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Berry GJ, Jhaveri TA, Larkin PMK, Mostafa H, Babady NE. ADLM Guidance Document on Laboratory Diagnosis of Respiratory Viruses. J Appl Lab Med 2024; 9:599-628. [PMID: 38695489 DOI: 10.1093/jalm/jfae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 06/06/2024]
Abstract
Respiratory viral infections are among the most frequent infections experienced worldwide. The COVID-19 pandemic has highlighted the need for testing and currently several tests are available for the detection of a wide range of viruses. These tests vary widely in terms of the number of viral pathogens included, viral markers targeted, regulatory status, and turnaround time to results, as well as their analytical and clinical performance. Given these many variables, selection and interpretation of testing requires thoughtful consideration. The current guidance document is the authors' expert opinion based on the preponderance of available evidence to address key questions related to best practices for laboratory diagnosis of respiratory viral infections including who to test, when to test, and what tests to use. An algorithm is proposed to help laboratories decide on the most appropriate tests to use for the diagnosis of respiratory viral infections.
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Affiliation(s)
- Gregory J Berry
- Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian-Columbia University Irving Medical Center, New York, NY, United States
| | - Tulip A Jhaveri
- Department of Internal Medicine, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS, United States
| | - Paige M K Larkin
- University of Chicago Pritzker School of Medicine, NorthShore University Health System, Chicago, IL, United States
| | - Heba Mostafa
- Johns Hopkins School of Medicine, Department of Pathology, Baltimore, MD, United States
| | - N Esther Babady
- Clinical Microbiology and Infectious Disease Services, Department of Pathology and Laboratory Medicine and Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
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2
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Fischl MJ, Young J, Kardos K, Roehler M, Miller T, Wooten M, Holmes N, Gula N, Baglivo M, Steen J, Zelenz N, Joyee AG, Munster V, Weishampel Z, Yinda CK, Rouse KG, Gvozden C, Wever D, Yanez G, Anderson M, Yu S, Bearie B, Young S, Berry JD. Development and Clinical Performance of InteliSwab ® COVID-19 Rapid Test: Evaluation of Antigen Test for the Diagnosis of SARS-CoV-2 and Analytical Sensitivity to Detect Variants of Concern Including Omicron and Subvariants. Viruses 2023; 16:61. [PMID: 38257761 PMCID: PMC10821026 DOI: 10.3390/v16010061] [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: 11/28/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Timely detection of SARS-CoV-2 infection with subsequent contact tracing and rapid isolation are considered critical to containing the pandemic, which continues with the emergence of new variants. Hence, there is an ongoing need for reliable point-of-care antigen rapid diagnostic tests (Ag-RDT). This report describes the development, evaluation, and analytical sensitivity of the diagnostic performance of the InteliSwab® COVID-19 Rapid Test. Methods: Samples from 165 symptomatic subjects were tested with InteliSwab® and the results were compared to RT-PCR to determine the antigen test performance. The analytical sensitivity of InteliSwab® for the detection of different variants was assessed by limit of detection (LOD) determination using recombinant nucleocapsid proteins (NPs) and testing with virus isolates. Western immunoblot independently confirmed that each monoclonal Ab is capable of binding to all variants tested thus far. RESULTS The overall positivity rate by RT-PCR was 37% for the 165 symptomatic subjects. Based on RT-PCR results as the reference standard, InteliSwab® showed clinical sensitivity and specificity of 85.2% (95% CI, 74.3-92.0%) and 98.1% (95% CI, 93.3-99.7%), respectively. The overall agreement was 93.3% (Kappa index value 0.85; 95% CI, 0.77-0.74) between RT-PCR and InteliSwab® test results. Furthermore, the evaluation of analytical sensitivity for different SARS-CoV-2 variants by InteliSwab® was comparable in the detection of all the variants tested, including Omicron subvariants, BA.4, BA.5, and BQ.1. CONCLUSIONS Due to the surge of infections caused by different variants from time to time, there is a critical need to evaluate the sensitivity of rapid antigen-detecting tests for new variants. The study findings showed the robust diagnostic performance of InteliSwab® and analytical sensitivity in detecting different SARS-CoV-2 variants, including the Omicron subvariants. With the integrated swab and excellent sensitivity and variant detection, this test has high potential as a point-of-care Ag-RDT in various settings when molecular assays are in limited supply and rapid diagnosis of SARS-CoV-2 is necessary.
