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Hung MH, Cheng SY. Intracranial Nasogastric Tube Placement in a Nontrauma Patient: Comment. Anesthesiology 2024; 140:1054. [PMID: 38457200 DOI: 10.1097/aln.0000000000004917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Affiliation(s)
- Ming-Hui Hung
- National Taiwan University Hospital, Taipei, Taiwan (M.-H.H.).
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Shim S, Seo J. Robotic system for nasopharyngeal swab sampling based on remote center of motion mechanism. Int J Comput Assist Radiol Surg 2024; 19:395-403. [PMID: 37985641 DOI: 10.1007/s11548-023-03032-8] [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: 05/23/2023] [Accepted: 10/16/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE In this study, a robotic system is proposed for nasopharyngeal (NP) swab sampling with high safety and efficiency. Most existing swab-sampling robots have more than six degrees of freedom (DOFs). However, not all six DOFs are necessarily required for NP swab sampling. A high number of DOFs can cause safety problems, such as collisions between the robot and patient. METHOD We developed a new type of robot with four DOFs for NP swab sampling that consists of a two DOFs remote center of motion (RCM) mechanism, a two DOFs insertion mechanism, and a nostril support unit. With the nostril support unit, the robot no longer needs to adjust the insertion position of the swab. The proposed robot enables the insertion orientation and depth to be adjusted according to different postures or facial shapes of the subject. For intuitive and precise remote control of the robot, a dedicated master device for the RCM and a visual feedback system were developed. RESULT The effectiveness of the robotic system was demonstrated by repeatability, RCM accuracy, tracking accuracy, and in vitro phantom experiments. The average tracking error between the master device and the robot was less than 2 mm. The contact force exerted on the swab prior to reaching the nasopharynx was less than 0.04 N, irrespective of the phantom's pose. CONCLUSION This study confirmed that the RCM-based robotic system is effective and safe for NP swab sampling while using minimal DOFs.
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Affiliation(s)
- Seongbo Shim
- Department of Medical Robotics, Korea Institute of Machinery and Materials, Daegu, 42994, South Korea
| | - Joonho Seo
- Department of Medical Robotics, Korea Institute of Machinery and Materials, Daegu, 42994, South Korea.
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Greenmyer JR, Kohorst MA, Thompson WS, Kaczor M, Alajbegovic K, Kranz LA, Cain M, Ristagno EH. Nasopharyngeal Swabs in Pediatric Patients With Thrombocytopenia and Anticoagulant Use. J Pediatr Hematol Oncol 2023; 45:e910-e914. [PMID: 37582659 DOI: 10.1097/mph.0000000000002741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/06/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Nasopharyngeal (NP) swabbing is a technique that is commonly used to test pediatric patients for viral infections with increased use during the coronavirus disease 2019 pandemic. Complications from NP swabbing are rare and seem to occur more frequently in patients at risk of bleeding. Little is known about institutional or individual practices and experiences with NP swab testing in pediatric patients with risk factors for bleeding. METHODS We conducted a survey study of pediatric hematology/oncology (PHO) attending physicians to assess practices and experiences with NP swab testing in pediatric patients with thrombocytopenia and/or on anticoagulation. RESULTS There were 130 total respondents (5.6%, n = 130/2327) from 6 countries. Relatively few respondents (n = 17/130, 13.1%) reported that their institution had a policy specifying a lower-level platelet cutoff for patients undergoing NP swabbing. The median platelet cutoff below which NP swabs are not performed according to existing policies is 30,000×10(9)/L (interquartile range: 20,000 to 40,000). The median cutoff based on the opinion of the respondents was 10,000 (interquartile range: 10,000 to 20,000). There were 24 episodes of epistaxis among PHO patients that were NP swabbed; many adverse events (56.5%, n = 13/23) were described as persistent, severe, and/or required intervention. Three reported cases of epistaxis with anticoagulation or antiplatelet therapy occurred in patients with concomitant thrombocytopenia. Only 1 respondent (n = 1/130, 0.7%) reported an institutional policy for limiting NP swabs in patients on anticoagulant therapy. NP (66.9%) and nares (33.1%) were the most common sources of coronavirus disease 2019 testing that were reported. CONCLUSION A small percentage of institutions in this survey have a policy restricting NP swabs in PHO patients. The discrepancy between lower platelet cutoffs proposed by experts and institutional policy suggests that existing policies may be too conservative. Expert guidelines are needed on this topic. Other bleeding risk factors (eg, aspirin use and von Willebrand disease) should be considered in policies and guidelines.
