1
|
Köse B, Schaumburg F. Diagnostic accuracy of Savanna RVP4 (QuidelOrtho) for the detection of Influenza A virus, RSV, and SARS-CoV-2. Microbiol Spectr 2024; 12:e0115324. [PMID: 38990032 PMCID: PMC11302293 DOI: 10.1128/spectrum.01153-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 06/21/2024] [Indexed: 07/12/2024] Open
Abstract
Seasonal increase of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza virus A/B (Flu A/B), and respiratory syncytial virus (RSV) require rapid diagnostic test methods for the management of respiratory tract infections. In this study, we compared the diagnostic accuracy of Savanna RVP4 (RVP4, QuidelOrtho) with Xpert Xpress Plus SARS-CoV-2/Flu/RSV (Xpert, Cepheid). Nasopharyngeal swabs from patients treated at a tertiary care hospital (Germany) were tested for SARS-CoV-2, Flu A/B, and RSV by RVP4 to assess diagnostic accuracy (reference standard: Xpert). The intra and inter assay precision of Ct-values was assessed by repeated test in triplicates (on day 1) and duplicates (days 2-3). All patients with a physician's order for a multiplex test for SARS-CoV-2, Flu, and RSV test were included. Duplicate swabs from the same patient, samples with a total volume ≤1 mL, or inappropriate shipment/storage were excluded. In total, 229 swabs were included between September 2023 and February 2024. The concordance between both tests was 96.5% (SARS-CoV-2), 98.7% (Flu A), and 99.6% (RSV). Flu B was not detected by both tests. The RVP4 test had a sensitivity of 85%-95% and a specificity of 100% for the detection of SARS-CoV-2, Flu A, and RSV. The intra and inter assay precision of Ct-values from RVP4 was 3% and 2% (SARS-CoV-2), 5% and 4% (Flu A), and 0% and 3% (RSV), respectively. The Savanna RVP4 has a favorable diagnostic accuracy for the detection of SARS-CoV-2, Flu A, and RSV. IMPORTANCE We assessed the diagnostic accuracy of a new point-of-care test for the rapid detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza virus A/B (Flu A/B), and respiratory syncytial virus (RSV). The new test has a concordance with the reference standard of 96.5% (SARS-CoV-2), 98.7% (Flu A), and 99.1% (RSV). The sensitivity of 85%-95% and specificity of 100% for the detection of SARS-CoV-2, Flu A, and RSV is comparable with similar nucleic acid amplification-based point of care tests but at lower costs.
Collapse
Affiliation(s)
- Büsra Köse
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Frieder Schaumburg
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| |
Collapse
|
2
|
Shang N, Li X, Guo Z, Zhang L, Wang S. Comparative analysis of the safety and effectiveness of Nirmatrelvir-Ritonavir and Azvudine in older patients with COVID-19: a retrospective study from a tertiary hospital in China. Front Pharmacol 2024; 15:1362345. [PMID: 39104387 PMCID: PMC11298358 DOI: 10.3389/fphar.2024.1362345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 06/27/2024] [Indexed: 08/07/2024] Open
Abstract
Introduction: Numerous studies have explored the treatment outcomes of Nirmatrelvir-Ritonavir and Azvudine in older patients with COVID-19. However, direct comparisons between these two drugs are still relatively limited. This study aims to compare the safety and effectiveness of these two drugs in Chinese older patients with early infection to provide strategies for clinical treatment. Methods: Older COVID-19 patients (age ≥65) hospitalized during the winter 2022 epidemic in China were included and divided into Nirmatrelvir-Ritonavir and Azvudine. Demographics, medication information, laboratory parameters, and treatment outcomes were collected. All-cause 28-day mortality, delta cycle threshold (ΔCt), nucleic acid negative conversion time, and incidence of adverse events were defined as outcomes. Propensity score matching (PSM), Kaplan-Meier, Cox proportional hazards model, subgroup analysis, and nomograms were selected to evaluate the outcomes. Results: A total of 1,508 older COVID-19 patients were screened. Based on the inclusion and exclusion criteria, 1,075 patients were eligible for the study. After PSM, the final number of older COVID-19 patients included in the study was 375, and there were no significant differences in demographic characteristics between the two groups (p > 0.05). Compared to the Azvudine group, the Nirmatrelvir-Ritonavir group showed a higher incidence of multiple adverse events (12.8% vs 5.2%, p = 0.009). The incidence of adverse events related to abnormal renal function was higher in the Nirmatrelvir-Ritonavir group compared to the Azvudine group (13.6% vs 7.2%, p = 0.045). There were no significant differences between the two groups in terms of all-cause 28-day mortality (HR = 1.020, 95% CI: 0.542 - 1.921, p = 0.951), whereas there were significant differences in nucleic acid negative conversion time (HR = 1.659, 95% CI: 1.166 - 2.360, p = 0.005) and ΔCt values (HR = 1.442, 95% CI: 1.084 - 1.918, p = 0.012). Conclusion: Azvudine and Nirmatrelvir-Ritonavir have comparable effectiveness in reducing mortality risk. Azvudine may perform better in nucleic acid negative conversion time and virus clearance and shows slightly better safety in older patients. Further studies with a larger sample size were needed to validate the result.