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Affiliation(s)
- Mark J. Fischl
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Janean Young
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Keith Kardos
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Michele Roehler
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Tiffany Miller
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Melinda Wooten
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Natalie Holmes
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Nicole Gula
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Mia Baglivo
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Justin Steen
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Nori Zelenz
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Antony George Joyee
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Vincent Munster
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Hamilton, MT 59840, USA; (V.M.); (Z.W.); (C.K.Y.)
| | - Zack Weishampel
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Hamilton, MT 59840, USA; (V.M.); (Z.W.); (C.K.Y.)
| | - Claude Kwe Yinda
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Hamilton, MT 59840, USA; (V.M.); (Z.W.); (C.K.Y.)
| | | | | | - David Wever
- Cahaba Research Inc., Pelham, AL 35124, USA;
| | - Giralt Yanez
- South Florida Research Organization, Medley, FL 33166, USA;
| | | | - Song Yu
- Cahaba Research Inc., MedHelp Urgent Care, Birmingham, AL 32535, USA;
| | - Brian Bearie
- Urgent Care of Colton, Benchmark Research Group, Colton, CA 92324, USA
| | - Stephen Young
- TriCore Reference Laboratories, Albuquerque, NM 87102, USA;
| | - Jody D. Berry
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
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3
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Krenn F, Dächert C, Badell I, Lupoli G, Öztan GN, Feng T, Schneider N, Huber M, Both H, Späth PM, Muenchhoff M, Graf A, Krebs S, Blum H, Durner J, Czibere L, Kaderali L, Keppler OT, Baldauf HM, Osterman A. Ten rapid antigen tests for SARS-CoV-2 widely differ in their ability to detect Omicron-BA.4 and -BA.5. Med Microbiol Immunol 2023; 212:323-337. [PMID: 37561225 PMCID: PMC10501931 DOI: 10.1007/s00430-023-00775-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/11/2023] [Indexed: 08/11/2023]
Abstract
Since late 2021, the variant landscape of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been dominated by the variant of concern (VoC) Omicron and its sublineages. We and others have shown that the detection of Omicron-BA.1 and -BA.2-positive respiratory specimens by rapid antigen tests (RATs) is impaired compared to Delta VoC-containing samples. Here, in a single-center retrospective laboratory study, we evaluated the performance of ten most commonly used RATs for the detection of Omicron-BA.4 and -BA.5 infections. We used 171 respiratory swab specimens from SARS-CoV-2 RNA-positive patients, of which 71 were classified as BA.4 and 100 as BA.5. All swabs were collected between July and September 2022. 50 SARS-CoV-2 PCR-negative samples from healthy individuals, collected in October 2022, showed high specificity in 9 out of 10 RATs. When assessing analytical sensitivity using clinical specimens, the 50% limit of detection (LoD50) ranged from 7.6 × 104 to 3.3 × 106 RNA copies subjected to the RATs for BA.4 compared to 6.8 × 104 to 3.0 × 106 for BA.5. Overall, intra-assay differences for the detection of these two Omicron subvariants were not significant for both respiratory swabs and tissue culture-expanded virus isolates. In contrast, marked heterogeneity was observed among the ten RATs: to be positive in these point-of-care tests, up to 443-fold (BA.4) and up to 56-fold (BA.5) higher viral loads were required for the worst performing RAT compared to the best performing RAT. True-positive rates for Omicron-BA.4- or -BA.5-containing specimens in the highest viral load category (Ct values < 25) ranged from 94.3 to 34.3%, dropping to 25.6 to 0% for samples with intermediate Ct values (25-30). We conclude that the high heterogeneity in the performance of commonly used RATs remains a challenge for the general public to obtain reliable results in the evolving Omicron subvariant-driven pandemic.
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Affiliation(s)
- Franziska Krenn
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Christopher Dächert
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
- German Center for Infection Research (DZIF), Partner Site, Munich, Germany
| | - Irina Badell
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Gaia Lupoli
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Gamze Naz Öztan
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Tianle Feng
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Nikolas Schneider
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Melanie Huber
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Hanna Both
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Patricia M. Späth
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Maximilian Muenchhoff
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
- German Center for Infection Research (DZIF), Partner Site, Munich, Germany
- COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, LMU München, Munich, Germany
| | - Alexander Graf
- Laboratory for Functional Genome Analysis, Gene Center, LMU München, Munich, Germany
| | - Stefan Krebs
- Laboratory for Functional Genome Analysis, Gene Center, LMU München, Munich, Germany
| | - Helmut Blum
- Laboratory for Functional Genome Analysis, Gene Center, LMU München, Munich, Germany
| | | | | | - Lars Kaderali
- Institute of Bioinformatics, University Medicine Greifswald, Greifswald, Germany
| | - Oliver T. Keppler
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
- German Center for Infection Research (DZIF), Partner Site, Munich, Germany
- COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, LMU München, Munich, Germany
| | - Hanna-Mari Baldauf
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Andreas Osterman
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
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4
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Viloria Winnett A, Akana R, Shelby N, Davich H, Caldera S, Yamada T, Reyna JRB, Romano AE, Carter AM, Kim MK, Thomson M, Tognazzini C, Feaster M, Goh YY, Chew YC, Ismagilov RF. Daily SARS-CoV-2 Nasal Antigen Tests Miss Infected and Presumably Infectious People Due to Viral Load Differences among Specimen Types. Microbiol Spectr 2023; 11:e0129523. [PMID: 37314333 PMCID: PMC10434058 DOI: 10.1128/spectrum.01295-23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/21/2023] [Indexed: 06/15/2023] Open
Abstract
