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Thell R, Kallab V, Weinhappel W, Mueckstein W, Heschl L, Heschl M, Korsatko S, Toedling F, Blaschke A, Herzog T, Klicpera A, Koeller C, Haugk M, Kreil A, Spiel A, Kreuzer P, Krause R, Sebesta C, Winkler S, Laky B, Szell M. Evaluation of a novel, rapid antigen detection test for the diagnosis of SARS-CoV-2. PLoS One 2021; 16:e0259527. [PMID: 34843505 PMCID: PMC8629250 DOI: 10.1371/journal.pone.0259527] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 10/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) is currently finally determined in laboratory settings by real-time reverse-transcription polymerase-chain-reaction (rt-PCR). However, simple testing with immediately available results are crucial to gain control over COVID-19. The aim was to evaluate such a point-of-care antigen rapid test (AG-rt) device in its performance compared to laboratory-based rt-PCR testing in COVID-19 suspected, symptomatic patients. Methods For this prospective study, two specimens each of 541 symptomatic female (54.7%) and male (45.3%) patients aged between 18 and 95 years tested at five emergency departments (ED, n = 296) and four primary healthcare centres (PHC, n = 245), were compared, using AG-rt (positive/negative/invalid) and rt-PCR (positive/negative and cycle threshold, Ct) to diagnose SARS-CoV-2. Diagnostic accuracy, sensitivity, specificity, positive predictive values (PPV), negative predictive value (NPV), and likelihood ratios (LR+/-) of the AG-rt were assessed. Results Differences between ED and PHC were detected regarding gender, age, symptoms, disease prevalence, and diagnostic performance. Overall, 174 (32.2%) were tested positive on AG-rt and 213 (39.4%) on rt-PCR. AG correctly classified 91.7% of all rt-PCR positive cases with a sensitivity of 80.3%, specificity of 99.1%, PPV of 98.3, NPV of 88.6%, LR(+) of 87.8, and LR(-) of 0.20. The highest sensitivities and specificities of AG-rt were detected in PHC (sensitivity: 84.4%, specificity: 100.0%), when using Ct of 30 as cut-off (sensitivity: 92.5%, specificity: 97.8%), and when symptom onset was within the first three days (sensitivity: 82.9%, specificity: 99.6%). Conclusions The highest sensitivity was detected with a high viral load. Our findings suggest that AG-rt are comparable to rt-PCR to diagnose SARS-CoV-2 in COVID-19 suspected symptomatic patients presenting both at emergency departments and primary health care centres.
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Affiliation(s)
- Rainer Thell
- Wiener Gesundheitsverbund, Vienna, Australia
- Department of Internal Medicine 2, Emergency Department, Klinik Donaustadt, Vienna, Austria
- * E-mail: (RT); (MS)
| | - Verena Kallab
- Wiener Gesundheitsverbund, Vienna, Australia
- Department of Internal Medicine 2, Emergency Department, Klinik Donaustadt, Vienna, Austria
| | | | | | - Lukas Heschl
- Primary Health Care Centre Landarztteam, Oed, Austria
| | | | | | - Franz Toedling
- Primary Health Care Centre Praxis Dr Toedling, Probstdorf, Austria
| | - Amelie Blaschke
- Wiener Gesundheitsverbund, Vienna, Australia
- Department of Internal Medicine 2, Emergency Department, Klinik Donaustadt, Vienna, Austria
| | - Theresa Herzog
- Wiener Gesundheitsverbund, Vienna, Australia
- Department of Internal Medicine 2, Emergency Department, Klinik Donaustadt, Vienna, Austria
| | - Anna Klicpera
- Wiener Gesundheitsverbund, Vienna, Australia
- Department of Internal Medicine 2, Emergency Department, Klinik Donaustadt, Vienna, Austria
| | - Clara Koeller
- Emergency Department, Klinik Hietzing, Vienna, Austria
- Semmelweis University Budapest, Hungary
| | - Moritz Haugk
- Wiener Gesundheitsverbund, Vienna, Australia
- Emergency Department, Klinik Hietzing, Vienna, Austria
| | - Anna Kreil
- Wiener Gesundheitsverbund, Vienna, Australia
- Emergency Department, Klinik Landstrasse, Vienna, Austria
| | - Alexander Spiel
- Wiener Gesundheitsverbund, Vienna, Australia
- Emergency Department, Klinik Ottakring, Vienna, Austria