Collapse
Affiliation(s)
- Nan Shang
- Department of Pharmacy, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xianlin Li
- School of Pharmacy, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Zhiyu Guo
- School of Pharmacy, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Lan Zhang
- School of Public Health, Capital Medical University, Beijing, China
| | - Shanshan Wang
- Section of Occupational Medicine, Department of Special Medicine, Shanxi Medical University, Taiyuan, China
| |
Collapse
|
3
|
Mills DC, Huder JB, Bloemberg GV, Huber M. Comparison of three cartridge-based platforms for syndromic testing for respiratory viruses. Diagn Microbiol Infect Dis 2024; 109:116308. [PMID: 38688147 DOI: 10.1016/j.diagmicrobio.2024.116308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 04/17/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
Syndromic testing, the simultaneous testing for multiple pathogens causing similar symptoms, has recently gained ground in clinical diagnostics. This approach can significantly shorten time to diagnosis and speed up decision-making, leading to an improved outcome for the patient. Here, we compared three automated multiplex PCR platforms for syndromic testing of respiratory samples in a retrospective study, and assessed their relative sensitivities. The PPA between BioFire and QIAstat compared to ePlex was 98.4 % and 93.8 %, respectively, and 6 discrepant results were observed. The BioFire was identified as the platform with the highest relative sensitivity. Overall, the platforms performed similarly and are all suitable for syndromic testing of respiratory samples.
Collapse
Affiliation(s)
| | - Jon Barduot Huder
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | | | - Michael Huber
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| |
Collapse
|
4
|
Rotundo S, Berardelli L, Gullì S, La Gamba V, Lionello R, Russo A, Trecarichi EM, Torti C. Early initiation of combined therapy in severely immunocompromised patients with COVID-19: a retrospective cohort study. BMC Infect Dis 2024; 24:564. [PMID: 38844861 PMCID: PMC11155142 DOI: 10.1186/s12879-024-09466-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024] Open
Abstract
This single-centre retrospective cohort study reports on the results of a descriptive (non-comparative) retrospective cohort study of early initiation of antivirals and combined monoclonal antibody therapy (mAbs) in 48 severely immunocompromised patients with COVID-19. The study assessed the outcomes and the duration of viral shedding. The patients started early combined therapy (ECT) a median of 2 days (interquartile range [IQR]: 1-3 days) after the diagnosis of SARS-CoV-2 infection. Except for 1 patient who died due COVID-19-related respiratory failure, patients had their first negative nasopharyngeal swab result after a median of 11 days (IQR: 6-17 days) after starting combined therapy. There were no reports of severe side effects. During a follow-up period of 512 days (interquartile range [IQR]: 413-575 days), 6 patients (12.5%) died and 16 (33.3%) were admitted to hospital. Moreover, 12 patients (25%) were diagnosed with SARS-CoV-2 reinfection a median of 245 days (IQR: 138-401 days) after starting combined treatment. No relapses were reported. Although there was no comparison group, these results compare favourably with the outcomes of severely immunocompromised patients with COVID-19 reported in the literature.