In a recent household transmission study of SARS-CoV-2, we found extreme differences in SARS-CoV-2 viral loads among paired saliva, anterior nares swab (ANS), and oropharyngeal swab specimens collected from the same time point. We hypothesized these differences may hinder low-analytical-sensitivity assays (including antigen rapid diagnostic tests [Ag-RDTs]) by using a single specimen type (e.g., ANS) from reliably detecting infected and infectious individuals. We evaluated daily at-home ANS Ag-RDTs (Quidel QuickVue) in a cross-sectional analysis of 228 individuals and a longitudinal analysis (throughout infection) of 17 individuals enrolled early in the course of infection. Ag-RDT results were compared to reverse transcription-quantitative PCR (RT-qPCR) results and high, presumably infectious viral loads (in each, or any, specimen type). The ANS Ag-RDT correctly detected only 44% of time points from infected individuals on cross-sectional analysis, and this population had an inferred limit of detection of 7.6 × 106 copies/mL. From the longitudinal cohort, daily Ag-RDT clinical sensitivity was very low (<3%) during the early, preinfectious period of the infection. Further, the Ag-RDT detected ≤63% of presumably infectious time points. The poor observed clinical sensitivity of the Ag-RDT was similar to what was predicted based on quantitative ANS viral loads and the inferred limit of detection of the ANS Ag-RDT being evaluated, indicating high-quality self-sampling. Nasal Ag-RDTs, even when used daily, can miss individuals infected with the Omicron variant and even those presumably infectious. Evaluations of Ag-RDTs for detection of infected or infectious individuals should be compared with a composite (multispecimen) infection status to correctly assess performance. IMPORTANCE We reveal three findings from a longitudinal study of daily nasal antigen rapid diagnostic test (Ag-RDT) evaluated against SARS-CoV-2 viral load quantification in three specimen types (saliva, nasal swab, and throat swab) in participants enrolled at the incidence of infection. First, the evaluated Ag-RDT showed low (44%) clinical sensitivity for detecting infected persons at all infection stages. Second, the Ag-RDT poorly detected (≤63%) time points that participants had high and presumably infectious viral loads in at least one specimen type. This poor clinical sensitivity to detect infectious individuals is inconsistent with the commonly held view that daily Ag-RDTs have near-perfect detection of infectious individuals. Third, use of a combination nasal-throat specimen type was inferred by viral loads to significantly improve Ag-RDT performance to detect infectious individuals.
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Affiliation(s)
| | - Reid Akana
- California Institute of Technology, Pasadena, California, USA
| | - Natasha Shelby
- California Institute of Technology, Pasadena, California, USA
| | - Hannah Davich
- California Institute of Technology, Pasadena, California, USA
| | - Saharai Caldera
- California Institute of Technology, Pasadena, California, USA
| | - Taikun Yamada
- Pangea Laboratory LLC, Tustin, California, USA
- Zymo Research Corporation, Irvine, California, USA
| | | | - Anna E. Romano
- California Institute of Technology, Pasadena, California, USA
| | | | - Mi Kyung Kim
- California Institute of Technology, Pasadena, California, USA
| | - Matt Thomson
- California Institute of Technology, Pasadena, California, USA
| | | | - Matthew Feaster
- Pasadena Public Health Department, Pasadena, California, USA
| | - Ying-Ying Goh
- Pasadena Public Health Department, Pasadena, California, USA
| | - Yap Ching Chew
- Pangea Laboratory LLC, Tustin, California, USA
- Zymo Research Corporation, Irvine, California, USA
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5
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Vaeth MJE, Abdullah O, Cheema M, Sun K, Elhabashy M, Mitchell A, Foyez M, Talla M, Cheema A, Locke C, Kantsiper M, Pekosz A, Mostafa HH, Siddiqui ZK. Accuracy of Expired BinaxNOW Rapid Antigen Tests. Microbiol Spectr 2023; 11:e0208823. [PMID: 37428037 PMCID: PMC10434179 DOI: 10.1128/spectrum.02088-23] [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: 05/18/2023] [Accepted: 06/22/2023] [Indexed: 07/11/2023] Open
Abstract
The widespread existence of expired antigen testing kits in households and potential coronavirus outbreaks necessitates evaluating the reliability of these expired kits. Our study examined BinaxNOW COVID-19 rapid antigen tests 27 months postmanufacture and 5 months past their FDA extended expiration dates, using SARS-CoV-2 variant XBB.1.5 viral stock. We conducted testing at two concentrations, the limit of detection (LOD) and 10 times the LOD. One hundred expired and unexpired kits were tested at each concentration for a total of 400 antigen tests. At the LOD (2.32 × 102 50% tissue culture infective dose/mL [TCID50/mL]), both expired and unexpired tests displayed 100% sensitivity (95% confidence interval [CI], 96.38% to 100%), with no statistical difference (95% CI, -3.92% to 3.92%). Similarly, at 10 times the LOD, unexpired tests retained 100% sensitivity (95% CI, 96.38% to 100%), while expired tests exhibited 99% sensitivity (95% CI, 94.61% to 99.99%), demonstrating a statistically insignificant 1% difference (95% CI, -2.49% to 4.49%; P = 0.56). Expired rapid antigen tests had fainter lines than the unexpired tests at each viral concentration. The expired rapid antigen tests at the LOD were only just visible. These findings carry significant implications for waste management, cost efficiency, and supply chain resilience in pandemic readiness efforts. They also provide critical insights for formulating clinical guidelines for interpreting results from expired kits. In light of expert warnings of a potential outbreak of a severity rivaling the Omicron variant, our study underscores the importance of maximizing the utility of expired antigen testing kits in managing future health emergencies. IMPORTANCE The study examining the reliability of expired antigen testing kits in the context of COVID-19 has significant real-world implications. By demonstrating that these expired kits retain their sensitivity in detecting the virus, this work provides evidence that expired kits can still be utilized, reducing waste and optimizing resources in health care systems. These findings are especially crucial in light of potential future coronavirus outbreaks and the need to be prepared. The study's outcomes have the potential to contribute to waste management efforts, cost efficiency, and supply chain resilience, ensuring that diagnostic tests remain readily available for effective public health interventions. Furthermore, it provides critical insights for formulating clinical guidelines on interpreting results from expired kits, enhancing the accuracy of testing outcomes, and supporting informed decision-making. Ultimately, this work holds great importance in maximizing the utility of expired antigen testing kits, safeguarding public health, and enhancing pandemic readiness on a global scale.
