N, Ross J, LeBlanc JJ. Generation of False-Positive SARS-CoV-2 Antigen Results with Testing Conditions outside Manufacturer Recommendations: A Scientific Approach to Pandemic Misinformation. Microbiol Spectr 2021; 9:e0068321. [PMID: 34668722 PMCID: PMC8528119 DOI: 10.1128/spectrum.00683-21] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/29/2021] [Indexed: 11/20/2022] Open
Abstract
Antigen-based rapid diagnostics tests (Ag-RDTs) are useful tools for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection. However, misleading demonstrations of the Abbott Panbio coronavirus disease 2019 (COVID-19) Ag-RDT on social media claimed that SARS-CoV-2 antigen could be detected in municipal water and food products. To offer a scientific rebuttal to pandemic misinformation and disinformation, this study explored the impact of using the Panbio SARS-CoV-2 assay with conditions falling outside manufacturer recommendations. Using Panbio, various water and food products, laboratory buffers, and SARS-CoV-2-negative clinical specimens were tested with and without manufacturer buffer. Additional experiments were conducted to assess the role of each Panbio buffer component (tricine, NaCl, pH, and Tween 20) as well as the impact of temperature (4°C, 20°C, and 45°C) and humidity (90%) on assay performance. Direct sample testing (without the kit buffer) resulted in false-positive signals resembling those obtained with SARS-CoV-2 positive controls tested under proper conditions. The likely explanation of these artifacts is nonspecific interactions between the SARS-CoV-2-specific conjugated and capture antibodies, as proteinase K treatment abrogated this phenomenon, and thermal shift assays showed pH-induced conformational changes under conditions promoting artifact formation. Omitting, altering, and reverse engineering the kit buffer all supported the importance of maintaining buffering capacity, ionic strength, and pH for accurate kit function. Interestingly, the Panbio assay could tolerate some extremes of temperature and humidity outside manufacturer claims. Our data support strict adherence to manufacturer instructions to avoid false-positive SARS-CoV-2 Ag-RDT reactions, otherwise resulting in anxiety, overuse of public health resources, and dissemination of misinformation. IMPORTANCE With the Panbio severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen test being deployed in over 120 countries worldwide, understanding conditions required for its ideal performance is critical. Recently on social media, this kit was shown to generate false positives when manufacturer recommendations were not followed. While erroneous results from improper use of a test may not be surprising to some health care professionals, understanding why false positives occur can help reduce the propagation of misinformation and provide a scientific rebuttal for these aberrant findings. This study demonstrated that the kit buffer's pH, ionic strength, and buffering capacity were critical components to ensure proper kit function and avoid generation of false-positive results. Typically, false positives arise from cross-reacting or interfering substances; however, this study demonstrated a mechanism where false positives were generated under conditions favoring nonspecific interactions between the two antibodies designed for SARS-CoV-2 antigen detection. Following the manufacturer instructions is critical for accurate test results.