Collapse
Affiliation(s)
- Salvatore Rotundo
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy.
| | - Lavinia Berardelli
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
| | - Sara Gullì
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
| | - Valentina La Gamba
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
- Unità Operativa Complessa di Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria "R. Dulbecco", Catanzaro, Italy
| | - Rosaria Lionello
- Unità Operativa Complessa di Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria "R. Dulbecco", Catanzaro, Italy
| | - Alessandro Russo
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
- Unità Operativa Complessa di Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria "R. Dulbecco", Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
- Unità Operativa Complessa di Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria "R. Dulbecco", Catanzaro, Italy
| | - Carlo Torti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
5
|
Grajdieru C, Mitina I, Tumanova L, Mitin V. Assessing several fungal contaminants and their associated mycotoxins in maize cultivated on cornfields of Republic of Moldova. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2024; 41:675-687. [PMID: 38662872 DOI: 10.1080/19440049.2024.2345721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/16/2024] [Indexed: 05/29/2024]
Abstract
Maize is an important crop for the Republic of Moldova and one of the crops most contaminated with mycotoxins. Maize grain obtained from plants cultivated on Moldavian cornfields in 2021 and 2022 were tested for mycotoxigenic risk using qPCR with primers to several fungal genome sequences engaged in mycotoxin synthesis and ELISA test to screen total aflatoxins, fumonisin B1, zearalenone, deoxynivalenol and T-2 toxin. Except for T-2 toxin, the mycotoxin concentrations were under the limits of detection and did not exceed maximum admissible levels for unprocessed grain. Concentrations of T-2 toxin in grain samples did not correlate significantly with the quantity of toxigenic F. sporotrichioides. All of the analysed grain samples were contaminated with at least one toxigenic fungus, and 20% of the samples were infected with seven different species of toxigenic fungi. Accumulation of fungi in maize kernels was affected significantly by the season, and generally a decrease was observed in fungal frequency and quantity under drought conditions. However, several toxigenic Aspergillus and Fusarium fungi that are able to produce aflatoxins and fumonisins under improper storage conditions were found in the kernels during the whole period of monitoring.
Collapse
Affiliation(s)
- Cristina Grajdieru
- Laboratory of Molecular genetics, Institute of Genetics, Physiology and Plant Protection of Moldova State University, Chisinau, Republic of Moldova
| | - Irina Mitina
- Laboratory of Molecular genetics, Institute of Genetics, Physiology and Plant Protection of Moldova State University, Chisinau, Republic of Moldova
| | - Lidia Tumanova
- Laboratory of Molecular genetics, Institute of Genetics, Physiology and Plant Protection of Moldova State University, Chisinau, Republic of Moldova
| | - Valentin Mitin
- Laboratory of Molecular genetics, Institute of Genetics, Physiology and Plant Protection of Moldova State University, Chisinau, Republic of Moldova
| |
Collapse
|
6
|
Kim M, Heo ST, Kim HC, Kang MJ, Kim S, Lee KH, Yoo JR. Correlation between the Cycle Threshold Values in Detection of Severe Fever with Thrombocytopenia Syndrome Virus Using PowerChek TM SFTSV Real-Time PCR Kit and Viral Load: Prognostic Implications. Viruses 2024; 16:700. [PMID: 38793582 PMCID: PMC11125572 DOI: 10.3390/v16050700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/23/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND This study aimed to analyze the correlation between the cycle threshold (Ct) values of severe fever with thrombocytopenia syndrome (SFTS) virus small (S) and middle (M) segments and the SFTS viral load, aiming to estimate the initial viral load and predict prognosis in the early clinical course. METHOD A retrospective study was conducted with confirmed SFTS patients at Jeju National University Hospital (2016-2022). Patients were categorized into non-fatal and fatal groups. RESULTS This study included 49 patients with confirmed SFTS (non-fatal group, n = 42; fatal group, n = 7). A significant negative correlation (-0.783) was observed between the log SFTS viral load and Ct values (p < 0.001). This negative correlation was notably stronger in the fatal group (correlation coefficient -0.940) than in the non-fatal group (correlation coefficient -0.345). CONCLUSION In this study, we established a correlation between SFTS viral load and Ct values for estimating the initial viral load and early predicting prognosis. These results are expected to offer valuable insights for SFTS patient treatment and prognosis prediction.