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Affiliation(s)
| | - Omar Abdullah
- Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Minahil Cheema
- University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Kristie Sun
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Maryam Elhabashy
- University of Maryland Baltimore County, Baltimore, Maryland, USA
| | - Asia Mitchell
- Baltimore Convention Center Field Hospital, Baltimore, Maryland, USA
| | - Maisha Foyez
- Baltimore Convention Center Field Hospital, Baltimore, Maryland, USA
| | - Mahita Talla
- University of Maryland College Park, College Park, Maryland, USA
| | - Aamna Cheema
- University of Maryland College Park, College Park, Maryland, USA
| | - Charles Locke
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Melinda Kantsiper
- Division of Hospital Medicine, The Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA
| | - Andrew Pekosz
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Heba H. Mostafa
- Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Zishan K. Siddiqui
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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6
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Zabidi NZ, Liew HL, Farouk IA, Puniyamurti A, Yip AJW, Wijesinghe VN, Low ZY, Tang JW, Chow VTK, Lal SK. Evolution of SARS-CoV-2 Variants: Implications on Immune Escape, Vaccination, Therapeutic and Diagnostic Strategies. Viruses 2023; 15:v15040944. [PMID: 37112923 PMCID: PMC10145020 DOI: 10.3390/v15040944] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
The COVID-19 pandemic caused by SARS-CoV-2 is associated with a lower fatality rate than its SARS and MERS counterparts. However, the rapid evolution of SARS-CoV-2 has given rise to multiple variants with varying pathogenicity and transmissibility, such as the Delta and Omicron variants. Individuals with advanced age or underlying comorbidities, including hypertension, diabetes and cardiovascular diseases, are at a higher risk of increased disease severity. Hence, this has resulted in an urgent need for the development of better therapeutic and preventive approaches. This review describes the origin and evolution of human coronaviruses, particularly SARS-CoV-2 and its variants as well as sub-variants. Risk factors that contribute to disease severity and the implications of co-infections are also considered. In addition, various antiviral strategies against COVID-19, including novel and repurposed antiviral drugs targeting viral and host proteins, as well as immunotherapeutic strategies, are discussed. We critically evaluate strategies of current and emerging vaccines against SARS-CoV-2 and their efficacy, including immune evasion by new variants and sub-variants. The impact of SARS-CoV-2 evolution on COVID-19 diagnostic testing is also examined. Collectively, global research and public health authorities, along with all sectors of society, need to better prepare against upcoming variants and future coronavirus outbreaks.