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Affiliation(s)
- Glenn Patriquin
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health (NSH), Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ross J. Davidson
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health (NSH), Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine (Infectious Diseases), Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Todd F. Hatchette
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health (NSH), Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine (Infectious Diseases), Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Breanne M. Head
- National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - Edgard Mejia
- National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - Michael G. Becker
- National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - Adrienne Meyers
- National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | - Paul Sandstrom
- National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada
| | | | - Ava Block
- Praxes Medical Group, Halifax, Nova Scotia, Canada
| | - Nicole Smith
- Praxes Medical Group, Halifax, Nova Scotia, Canada
| | - John Ross
- Praxes Medical Group, Halifax, Nova Scotia, Canada
| | - Jason J. LeBlanc
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health (NSH), Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine (Infectious Diseases), Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
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22
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Gobeille Paré S, Bestman-Smith J, Fafard J, Doualla-Bell F, Jacob-Wagner M, Lavallée C, Charest H, Beauchemin S, Coutlée F, Dumaresq J, Busque L, St-Hilaire M, Lépine G, Boucher V, Desforges M, Goupil-Sormany I, Labbé AC. Natural spring water gargle samples as an alternative to nasopharyngeal swabs for SARS-CoV-2 detection using a laboratory-developed test. J Med Virol 2021; 94:985-993. [PMID: 34672374 PMCID: PMC8661969 DOI: 10.1002/jmv.27407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/28/2021] [Accepted: 10/18/2021] [Indexed: 01/23/2023]
Abstract
The objective of this study was to validate the use of spring water gargle (SWG) as an alternative to oral and nasopharyngeal swab (ONPS) for SARS‐CoV‐2 detection with a laboratory‐developed test. Healthcare workers and adults from the general population, presenting to one of two COVID‐19 screening clinics in Montréal and Québec City, were prospectively recruited to provide a gargle sample in addition to the standard ONPS. The paired specimens were analyzed using thermal lysis followed by a laboratory‐developed nucleic acid amplification test (LD‐NAAT) to detect SARS‐CoV‐2, and comparative performance analysis was performed. An individual was considered infected if a positive result was obtained on either sample. A total of 1297 adult participants were recruited. Invalid results (n = 18) were excluded from the analysis. SARS‐CoV‐2 was detected in 144/1279 (11.3%) participants: 126 from both samples, 15 only from ONPS, and 3 only from SWG. Overall, the sensitivity was 97.9% (95% CI: 93.7–99.3) for ONPS and 89.6% (95% CI: 83.4–93.6; p = 0.005) for SWG. The mean ONPS cycle threshold (Ct) value was significantly lower for the concordant paired samples as compared to discordant ones (22.9 vs. 32.1; p < 0.001). In conclusion, using an LD‐NAAT with thermal lysis, SWG is a less sensitive sampling method than the ONPS. However, the higher acceptability of SWG might enable a higher rate of detection from a population‐based perspective. Nonetheless, in patients with a high clinical suspicion of COVID‐19, a repeated analysis with ONPS should be considered. The sensitivity of SWG using NAAT preceded by chemical extraction should be evaluated. Using a laboratory‐developed NAAT preceded by thermal lysis, the overall percent agreement between spring water gargle (SWG) and oral combined with nasopharyngeal swab (ONPS), sampled at the same time among 1297 participants, is excellent (98.6%). Although the SARS‐CoV‐2 NAAT from SWG is globally less sensitive than from ONPS (89.6% vs. 97.9%), the difference is markedly less in individuals symptomatic for <3 days (2.7%; p=NS) than in those whose symptoms started ≥7 days before testing (35.7%; p= 0.005).
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Affiliation(s)
- Sarah Gobeille Paré
- Département de microbiologie-infectiologie et d'immunologie, Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - Julie Bestman-Smith
- Département de microbiologie-infectiologie et d'immunologie, Faculté de Médecine, Université Laval, Québec, Québec, Canada.,Département de microbiologie et d'infectiologie du Centre hospitalier universitaire (CHU) de Québec, Québec, Québec, Canada
| | - Judith Fafard
- Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Sainte-Anne-de-Bellevue, Québec, Québec, Canada.,Département de microbiologie, infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada
| | - Florence Doualla-Bell
- Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Sainte-Anne-de-Bellevue, Québec, Québec, Canada
| | - Mariève Jacob-Wagner
- Département de microbiologie et d'infectiologie du Centre hospitalier universitaire (CHU) de Québec, Québec, Québec, Canada