Collapse
Affiliation(s)
- Misun Kim
- Department of Internal Medicine, Jeju National University Hospital, Jeju 63241, Republic of Korea; (M.K.); (S.T.H.); (H.C.K.); (M.J.K.); (S.K.)
- Department of Internal Medicine, Jeju National University College of Medicine, Jeju 63241, Republic of Korea
| | - Sang Taek Heo
- Department of Internal Medicine, Jeju National University Hospital, Jeju 63241, Republic of Korea; (M.K.); (S.T.H.); (H.C.K.); (M.J.K.); (S.K.)
- Department of Internal Medicine, Jeju National University College of Medicine, Jeju 63241, Republic of Korea
| | - Hee Cheol Kim
- Department of Internal Medicine, Jeju National University Hospital, Jeju 63241, Republic of Korea; (M.K.); (S.T.H.); (H.C.K.); (M.J.K.); (S.K.)
| | - Myeong Jin Kang
- Department of Internal Medicine, Jeju National University Hospital, Jeju 63241, Republic of Korea; (M.K.); (S.T.H.); (H.C.K.); (M.J.K.); (S.K.)
| | - Sora Kim
- Department of Internal Medicine, Jeju National University Hospital, Jeju 63241, Republic of Korea; (M.K.); (S.T.H.); (H.C.K.); (M.J.K.); (S.K.)
| | - Keun Hwa Lee
- Department of Microbiology, Hanyang University College of Medicine, Seoul 04763, Republic of Korea;
| | - Jeong Rae Yoo
- Department of Internal Medicine, Jeju National University Hospital, Jeju 63241, Republic of Korea; (M.K.); (S.T.H.); (H.C.K.); (M.J.K.); (S.K.)
- Department of Internal Medicine, Jeju National University College of Medicine, Jeju 63241, Republic of Korea
| |
Collapse
|
7
|
Pourakbari R, Gholami M, Shakerimoghaddam A, Khiavi FM, Mohammadimehr M, Khomartash MS. Comparison of RT-LAMP and RT-qPCR assays for detecting SARS-CoV-2 in the extracted RNA and direct swab samples. J Virol Methods 2024; 324:114871. [PMID: 38103738 DOI: 10.1016/j.jviromet.2023.114871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/10/2023] [Accepted: 12/13/2023] [Indexed: 12/19/2023]
Abstract
Rapid detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in infected patients is critical for infection control. Loop-mediated isothermal amplification (LAMP) has been demonstrated to be a rapid, simple, reliable, cost-effective and sensitive method to detect SARS-CoV-2 in a variety of samples in considerably less time than Real-Time PCR. In this study, we developed and optimized a rapid detection method for SARS-CoV-2 based on RT-LAMP method utilizing a specific primer set targeting the ORF1a gene and then examined its sensitivity and efficiency using a serially diluted viral RNA sample with a known concentration. Furthermore, the sensitivity of the RT-LAMP to detect SARS-CoV-2 in direct swab samples with varying Ct values were compared to a commercial molecular RT-qPCR based detection kit. According to our findings the optimal incubation time for RT-LAMP assay was 45 min. There was a complete agreement between RT-LAMP and RT-qPCR in diagnosing the viral genome in the diluted extracted RNA sample. However, it had a lower sensitivity (71%) to detect the viral genome in direct swab samples compared to RT-qPCR. In conclusion, due to its simplicity, rapidness, sensitivity, and specificity, RT-LAMP has tremendous potential as a point-of-care tool; nevertheless, more research is needed to utilize it for detecting SARS-CoV-2, particularly in direct swab samples.