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Affiliation(s)
- Nur Zawanah Zabidi
- School of Science, Monash University Malaysia, Subang Jaya 47500, Selangor, Malaysia
| | - Hern Liang Liew
- School of Science, Monash University Malaysia, Subang Jaya 47500, Selangor, Malaysia
| | - Isra Ahmad Farouk
- School of Science, Monash University Malaysia, Subang Jaya 47500, Selangor, Malaysia
| | - Ashwini Puniyamurti
- School of Science, Monash University Malaysia, Subang Jaya 47500, Selangor, Malaysia
| | - Ashley Jia Wen Yip
- School of Science, Monash University Malaysia, Subang Jaya 47500, Selangor, Malaysia
| | | | - Zheng Yao Low
- School of Science, Monash University Malaysia, Subang Jaya 47500, Selangor, Malaysia
| | - Julian W Tang
- Department of Respiratory Sciences, University of Leicester, Leicester LE1 7RH, UK
| | - Vincent T K Chow
- Infectious Diseases Translational Research Program, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore
| | - Sunil K Lal
- School of Science, Monash University Malaysia, Subang Jaya 47500, Selangor, Malaysia
- Tropical Medicine & Biology Platform, Monash University, Subang Jaya 47500, Selangor, Malaysia
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7
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Puyskens A, Bayram F, Sesver A, Michel J, Krause E, Bourquain D, Filomena A, Esser-Nobis K, Steffanowski C, Nübling CM, Scheiblauer H, Schaade L, Nitsche A. Performance of 20 rapid antigen detection tests to detect SARS-CoV-2 B.1.617.2 (Delta) and B.1.1.529 (Omicron) variants using a clinical specimen panel from January 2022, Berlin, Germany. Euro Surveill 2023; 28:2200615. [PMID: 37078884 PMCID: PMC10283455 DOI: 10.2807/1560-7917.es.2023.28.16.2200615] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 02/01/2023] [Indexed: 05/05/2023] Open
Abstract
BackgroundThere are conflicting reports on the performance of rapid antigen detection tests (RDT) in the detection of the SARS-CoV-2 Omicron (B.1.1.529) variant; however, these tests continue to be used frequently to detect potentially contagious individuals with high viral loads.AimThe aim of this study was to investigate comparative detection of the Delta (B.1.617.2) and Omicron variants by using a selection of 20 RDT and a limited panel of pooled combined oro- and nasopharyngeal clinical Delta and Omicron specimens.MethodsWe tested 20 CE-marked RDT for their performance to detect SARS-CoV-2 Delta and Omicron by using a panel of pooled clinical specimens collected in January 2022 in Berlin, Germany.ResultsWe observed equivalent detection performance for Delta and Omicron for most RDT, and sensitivity was widely in line with our previous pre-Delta/Omicron evaluation. Some variation for individual RDT was observed either for Delta vs Omicron detection, or when compared with the previous evaluation, which may be explained both by different panel sizes resulting in different data robustness and potential limitation of batch-to-batch consistency. Additional experiments with three RDT using non-pooled routine clinical samples confirmed comparable performance to detect Delta vs Omicron. Overall, RDT that were previously positively evaluated retained good performance also for Delta and Omicron variants.ConclusionOur findings suggest that currently available RDT are sufficient for the detection of SARS-CoV-2 Delta and Omicron variants.
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Affiliation(s)
- Andreas Puyskens
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Berlin, Germany
| | - Fatimanur Bayram
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Berlin, Germany
| | - Akin Sesver
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Berlin, Germany
| | - Janine Michel
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Berlin, Germany
| | - Eva Krause
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Berlin, Germany
| | - Daniel Bourquain
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Berlin, Germany
| | - Angela Filomena
- Paul-Ehrlich-Institute, Testing Laboratory for In-vitro Diagnostic Medical Devices, Langen, Germany
| | - Katharina Esser-Nobis
- Paul-Ehrlich-Institute, Testing Laboratory for In-vitro Diagnostic Medical Devices, Langen, Germany
| | - Carla Steffanowski
- Paul-Ehrlich-Institute, Testing Laboratory for In-vitro Diagnostic Medical Devices, Langen, Germany
| | - C Micha Nübling
- Paul-Ehrlich-Institute, Division Major Policy Issues, Coordination, Langen, Germany
| | - Heinrich Scheiblauer
- Paul-Ehrlich-Institute, Testing Laboratory for In-vitro Diagnostic Medical Devices, Langen, Germany
| | - Lars Schaade
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Berlin, Germany
| | - Andreas Nitsche
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Berlin, Germany
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8
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Naidoo DB, Chuturgoon AA. The Potential of Nanobodies for COVID-19 Diagnostics and Therapeutics. Mol Diagn Ther 2023; 27:193-226. [PMID: 36656511 PMCID: PMC9850341 DOI: 10.1007/s40291-022-00634-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 01/20/2023]
Abstract
The infectious severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative agent for coronavirus disease 2019 (COVID-19). Globally, there have been millions of infections and fatalities. Unfortunately, the virus has been persistent and a contributing factor is the emergence of several variants. The urgency to combat COVID-19 led to the identification/development of various diagnosis (polymerase chain reaction and antigen tests) and treatment (repurposed drugs, convalescent plasma, antibodies and vaccines) options. These treatments may treat mild symptoms and decrease the risk of life-threatening disease. Although these options have been fairly beneficial, there are some challenges and limitations, such as cost of tests/drugs, specificity, large treatment dosages, intravenous administration, need for trained personal, lengthy production time, high manufacturing costs, and limited availability. Therefore, the development of more efficient COVID-19 diagnostic and therapeutic options are vital. Nanobodies (Nbs) are novel monomeric antigen-binding fragments derived from camelid antibodies. Advantages of Nbs include low immunogenicity, high specificity, stability and affinity. These characteristics allow for rapid Nb generation, inexpensive large-scale production, effective storage, and transportation, which is essential during pandemics. Additionally, the potential aerosolization and inhalation delivery of Nbs allows for targeted treatment delivery as well as patient self-administration. Therefore, Nbs are a viable option to target SARS-CoV-2 and overcome COVID-19. In this review we discuss (1) COVID-19; (2) SARS-CoV-2; (3) the present conventional COVID-19 diagnostics and therapeutics, including their challenges and limitations; (4) advantages of Nbs; and (5) the numerous Nbs generated against SARS-CoV-2 as well as their diagnostic and therapeutic potential.
