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Tan KS, Ong SWX, Koh MH, Tay DJW, Aw DZH, Nah YW, Abdullah MRB, Coleman KK, Milton DK, Chu JJH, Chow VTK, Tambyah PA, Tham KW. SARS-CoV-2 Omicron variant shedding during respiratory activities. Int J Infect Dis 2023; 131:19-25. [PMID: 36948451 PMCID: PMC10028358 DOI: 10.1016/j.ijid.2023.03.029] [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: 12/04/2022] [Revised: 02/24/2023] [Accepted: 03/13/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND As the world transitions to COVID-19 endemicity, studies focusing on aerosol shedding of highly transmissible SARS-CoV-2 variants of concern (VOCs) are vital for the calibration of infection control measures against VOCs that are likely to circulate seasonally. OBJECTIVE This follow-up G-II aerosol sampling study aims to compare the aerosol shedding patterns of Omicron VOC samples with pre-Omicron variants analyzed in our previous study. STUDY DESIGN Coarse and fine aerosol samples from 47 SARS-CoV-2 infected patients were collected during various respiratory activities (passive breathing, talking, and singing) and analyzed via reverse transcription quantitative polymerase chain reaction (RT-qPCR) and virus culture. RESULTS Compared to patients infected with pre-Omicron variants, comparable SARS-CoV-2 RNA copy numbers were detectable in aerosol samples of Omicron infected patients despite being fully vaccinated. Omicron-infected patients also showed a slight increase in viral aerosol shedding during breathing activities, and were more likely to have persistent aerosol shedding beyond 7 days post-disease onset. CONCLUSION This follow-up study reaffirms the aerosol shedding properties of Omicron, and should guide continued layering of public health interventions even in highly vaccinated populations.
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Affiliation(s)
- Kai Sen Tan
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Biosafety Level 3 Core Facility, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Sean Wei Xiang Ong
- National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital, Singapore; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Ming Hui Koh
- Department of the Built Environment, College of Design and Engineering, National University of Singapore, Singapore
| | - Douglas Jie Wen Tay
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Biosafety Level 3 Core Facility, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Daryl Zheng Hao Aw
- Department of the Built Environment, College of Design and Engineering, National University of Singapore, Singapore
| | - Yi Wei Nah
- Department of the Built Environment, College of Design and Engineering, National University of Singapore, Singapore
| | | | - Kristen K Coleman
- Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD
| | - Donald K Milton
- Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD
| | - Justin Jang Hann Chu
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Biosafety Level 3 Core Facility, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Vincent T K Chow
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Paul Anantharajah Tambyah
- Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Kwok Wai Tham
- Department of the Built Environment, College of Design and Engineering, National University of Singapore, Singapore.
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Hardjojo A, Gunachandran A, Pang L, Abdullah MRB, Wah W, Chong JWC, Goh EH, Teo SH, Lim G, Lee ML, Hsu W, Lee V, Chen MIC, Wong F, Phang JSK. Validation of a Natural Language Processing Algorithm for Detecting Infectious Disease Symptoms in Primary Care Electronic Medical Records in Singapore. JMIR Med Inform 2018; 6:e36. [PMID: 29907560 PMCID: PMC6026305 DOI: 10.2196/medinform.8204] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 06/14/2017] [Revised: 02/14/2018] [Accepted: 03/19/2018] [Indexed: 02/04/2023] Open
Abstract
Background Free-text clinical records provide a source of information that complements traditional disease surveillance. To electronically harness these records, they need to be transformed into codified fields by natural language processing algorithms. Objective The aim of this study was to develop, train, and validate Clinical History Extractor for Syndromic Surveillance (CHESS), an natural language processing algorithm to extract clinical information from free-text primary care records. Methods CHESS is a keyword-based natural language processing algorithm to extract 48 signs and symptoms suggesting respiratory infections, gastrointestinal infections, constitutional, as well as other signs and symptoms potentially associated with infectious diseases. The algorithm also captured the assertion status (affirmed, negated, or suspected) and symptom duration. Electronic medical records from the National Healthcare Group Polyclinics, a major public sector primary care provider in Singapore, were randomly extracted and manually reviewed by 2 human reviewers, with a third reviewer as the adjudicator. The algorithm was evaluated based on 1680 notes against the human-coded result as the reference standard, with half of the data used for training and the other half for validation. Results The symptoms most commonly present within the 1680 clinical records at the episode level were those typically present in respiratory infections such as cough (744/7703, 9.66%), sore throat (591/7703, 7.67%), rhinorrhea (552/7703, 7.17%), and fever (928/7703, 12.04%). At the episode level, CHESS had an overall performance of 96.7% precision and 97.6% recall on the training dataset and 96.0% precision and 93.1% recall on the validation dataset. Symptoms suggesting respiratory and gastrointestinal infections were all detected with more than 90% precision and recall. CHESS correctly assigned the assertion status in 97.3%, 97.9%, and 89.8% of affirmed, negated, and suspected signs and symptoms, respectively (97.6% overall accuracy). Symptom episode duration was correctly identified in 81.2% of records with known duration status. Conclusions We have developed an natural language processing algorithm dubbed CHESS that achieves good performance in extracting signs and symptoms from primary care free-text clinical records. In addition to the presence of symptoms, our algorithm can also accurately distinguish affirmed, negated, and suspected assertion statuses and extract symptom durations.
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Affiliation(s)
- Antony Hardjojo
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | - Arunan Gunachandran
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | - Long Pang
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | - Mohammed Ridzwan Bin Abdullah
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | - Win Wah
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | - Joash Wen Chen Chong
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | - Ee Hui Goh
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | - Sok Huang Teo
- National Healthcare Group Polyclinics, Singapore, Singapore
| | - Gilbert Lim
- School of Computing, National University of Singapore, Singapore, Singapore
| | - Mong Li Lee
- School of Computing, National University of Singapore, Singapore, Singapore
| | - Wynne Hsu
- School of Computing, National University of Singapore, Singapore, Singapore
| | - Vernon Lee
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | - Mark I-Cheng Chen
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore.,National Centre for Infectious Diseases, Singapore, Singapore
| | - Franco Wong
- National Healthcare Group Polyclinics, Singapore, Singapore.,National University Polyclinics, Singapore, Singapore
| | - Jonathan Siung King Phang
- National Healthcare Group Polyclinics, Singapore, Singapore.,National University Polyclinics, Singapore, Singapore
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