Collapse
Affiliation(s)
- Ramin Pourakbari
- Infectious Diseases Research Center, Aja University of Medical Sciences, Tehran, Iran.; Medical Biotechnology Research Center, Aja University of Medical Sciences, Tehran, Iran
| | - Mohammad Gholami
- Infectious Diseases Research Center, Aja University of Medical Sciences, Tehran, Iran
| | - Ali Shakerimoghaddam
- Infectious Diseases Research Center, Aja University of Medical Sciences, Tehran, Iran.; Medical Biotechnology Research Center, Aja University of Medical Sciences, Tehran, Iran
| | - Farhad Motavalli Khiavi
- Infectious Diseases Research Center, Aja University of Medical Sciences, Tehran, Iran.; Medical Biotechnology Research Center, Aja University of Medical Sciences, Tehran, Iran
| | - Mojgan Mohammadimehr
- Infectious Diseases Research Center, Aja University of Medical Sciences, Tehran, Iran
| | - Mehdi Shakouri Khomartash
- Infectious Diseases Research Center, Aja University of Medical Sciences, Tehran, Iran.; Medical Biotechnology Research Center, Aja University of Medical Sciences, Tehran, Iran..
| |
Collapse
|
8
|
Sritong N, Ngo WW, Ejendal KFK, Linnes JC. Development of an integrated sample amplification control for salivary point-of-care pathogen testing. Anal Chim Acta 2024; 1287:342072. [PMID: 38182338 DOI: 10.1016/j.aca.2023.342072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/20/2023] [Accepted: 11/25/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND The COVID-19 pandemic has led to a rise in point-of-care (POC) and home-based tests, but concerns over usability, accuracy, and effectiveness have arisen. The incorporation of internal amplification controls (IACs), essential control for translational POC diagnostics, could mitigate false-negative and false-positive results due to sample matrix interference or inhibition. Although emerging POC nucleic acid amplification tests (NAATs) for detecting SARS-CoV-2 show impressive analytical sensitivity in the lab, the assessment of clinical accuracy with IACs is often overlooked. In some cases, the IACs were run spatially, complicating assay workflow. Therefore, the multiplex assay for pathogen and IAC is needed. RESULTS We developed a one-pot duplex reverse transcriptase loop-mediated isothermal amplification (RT-LAMP) assay for saliva samples, a non-invasive and simple collected specimen for POC NAATs. The ORF1ab gene of SARS-CoV-2 was used as a target and a human 18S ribosomal RNA in human saliva was employed as an IAC to ensure clinical reliability of the RT-LAMP assay. The optimized assay could detect SARS-CoV-2 viral particles down to 100 copies/μL of saliva within 30 min without RNA extraction. The duplex RT-LAMP for SARS-CoV-2 and IAC is successfully amplified in the same reaction without cross-reactivity. The valid results were easily visualized in triple-line lateral flow immunoassay, in which two lines (flow control and IAC lines) represent valid negative results and three lines (flow control, IAC, and test line) represent valid positive results. This duplex assay demonstrated a clinical sensitivity of 95%, specificity of 100%, and accuracy of 96% in 30 clinical saliva samples. SIGNIFICANCE IACs play a crucial role in ensuring user confidence with respect to the accuracy and reliability of at-home and POC molecular diagnostics. We demonstrated the multiplex capability of SARS-COV-2 and human18S ribosomal RNA RT-LAMP without complicating assay design. This generic platform can be extended in a similar manner to include human18S ribosomal RNA IACs into different clinical sample matrices.
Collapse
Affiliation(s)
- Navaporn Sritong
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Winston Wei Ngo
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Karin F K Ejendal
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Jacqueline C Linnes
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; Department of Public Health, Purdue University, West Lafayette, IN, USA.