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Affiliation(s)
| | | | - Whitney S Thompson
- Pediatric and Adolescent Medicine
- Center for Individualized Medicine
- Neonatal and Perinatal Medicine
- Clinical Genomics
| | | | | | - Lincoln A Kranz
- University of North Dakota School of Medicine, Grand Forks, ND
| | - Meghan Cain
- Pediatric and Adolescent Medicine
- Emergency Medicine
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Aparicio-Alonso M, Torres-Solórzano V, Méndez-Contreras JF, Acevedo-Whitehouse K. Scanning Electron Microscopy and EDX Spectroscopy of Commercial Swabs Used for COVID-19 Lateral Flow Testing. TOXICS 2023; 11:805. [PMID: 37888657 PMCID: PMC10610828 DOI: 10.3390/toxics11100805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023]
Abstract
The chemical composition of COVID test swabs has not been examined beyond the manufacturer's datasheets. The unprecedented demand for swabs to conduct rapid lateral flow tests and nucleic acid amplification tests led to mass production, including 3D printing platforms. Manufacturing impurities could be present in the swabs and, if so, could pose a risk to human health. We used scanning electron microscopy and energy dispersive X-ray (EDX) spectroscopy to examine the ultrastructure of seven assorted brands of COVID test swabs and to identify and quantify their chemical elements. We detected eight unexpected elements, including transition metals, such as titanium and zirconium, the metalloid silicon, as well as post-transition metals aluminium and gallium, and the non-metal elements sulphur and fluorine. Some of the elements were detected as trace amounts, but for others, the amount was close to reported toxicological thresholds for inhalation routes. Experimental studies have shown that the detrimental effects of unexpected chemical elements include moderate to severe inflammatory states in the exposed epithelium as well as proliferative changes. Given the massive testing still being used in the context of the COVID pandemic, we urge caution in continuing to recommend repeated and frequent testing, particularly of healthy, non-symptomatic, individuals.
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Affiliation(s)
- Manuel Aparicio-Alonso
- Medical Direction and Healthcare Responsibility, Centro Médico Jurica, Santiago de Querétaro 76100, Mexico
| | - Verónica Torres-Solórzano
- Unit for Basic and Applied Microbiology, Universidad Autónoma de Querétaro, Santiago de Querétaro 76140, Mexico;
| | | | - Karina Acevedo-Whitehouse
- Unit for Basic and Applied Microbiology, Universidad Autónoma de Querétaro, Santiago de Querétaro 76140, Mexico;
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Vasei M, Jafari E, Falah Azad V, Safavi M, Sotoudeh M. Molecular Diagnosis of COVID-19; Biosafety and Pre-analytical Recommendations. IRANIAN JOURNAL OF PATHOLOGY 2023; 18:244-256. [PMID: 37942195 PMCID: PMC10628373 DOI: 10.30699/ijp.2023.1988405.3061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/08/2023] [Indexed: 11/10/2023]
Abstract
From the beginning of the COVID-19 epidemic, clinical laboratories around the world have been involved with tests for detection of SARS-CoV-2. At present, RT-PCR (real-time reverse transcription polymerase chain reaction assay) is seen as the gold standard for identifying the virus. Many factors are involved in achieving the highest accuracy in this test, including parameters related to the pre-analysis stage. Having instructions on the type of sample, how to take the sample, and its storage and transportation help control the interfering factors at this stage. Studies have shown that pre-analytical factors might be the cause of the high SARS-CoV-2 test false-negative rates. Also, the safety of personnel in molecular laboratories is of utmost importance, and it requires strict guidelines to ensure the safety of exposed individuals and prevent the virus from spreading. Since the onset of the outbreak, various instructions and guidelines have been developed in this field by the institutions and the Ministry of Health of each country; these guidelines are seriously in need of integration and operation. In this study, we try to collect all the information and research done from the beginning of this pandemic in December 2019 - August 2022 concerning biosafety and protective measures, sample types, sampling methods, container, and storage solutions, sampling equipment, and sample storage and transportation for molecular testing of SARS-CoV-2.