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Affiliation(s)
- Dhaneshree Bestinee Naidoo
- Discipline of Medical Biochemistry and Chemical Pathology, Faculty of Health Sciences, Howard College, University of Kwa-Zulu Natal, Durban, 4013, South Africa
| | - Anil Amichund Chuturgoon
- Discipline of Medical Biochemistry and Chemical Pathology, Faculty of Health Sciences, Howard College, University of Kwa-Zulu Natal, Durban, 4013, South Africa.
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9
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Sharma R, Zang W, Tabartehfarahani A, Lam A, Huang X, Sivakumar AD, Thota C, Yang S, Dickson RP, Sjoding MW, Bisco E, Mahmood CC, Diaz KM, Sautter N, Ansari S, Ward KR, Fan X. Portable Breath-Based Volatile Organic Compound Monitoring for the Detection of COVID-19 During the Circulation of the SARS-CoV-2 Delta Variant and the Transition to the SARS-CoV-2 Omicron Variant. JAMA Netw Open 2023; 6:e230982. [PMID: 36853606 PMCID: PMC9975913 DOI: 10.1001/jamanetworkopen.2023.0982] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/12/2023] [Indexed: 03/01/2023] Open
Abstract
Importance Breath analysis has been explored as a noninvasive means to detect COVID-19. However, the impact of emerging variants of SARS-CoV-2, such as Omicron, on the exhaled breath profile and diagnostic accuracy of breath analysis is unknown. Objective To evaluate the diagnostic accuracies of breath analysis on detecting patients with COVID-19 when the SARS-CoV-2 Delta and Omicron variants were most prevalent. Design, Setting, and Participants This diagnostic study included a cohort of patients who had positive and negative test results for COVID-19 using reverse transcriptase polymerase chain reaction between April 2021 and May 2022, which covers the period when the Delta variant was overtaken by Omicron as the major variant. Patients were enrolled through intensive care units and the emergency department at the University of Michigan Health System. Patient breath was analyzed with portable gas chromatography. Main Outcomes and Measures Different sets of VOC biomarkers were identified that distinguished between COVID-19 (SARS-CoV-2 Delta and Omicron variants) and non-COVID-19 illness. Results Overall, 205 breath samples from 167 adult patients were analyzed. A total of 77 patients (mean [SD] age, 58.5 [16.1] years; 41 [53.2%] male patients; 13 [16.9%] Black and 59 [76.6%] White patients) had COVID-19, and 91 patients (mean [SD] age, 54.3 [17.1] years; 43 [47.3%] male patients; 11 [12.1%] Black and 76 [83.5%] White patients) had non-COVID-19 illness. Several patients were analyzed over multiple days. Among 94 positive samples, 41 samples were from patients in 2021 infected with the Delta or other variants, and 53 samples were from patients in 2022 infected with the Omicron variant, based on the State of Michigan and US Centers for Disease Control and Prevention surveillance data. Four VOC biomarkers were found to distinguish between COVID-19 (Delta and other 2021 variants) and non-COVID-19 illness with an accuracy of 94.7%. However, accuracy dropped substantially to 82.1% when these biomarkers were applied to the Omicron variant. Four new VOC biomarkers were found to distinguish the Omicron variant and non-COVID-19 illness (accuracy, 90.9%). Breath analysis distinguished Omicron from the earlier variants with an accuracy of 91.5% and COVID-19 (all SARS-CoV-2 variants) vs non-COVID-19 illness with 90.2% accuracy. Conclusions and Relevance The findings of this diagnostic study suggest that breath analysis has promise for COVID-19 detection. However, similar to rapid antigen testing, the emergence of new variants poses diagnostic challenges. The results of this study warrant additional evaluation on how to overcome these challenges to use breath analysis to improve the diagnosis and care of patients.