| | - Christian Lavallée
- Département de microbiologie, infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada.,Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada.,Service de maladies infectieuses, CIUSSS de l'Est-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Hugues Charest
- Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Sainte-Anne-de-Bellevue, Québec, Québec, Canada.,Département de microbiologie, infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada
| | - Stéphanie Beauchemin
- Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - François Coutlée
- Département de microbiologie, infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada.,Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Jeannot Dumaresq
- Département de microbiologie-infectiologie et d'immunologie, Faculté de Médecine, Université Laval, Québec, Québec, Canada.,Département de microbiologie et d'Infectiologie, CISSS de Chaudière-Appalaches, Lévis, Québec, Canada
| | - Lambert Busque
- Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Manon St-Hilaire
- Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Guylaine Lépine
- Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Valérie Boucher
- Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Marc Desforges
- Département de microbiologie, infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada.,Département clinique de médecine de laboratoire, CHU Ste-Justine, Montréal, Québec, Canada
| | - Isabelle Goupil-Sormany
- Direction de la vigie sanitaire, Ministère de la Santé et des Services sociaux du Québec, Québec, Québec, Canada
| | - Annie-Claude Labbé
- Département de microbiologie, infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada.,Département des laboratoires de biologie médicale, Grappe Optilab-CHUM, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada.,Service de maladies infectieuses, CIUSSS de l'Est-de-l'Île-de-Montréal, Montréal, Québec, Canada
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23
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Kinshella MLW, Tilley P, Al-Rawahi GN, Srigley JA, Kayda I, Canes M, McLennan M, Bone JN, Dittrick M, Gadkar VJ, Hoang LMN, Goldfarb DM. Evaluation of observed and unobserved self-collection of saline gargle samples for the detection of SARS-CoV-2 in outpatients. Diagn Microbiol Infect Dis 2021; 102:115566. [PMID: 34781164 PMCID: PMC8486683 DOI: 10.1016/j.diagmicrobio.2021.115566] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/18/2021] [Accepted: 09/26/2021] [Indexed: 11/04/2022]
Abstract
The diagnostic sensitivity of observed and unobserved self-collected saline gargle samples for the molecular detection of SARS-CoV-2 in adults and school-aged children was evaluated against a reference standard of health care worker collected nasopharyngeal flocked swab. A total of 46 participants had a positive nasopharyngeal swab sample; of these, 10 were in the observed phase and 36 were in the unobserved phase. Only one matching saline gargle sample tested negative and this was in the unobserved phase, giving an overall sensitivity of 98%. Average viral target Ct values were higher in the saline gargle samples. RNaseP Ct values were lower in unobserved collected samples compared to observed collected samples. Unobserved self-collection of saline gargle samples is a promising outpatient testing method for COVID-19 diagnosis. The self-collection method has potential to simplify the diagnostic cycle and facilitate implementation of COVID-19 testing, particularly in settings with limited access to health care workers.
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Affiliation(s)
| | - Peter Tilley
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada; Division of Medical Microbiology, BC Children's Hospital & BC Women's Hospital & Health Centre, Vancouver, British Columbia, Canada
| | - Ghada N Al-Rawahi
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada; Division of Medical Microbiology, BC Children's Hospital & BC Women's Hospital & Health Centre, Vancouver, British Columbia, Canada
| | - Jocelyn A Srigley
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada; Division of Medical Microbiology, BC Children's Hospital & BC Women's Hospital & Health Centre, Vancouver, British Columbia, Canada
| | - Iryna Kayda
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Mitchell Canes
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Meghan McLennan
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Jeffrey N Bone
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Michelle Dittrick
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Vijay J Gadkar
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada; Division of Medical Microbiology, BC Children's Hospital & BC Women's Hospital & Health Centre, Vancouver, British Columbia, Canada
| | - Linda M N Hoang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada; BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - David M Goldfarb
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada; Division of Medical Microbiology, BC Children's Hospital & BC Women's Hospital & Health Centre, Vancouver, British Columbia, Canada.