| |
Collapse
|
9
|
Opoku M, Obeng-Aboagye E, Boamah GYK, Adu-Asamoah D, Ismail RBY, Akpo MS, Dogbatse EE, Abraham J, Odoom JK, Owusu Donkor I, Akorli J. Assessing the performance of regular surgical nose masks as a sampling method for SARS-CoV-2 detection in a cross-sectional study. PLoS One 2023; 18:e0293001. [PMID: 37847712 PMCID: PMC10581487 DOI: 10.1371/journal.pone.0293001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 10/03/2023] [Indexed: 10/19/2023] Open
Abstract
Nose masks are widely worn for protection against respiratory pathogens, including SARS-CoV-2. They have been reported as possible substrates for viral sampling and testing for COVID-19 but, evaluations have so far been purposive; involving individuals known to have the infection and using improved materials on the nose masks to trap the virus. We investigated the feasibility of using the regular 3-ply surgical masks and, voluntary coughing as a mode of particle expulsion for detecting SARS-CoV-2 infections in a cross-sectional study at Ghana's first COVID-19 testing reference laboratory, the Noguchi Memorial Institute for Medical Research, University of Ghana. Paired samples of naso-oropharyngeal swabs and nose masks already worn by 103 consenting adult participants (retro masks) were collected. Participants were also required to produce three strong coughs into a newly supplied sterile surgical nose mask. Pre-wetted swabs in Viral Transport Media (VTM) were used in swabbing the inner lining of each nose mask. The swabs used were then stored in VTM to maintain the integrity of the samples. PCR results of SARS-CoV-2 detection from the nose masks were compared to those from naso-oropharyngeal swabs ('gold-standard'). Out of the 103 participants tested with all three methods, 66 individuals sampled with naso-oropharyngeal swabs were detected as positive, and the retro and new masks matched 9 and 4, respectively. Only 3 individuals were positive across all three sampling methods accessed. The retro nose masks performed better in matching the gold-standard results than the new mask + coughing method, with 90% vs 80% sensitivity, positive predictive value of 13.6% vs 6%, and a weak but significant linear relationship (adj. R2 = 0.1; P = 0.0004). Importantly, we also show that the nose masks would work for sampling whether individuals are symptomatic or asymptomatic since gold-standard PCR cycling threshold (Ct) values for positive individuals did not differ between the two groups (P< 0.05). We recommend including features such as talking during participant engagement, use of a spontaneous cough inducer and increased coughing bouts > 3, to improve the performance of sterile nose masks for SARS-CoV-2 detection.
Collapse
Affiliation(s)
- Millicent Opoku
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Elizabeth Obeng-Aboagye
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Georgina Yaa Kwartemaa Boamah
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Dina Adu-Asamoah
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Rahmat Bint Yusif Ismail
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Margaret Sena Akpo
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Elizabeth Etornam Dogbatse
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Joseph Abraham
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - John Kofi Odoom
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Irene Owusu Donkor
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Jewelna Akorli
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| |
Collapse
|
10
|
Sritong N, Ngo WW, Ejendal KFK, Linnes JC. Development of an Integrated Sample Amplification Control for Salivary Point-of-Care Pathogen Testing. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.03.23296477. [PMID: 37873363 PMCID: PMC10593008 DOI: 10.1101/2023.10.03.23296477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Background The COVID-19 pandemic has led to a rise in point-of-care (POC) and home-based tests, but concerns over usability, accuracy, and effectiveness have arisen. The incorporation of internal amplification controls (IACs), essential control for translational POC diagnostics, could mitigate false-negative and false-positive results due to sample matrix interference or inhibition. Although emerging POC nucleic acid amplification tests (NAATs) for detecting SARS-CoV-2 show impressive analytical sensitivity in the lab, the assessment of clinical accuracy with IACs is often overlooked. In some cases, the IACs were run spatially, complicating assay workflow. Therefore, the multiplex assay for pathogen and IAC is needed. Results We developed a one-pot duplex reverse transcriptase loop-mediated isothermal amplification (RT-LAMP) assay for saliva samples, a non-invasive and simple collected specimen for POC NAATs. The ORF1ab gene of SARS-CoV-2 was used as a target and a human 18S ribosomal RNA in human saliva was employed as an IAC to ensure clinical reliability of the RT-LAMP assay. The optimized assay could detect SARS-CoV-2 viral particles down to 100 copies/μL of saliva within 30 minutes without RNA extraction. The duplex RT-LAMP for SARS-CoV-2 and IAC is successfully amplified in the same reaction without cross-reactivity. The valid results were easily visualized in triple-line lateral flow immunoassay, in which two lines (flow control and IAC lines) represent valid negative results and three lines (flow control, IAC, and test line) represent valid positive results. This duplex assay demonstrated a clinical sensitivity of 95%, specificity of 100%, and accuracy of 96% in 30 clinical saliva samples. Significance IACs play a crucial role in ensuring user confidence with respect to the accuracy and reliability of at-home and POC molecular diagnostics. We demonstrated the multiplex capability of SARS-COV-2 and human18S ribosomal RNA RT-LAMP without complicating assay design. This generic platform can be extended in a similar manner to include human18S ribosomal RNA IACs into different clinical sample matrices.