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Affiliation(s)
- Ruchi Sharma
- Department of Biomedical Engineering, University of Michigan, Ann Arbor
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
| | - Wenzhe Zang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
| | - Ali Tabartehfarahani
- Department of Biomedical Engineering, University of Michigan, Ann Arbor
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
| | - Andres Lam
- Department of Biomedical Engineering, University of Michigan, Ann Arbor
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
| | - Xiaheng Huang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor
| | - Anjali Devi Sivakumar
- Department of Biomedical Engineering, University of Michigan, Ann Arbor
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor
| | - Chandrakalavathi Thota
- Department of Biomedical Engineering, University of Michigan, Ann Arbor
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
| | - Shuo Yang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
| | - Robert P. Dickson
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
- Department of Internal Medicine, Division of Pulmonary Critical Care Medicine, University of Michigan, Ann Arbor
| | - Michael W. Sjoding
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
- Department of Internal Medicine, Division of Pulmonary Critical Care Medicine, University of Michigan, Ann Arbor
| | - Erin Bisco
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
- Department of Emergency Medicine, University of Michigan, Ann Arbor
| | - Carmen Colmenero Mahmood
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
- Department of Emergency Medicine, University of Michigan, Ann Arbor
| | - Kristen Machado Diaz
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
- Department of Emergency Medicine, University of Michigan, Ann Arbor
| | - Nicholas Sautter
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor
| | - Sardar Ansari
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
- Department of Emergency Medicine, University of Michigan, Ann Arbor
| | - Kevin R. Ward
- Department of Biomedical Engineering, University of Michigan, Ann Arbor
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
- Department of Emergency Medicine, University of Michigan, Ann Arbor
| | - Xudong Fan
- Department of Biomedical Engineering, University of Michigan, Ann Arbor
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor
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10
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Chen M, Xu J, Ying L, Cai M, Tung TH, Zhou K, Zheng Y, Bi X, Wang J, Tu X, Shen B, Lv D. Clinical practice of rapid antigen tests for SARS-CoV-2 Omicron variant: A single-center study in China. Virol Sin 2022; 37:842-849. [PMID: 36049627 PMCID: PMC9422342 DOI: 10.1016/j.virs.2022.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/23/2022] [Indexed: 12/25/2022] Open
Abstract
Responding to the fast-spreading SARS-CoV-2 Omicron variant, to improve screening efficiency, rapid antigen tests (RATs) were first added as a supplementary detection method in China in mid-March, 2022. What and how big a role RATs should play need to be supported by clinical data. Here, RAT performance and relevant factors in comparison with nucleic acid amplification tests (NAATs) were assessed in Omicron-infected inpatients. From the NAAT results, nasopharyngeal swabs (NPs) performed better than oropharyngeal swabs (OPs). RATs tested on NAAT positive NPs performed better than those with OP-positive samples. The RAT positivity rate was strongly associated with high levels of N and OFR1ab genes, especially in NPs where patients also had significantly longer hospital stays and shorter days from symptom onset to RAT testing. Self-performed RATs had a detection accuracy that was comparable to professionally performed RATs when the subjects were well guided. The antigen negative rate of the studied patients was 100% at discharge. These findings suggest that, in addition to a supplementary detection role, RATs can be an important strategy for evaluating the disease progression of Omicron-infected inpatients. This study provides important clinical data to support better rules regarding RATs under China's COVID-19 prevention and control policy.
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Affiliation(s)
- Mengyuan Chen
- Department of Laboratory Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China
| | - Jiaqin Xu
- Department of Laboratory Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China
| | - Lingjun Ying
- Hepatology and Infectious Diseases Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China
| | - Miaoguo Cai
- Department of Radiation Oncology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China
| | - Kai Zhou
- Department of Laboratory Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China
| | - Yufen Zheng
- Department of Laboratory Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China
| | - Xiaojie Bi
- Department of Laboratory Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China
| | - Jing Wang
- Department of Laboratory Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China
| | - Xi Tu
- Department of Laboratory Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China
| | - Bo Shen
- Department of Laboratory Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China,Corresponding authors
| | - Dongqing Lv
- Department of Respiratory and Critical Diseases, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, 317000, China,Corresponding authors
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11
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Innes GK, Schmitz BW, Brierley PE, Guzman J, Prasek SM, Ruedas M, Sanchez A, Bhattacharjee S, Slinski S. Wastewater-Based Epidemiology Mitigates COVID-19 Outbreaks at a Food Processing Facility near the Mexico-U.S. Border-November 2020-March 2022. Viruses 2022; 14:2684. [PMID: 36560688 PMCID: PMC9786163 DOI: 10.3390/v14122684] [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: 10/31/2022] [Revised: 11/18/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
Background: Wastewater-based epidemiology (WBE) has the potential to inform activities to contain infectious disease outbreaks in both the public and private sectors. Although WBE for SARS-CoV-2 has shown promise over short time intervals, no other groups have evaluated how a public-private partnership could influence disease spread through public health action over time. The aim of this study was to characterize and assess the application of WBE to inform public health response and contain COVID-19 infections in a food processing facility. Methods: Over the period November 2020-March 2022, wastewater in an Arizona food processing facility was monitored for the presence of SARS-CoV-2 using Real-Time Quantitative PCR. Upon positive detection, partners discussed public health intervention strategies, including infection control reinforcement, antigen testing, and vaccination. Results: SARS-CoV-2 RNA was detected on 18 of 205 days in which wastewater was sampled and analyzed (8.8%): seven during Wild-type predominance and 11 during Omicron-variant predominance. All detections triggered the reinforcement of infection control guidelines. In five of the 18 events, active antigen testing identified asymptomatic workers. Conclusions: These steps heightened awareness to refine infection control protocols and averted possible transmission events during periods where detection occurred. This public-private partnership has potentially decreased human illness and economic loss during the COVID-19 pandemic.