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24
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Sweeney-Reed CM, Wolff D, Hörnschemeyer S, Faßhauer H, Haase A, Schomburg D, Niggel J, Kabesch M, Apfelbacher C. Feasibility of a surveillance programme based on gargle samples and pool testing to prevent SARS-CoV-2 outbreaks in schools. Sci Rep 2021; 11:19521. [PMID: 34593887 PMCID: PMC8484445 DOI: 10.1038/s41598-021-98849-1] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/15/2021] [Indexed: 01/12/2023] Open
Abstract
School closures have a negative impact on physical and mental well-being, and education, of children and adolescents. A surveillance programme to detect asymptomatic SARS-CoV-2 infection could allow schools to remain open, while protecting the vulnerable. We assessed the feasibility of a programme employing gargle samples and pool testing of individually extracted RNA using rRT-qPCR in a primary and a secondary school in Germany, based on programme logistics and acceptance. Twice a week, five participants per class were selected to provide samples, using an algorithm weighted by a risk-based priority score to increase likelihood of case detection. The positive response rate was 54.8% (550 of 1003 pupils). Logistics evaluation revealed the rate-limiting steps: completing the regular pre-test questionnaire and handing in the samples. Acceptance questionnaire responses indicated strong support for research into developing a surveillance programme and a positive evaluation of gargle tests. Participation was voluntary. As not all pupils participated, individual reminders could lead to participant identification. School-wide implementation of the programme for infection monitoring purposes would enable reminders to be given to all school pupils to address these steps, without compromising participant anonymity. Such a programme would provide a feasible means to monitor asymptomatic respiratory tract infection in schools.
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Affiliation(s)
- Catherine M Sweeney-Reed
- Neurocybernetics and Rehabilitation, Dept. of Neurology, Medical Faculty, Otto von Guericke University Magdeburg, Leipziger Str. 44, Magdeburg, Germany.
- Center for Behavioral Brain Sciences, Otto von Guericke University Magdeburg, Magdeburg, Germany.
| | - Doreen Wolff
- Institute of Social Medicine and Health System Research, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Sarah Hörnschemeyer
- Institute of Social Medicine and Health System Research, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Henriette Faßhauer
- Institute of Social Medicine and Health System Research, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Antonia Haase
- Institute of Social Medicine and Health System Research, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Dirk Schomburg
- Institute of Biometry und Medical Informatics (IBMI), Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Jakob Niggel
- University of Regensburg, Regensburg, Germany
- MaganaMed GmbH, Regensburg, Germany
| | - Michael Kabesch
- University Children's Hospital Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
- Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John and University of Regensburg, Regensburg, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health System Research, Otto von Guericke University Magdeburg, Magdeburg, Germany
- Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John and University of Regensburg, Regensburg, Germany
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25
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Zander J, Scholtes S, Ottinger M, Kremer M, Kharazi A, Stadler V, Bickmann J, Zeleny C, Kuiper JWP, Hauck CR. Self-Collected Gargle Lavage Allows Reliable Detection of SARS-CoV-2 in an Outpatient Setting. Microbiol Spectr 2021; 9:e0036121. [PMID: 34259547 PMCID: PMC8552688 DOI: 10.1128/spectrum.00361-21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/21/2021] [Indexed: 12/27/2022] Open
Abstract
Current procurement of specimens for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection requires trained personnel and dedicated equipment. We compared standard nasopharyngeal swabs with self-collected gargle lavage fluid obtained from 80 mostly symptomatic outpatients. After RNA extraction, RT-PCR to detect SARS-CoV-2 was performed. Qualitative results obtained with the paired samples from individual outpatients were 100% congruent. Therefore, self-collected gargle lavage fluid can serve as a suitable specimen for coronavirus disease 2019 (COVID-19) testing in outpatients. IMPORTANCE The SARS-CoV-2 pandemic still strains health care systems worldwide. While COVID-19 testing is considered an essential pillar in combating this infectious disease, shortages in supplies and trained health care personnel often limit the procurement of patient samples, in particular in outpatient settings. Here, we compared the simple self-collection of gargle lavage fluid with the gold standard nasopharyngeal swab as a specimen for COVID-19 testing. By finding complete congruence of results obtained with paired samples of a sizeable patient cohort, our results strongly support the idea that the painless self-collection of gargle lavage fluid provides a suitable and uncomplicated sample for reliable SARS-CoV-2 detection.
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Affiliation(s)
- Johannes Zander
- Labor Dr. Brunner, Konstanz, Germany
- Institut für Laboratoriumsmedizin, Klinikum der Universität München, Munich, Germany
| | | | | | | | | | | | | | | | | | - Christof R. Hauck
- Lehrstuhl Zellbiologie, Universität Konstanz, Konstanz, Germany
- Konstanz Research School Chemical Biology, Universität Konstanz, Konstanz, Germany
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