Collapse
Affiliation(s)
- Navaporn Sritong
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Winston Wei Ngo
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Karin F. K. Ejendal
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Jacqueline C. Linnes
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
- Department of Public Health, Purdue University, West Lafayette, IN, USA
| |
Collapse
|
11
|
Nasir A, Aamir UB, Kanji A, Bukhari AR, Ansar Z, Ghanchi NK, Masood KI, Samreen A, Islam N, Ghani S, Syed MA, Wassan M, Mahmood SF, Hasan Z. Tracking SARS-CoV-2 variants through pandemic waves using RT-PCR testing in low-resource settings. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001896. [PMID: 37262051 PMCID: PMC10234525 DOI: 10.1371/journal.pgph.0001896] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 05/05/2023] [Indexed: 06/03/2023]
Abstract
COVID-19 resulted in extensive morbidity and mortality worldwide. SARS-CoV-2 evolved rapidly, with increasing transmission due to Variants of Concern (VOC). Identifying VOC became important but genome submissions from low-middle income countries (LMIC) remained low leading to gaps in genomic epidemiology. We demonstrate the use of a specific mutation RT-PCR based approach to identify VOC in SARS-CoV-2 positive samples through the pandemic in Pakistan. We selected 2150 SARS-CoV-2 PCR positive respiratory specimens tested between April 2021 and February 2022, at the Aga Khan University Hospital Clinical Laboratories, Karachi, Pakistan. Commercially available RT-PCR assays were used as required for mutations in Spike protein (N501Y, A570D, E484K, K417N, L452R, P681R and deletion69_70) to identify Alpha, Beta, Gamma, Delta, and Omicron variants respectively. Three pandemic waves associated with Alpha, Delta and Omicron occurred during the study period. Of the samples screened, VOC were identified in 81.7% of cases comprising mainly; Delta (37.2%), Alpha (29.8%) and Omicron (17.1%) variants. During 2021, Alpha variants were predominant in April and May; Beta and Gamma variants emerged in May and peaked in June; the Delta variant peaked in July and remained predominant until November. Omicron (BA.1) emerged in December 2021 and remained predominant until February 2022. The CT values of Alpha, Beta, Gamma and Delta were all significantly higher than that of Omicron variants (p<0.0001). We observed VOC through the pandemic waves using spike mutation specific RT-PCR assays. We show the spike mutation specific RT-PCR assay is a rapid, low-cost and adaptable for the identification of VOC as an adjunct approach to NGS to effectively inform the public health response. Further, by associating the VOC with CT values of its diagnostic PCR we gain information regarding the viral load of samples and therefore the level of transmission and disease severity in the population.
Collapse
Affiliation(s)
- Asghar Nasir
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | | | - Akbar Kanji
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Ali Raza Bukhari
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Zeeshan Ansar
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Najia Karim Ghanchi
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Kiran Iqbal Masood
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Azra Samreen
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Nazneen Islam
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Samina Ghani
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - M. Asif Syed
- Department of Health, Government of Sindh, Karachi, Pakistan
| | - Mansoor Wassan
- Department of Health, Government of Sindh, Karachi, Pakistan
| | | | - Zahra Hasan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| |
Collapse
|
12
|
Ying WF, Chen Q, Jiang ZK, Hao DG, Zhang Y, Han Q. Chest computed tomography findings of the Omicron variants of SARS-CoV-2 with different cycle threshold values. World J Clin Cases 2023; 11:756-763. [PMID: 36818628 PMCID: PMC9928689 DOI: 10.12998/wjcc.v11.i4.756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/29/2022] [Accepted: 01/12/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mainly infects the upper respiratory tract. This study aimed to determine whether the probability of pulmonary infection and the cycle threshold (Ct) measured using the fluorescent polymerase chain reaction (PCR) method were related to pulmonary infections diagnosed via computed tomography (CT).