| | - Philipp Kreuzer
- Emergency Department, Univ. Clinic of Internal Medicine, Medical University Graz, Graz, Austria
| | - Robert Krause
- Univ. Clinic of Internal Medicine, Section of Infectiology and Tropical Medicine, Medical University Graz, Graz, Austria
| | - Christian Sebesta
- Wiener Gesundheitsverbund, Vienna, Australia
- Department of Internal Medicine 2, Emergency Department, Klinik Donaustadt, Vienna, Austria
| | - Stefan Winkler
- Department of Infectiology and Tropical Medicine, University Clinic of Internal Medicine I, Medical University Vienna, Austria
| | - Brenda Laky
- MedSciCare, Vienna, Austria
- Competence Centre Clinical Research, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Marton Szell
- Wiener Gesundheitsverbund, Vienna, Australia
- Department of Internal Medicine 2, Emergency Department, Klinik Donaustadt, Vienna, Austria
- * E-mail: (RT); (MS)
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Samaha E, Vierlinger K, Weinhappel W, Godnic-Cvar J, Nöhammer C, Koczan D, Thiesen HJ, Yanai H, Fraifeld VE, Ziesche R. Expression Profiling Suggests Loss of Surface Integrity and Failure of Regenerative Repair as Major Driving Forces for Chronic Obstructive Pulmonary Disease Progression. Am J Respir Cell Mol Biol 2021; 64:441-452. [PMID: 33524306 DOI: 10.1165/rcmb.2020-0270oc] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) poses a major risk for public health, yet remarkably little is known about its detailed pathophysiology. Definition of COPD as nonreversible pulmonary obstruction revealing more about spatial orientation than about mechanisms of pathology may be a major reason for this. We conducted a controlled observational study allowing for simultaneous assessment of clinical and biological development in COPD. Sixteen healthy control subjects and 104 subjects with chronic bronchitis, with or without pulmonary obstruction at baseline, were investigated. Using both the extent of and change in bronchial obstruction as main scoring criteria for the analysis of gene expression in lung tissue, we identified 410 genes significantly associated with progression of COPD. One hundred ten of these genes demonstrated a distinctive expression pattern, with their functional annotations indicating participation in the regulation of cellular coherence, membrane integrity, growth, and differentiation, as well as inflammation and fibroproliferative repair. The regulatory pattern indicates a sequentially unfolding pathology that centers on a two-step failure of surface integrity commencing with a loss of epithelial coherence as early as chronic bronchitis. Decline of regenerative repair starting in Global Initiative for Chronic Obstructive Lung Disease stage I then activates degradation of extracellular-matrix hyaluronan, causing structural failure of the bronchial wall that is only resolved by scar formation. Although they require independent confirmation, our findings provide the first tangible pathophysiological concept of COPD to be further explored.Clinical trial registered with www.clinicaltrials.gov (NCT00618137).
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Affiliation(s)
- Eslam Samaha
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Klemens Vierlinger
- Department of Health and Environment, Austrian Institute of Technology, Vienna, Austria
| | - Wolfgang Weinhappel
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Jasminka Godnic-Cvar
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Christa Nöhammer
- Department of Health and Environment, Austrian Institute of Technology, Vienna, Austria
| | - Dirk Koczan
- Department of Immunology, University of Rostock, Rostock, Germany; and
| | | | - Hagai Yanai
- Faculty of Health Sciences, Beer-Sheva Campus, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Vadim E Fraifeld
- Faculty of Health Sciences, Beer-Sheva Campus, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Rolf Ziesche
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
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