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Affiliation(s)
- Gabriel K. Innes
- Yuma Center of Excellence for Desert Agriculture (YCEDA), University of Arizona, 6425 W. 8th St., Yuma, AZ 85364, USA
| | - Bradley W. Schmitz
- Yuma Center of Excellence for Desert Agriculture (YCEDA), University of Arizona, 6425 W. 8th St., Yuma, AZ 85364, USA
| | - Paul E. Brierley
- Yuma Center of Excellence for Desert Agriculture (YCEDA), University of Arizona, 6425 W. 8th St., Yuma, AZ 85364, USA
| | - Juan Guzman
- DatePac LLC, 2575 E 23rd Ln, Yuma, AZ 85365, USA
| | - Sarah M. Prasek
- Water & Energy Sustainable Technology (WEST) Center, University of Arizona, 2959 W Calle Agua Nueva, Tucson, AZ 85745, USA
| | - Martha Ruedas
- Yuma Center of Excellence for Desert Agriculture (YCEDA), University of Arizona, 6425 W. 8th St., Yuma, AZ 85364, USA
| | - Ana Sanchez
- Yuma Center of Excellence for Desert Agriculture (YCEDA), University of Arizona, 6425 W. 8th St., Yuma, AZ 85364, USA
| | - Subhadeep Bhattacharjee
- Yuma Center of Excellence for Desert Agriculture (YCEDA), University of Arizona, 6425 W. 8th St., Yuma, AZ 85364, USA
| | - Stephanie Slinski
- Yuma Center of Excellence for Desert Agriculture (YCEDA), University of Arizona, 6425 W. 8th St., Yuma, AZ 85364, USA
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12
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Hill HJ, Uppal T, Hau D, Pandit SG, Arias-Umana J, Foster AJ, Gorzalski A, Pflughoeft KJ, Burnham-Marusich AR, Reed DE, Gates-Hollingsworth MA, Gumbleton L, Verma SC, AuCoin DP. Comparison of a Prototype SARS-CoV-2 Lateral Flow IMMUNOASSAY with the BinaxNOW TM COVID-19 Antigen CARD. Viruses 2022; 14:v14122609. [PMID: 36560613 PMCID: PMC9786212 DOI: 10.3390/v14122609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the COVID-19 pandemic. From the onset of the pandemic, rapid antigen tests have quickly proved themselves to be an accurate and accessible diagnostic platform. The initial (and still most commonly used antigen tests) for COVID-19 diagnosis were constructed using monoclonal antibodies (mAbs) specific to severe acute respiratory syndrome coronavirus (SARS-CoV) nucleocapsid protein (NP). These mAbs are able to bind SARS-CoV-2 NP due to high homology between the two viruses. However, since first being identified in 2019, SARS-CoV-2 has continuously mutated, and a multitude of variants have appeared. These mutations have an elevated risk of leading to possible diagnostic escape when using tests produced with SARS-CoV-derived mAbs. Here, we established a library of 18 mAbs specific to SARS-CoV-2 NP and used two of these mAbs (1CV7 and 1CV14) to generate a prototype antigen-detection lateral flow immunoassay (LFI). A side-by-side analysis of the 1CV7/1CV14 LFI and the commercially available BinaxNOWTM COVID-19 Antigen CARD was performed. Results indicated the 1CV7/1CV14 LFI outperformed the BinaxNOWTM test in the detection of BA.2, BA.2.12.1, and BA.5 Omicron sub-variants when testing remnant RT-PCR positive patient nasopharyngeal swabs diluted in viral transport media.
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Affiliation(s)
- Haydon J. Hill
- Department of Microbiology and Immunology, Reno School of Medicine, University of Nevada, Reno, NV 89557, USA
| | - Timsy Uppal
- Department of Microbiology and Immunology, Reno School of Medicine, University of Nevada, Reno, NV 89557, USA
| | - Derrick Hau
- Department of Microbiology and Immunology, Reno School of Medicine, University of Nevada, Reno, NV 89557, USA
| | - Sujata G. Pandit
- Department of Microbiology and Immunology, Reno School of Medicine, University of Nevada, Reno, NV 89557, USA
| | - Jose Arias-Umana
- Department of Microbiology and Immunology, Reno School of Medicine, University of Nevada, Reno, NV 89557, USA
| | - Abigail J. Foster
- Department of Microbiology and Immunology, Reno School of Medicine, University of Nevada, Reno, NV 89557, USA
| | | | | | | | - Dana E. Reed
- Department of Microbiology and Immunology, Reno School of Medicine, University of Nevada, Reno, NV 89557, USA
| | | | | | - Subhash C. Verma
- Department of Microbiology and Immunology, Reno School of Medicine, University of Nevada, Reno, NV 89557, USA
| | - David P. AuCoin
- Department of Microbiology and Immunology, Reno School of Medicine, University of Nevada, Reno, NV 89557, USA
- DxDiscovery Incorporated, Reno, NV 89557, USA
- Correspondence:
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