AIM To analyze the chest CT signs of SARS-CoV-2 Omicron variant infections with different Ct values, as determined via PCR.
METHODS The chest CT images and PCR Ct values of 331 patients with SARS-CoV-2 Omicron variant infections were retrospectively collected and categorized into low (< 25), medium (25.00-34.99), and high (≥ 35) Ct groups. The characteristics of chest CT images in each group were statistically analyzed.
RESULTS The PCR Ct values ranged from 13.36 to 39.81, with 99 patients in the low, 155 in the medium, and 77 in the high Ct groups. Six abnormal chest CT signs were detected, namely, focal infection, patchy consolidation shadows, patchy ground-glass shadows, mixed consolidation ground-glass shadows, subpleural interstitial changes, and pleural changes. Focal infections were less frequent in the low Ct group than in the medium and high Ct groups; these infections were the most common sign in the medium and high Ct groups. Patchy consolidation shadows and pleural changes were more frequent in the low Ct group than in the other two groups. The number of patients with two or more signs was greater in the low Ct group than in the medium and high Ct groups.
CONCLUSION The chest CT signs of patients with pulmonary infection caused by the Omicron variants of SARS-CoV-2 varied depending on the Ct values. Identification of the characteristics of Omicron variant infection can help subsequent planning of clinical treatment.
Collapse
Affiliation(s)
- Wei-Feng Ying
- Department of Radiology, Shanghai Xuhui Dahua Hospital, Shanghai 200237, China
| | - Qiong Chen
- Department of Radiology, Shanghai Xuhui Dahua Hospital, Shanghai 200237, China
| | - Zhi-Kui Jiang
- Department of Clinical Laboratory, Shanghai Xuhui Dahua Hospital, Shanghai 200237, China
| | - Da-Guang Hao
- Department of Radiology, Shanghai Xuhui Dahua Hospital, Shanghai 200237, China
| | - Ying Zhang
- Department of Radiology, Shanghai Xuhui Dahua Hospital, Shanghai 200237, China
| | - Qian Han
- Department of Clinical Laboratory, Shanghai Xuhui Dahua Hospital, Shanghai 200237, China
| |
Collapse
|
13
|
The Performance of Lateral Flow Tests in the Age of the Omicron: A Rapid Systematic Review. LIFE (BASEL, SWITZERLAND) 2022; 12:life12111941. [PMID: 36431077 PMCID: PMC9695766 DOI: 10.3390/life12111941] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022]
Abstract
Prompt detection and isolation of COVID-19 cases is vital for preventing further viral transmission, and lateral flow or rapid antigen tests have been an important diagnostic tool in this pandemic. However, concerns have emerged regarding the sensitivity of these devices for the new BA.1, BA.2, and BA.4/5 omicron variants, which have greater transmissibility and extensive mutations in its spike (S) and nucleocapsid (N) proteins. N protein is an important target protein for existing lateral flow devices. This paper therefore aimed to provide a rapid review of available literature on the performance of the lateral flow tests for detecting the omicron coronavirus variant. A systematic literature search of PubMed, EMBASE, OVID Medline, and Google Scholar found six published studies and four preprints investigating the performance of existing lateral flow devices for the omicron variant, as compared to the B.1.617.2 (Delta) variant. Overall, it appears that the devices have poorer performance for the omicron variant and when testing samples with cycle threshold (Ct) values greater than 25 and in asymptomatic individuals. As most available data were preliminary and had small sample sizes, it is recommended that these data be further studied to better inform and adapt our public health responses.
Collapse
|