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Affiliation(s)
- Mohammad Vasei
- Molecular Pathology and Cytogenetics Division, Pathology Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Cell-BasedTherapies Research Center, Digestive Disease Research Institute, Shari'ati Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Elham Jafari
- Molecular Pathology and Cytogenetics Division, Pathology Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Pathology and Stem Cells Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Vahid Falah Azad
- Molecular Pathology and Cytogenetics Division, Pathology Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Moeinadin Safavi
- Molecular Pathology and Cytogenetics Division, Pathology Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Sotoudeh
- Molecular Pathology and Cytogenetics Division, Pathology Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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Shrateh ON, Abugharbieh Y, Al-Fallah O. Brain abscess as a complication of nasopharyngeal COVID-19 swab testing: Two case reports and a literature review. Int J Surg Case Rep 2023; 108:108402. [PMID: 37331092 PMCID: PMC10273773 DOI: 10.1016/j.ijscr.2023.108402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 06/20/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE The nasopharyngeal swab, which has experienced a marked increase in utilization during the COVID-19 pandemic and is considered the gold standard for COVID-19 testing due to its high diagnostic accuracy and sensitivity, The procedure is generally safe and well-tolerated, with pain, discomfort, and the urge to cough or sneeze being the most common complications. Though it is occasionally associated with serious complications. CASE PRESENTATION we report two cases of brain abscess as a complication of nasopharyngeal COVID-19 testing. The first case was of a 47-year-old male diabetic patient with a positive medical history for immune thrombocytopenic purpura (ITP) who developed a frontal brain abscess one week after the swabbing procedure and was treated with systemic antibiotics followed by a successful functional endoscopic sinus surgery. The second case involved a hypertensive female patient in her 40s who also developed a frontal brain abscess on the same side as painful nasal COVID-19 testing. Systemic antibiotics were used to treat the patient. CLINICAL DISCUSSION Serious adverse events from nasopharyngeal COVID-19 testing were reported to occur rarely, with incidences ranging from 0.0012 to 0.026 %. Retained swabs, epistaxis, and CSF leakage were commonly reported complications, which were frequently associated with high-risk factors such as septal deviations, pre-existing basal skull defects, and sinus surgeries. However, brain abscess complications are considered one of the extremely rare complications, with only a few cases reported in the literature. CONCLUSION Appropriate approaches that depend on adequate anatomical knowledge are necessary for practitioners to perform nasopharyngeal COVID-19 testing.
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Affiliation(s)
- Oadi N Shrateh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
| | | | - Orwa Al-Fallah
- Deparment of Radiology, Al-Ahli Hospital, Hebron, Palestine
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Ahti J, Österback R, Keskitalo A, Mokkala K, Vidbäck S, Veikkolainen V, Vuorinen T, Peltola V, Hakanen AJ, Waris M, Laine M. Diagnostic Performance and Tolerability of Saliva and Nasopharyngeal Swab Specimens in the Detection of SARS-CoV-2 by RT-PCR. Microbiol Spectr 2023; 11:e0532422. [PMID: 37093085 PMCID: PMC10269602 DOI: 10.1128/spectrum.05324-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/03/2023] [Indexed: 04/25/2023] Open
Abstract
Saliva is a promising alternative for a nasopharyngeal swab (NPS) in specimen collection to detect SARS-CoV-2. We compared the diagnostic performance and tolerability of saliva collection versus NPS in a clinical setting. Paired NPS and saliva specimens were collected sequentially from participants (n = 250) at the Turku University Hospital drive-in coronavirus testing station in the spring of 2022, with Omicron BA.2 as the dominant SARS-CoV-2 variant. Discomfort and preference for the sampling method were assessed. The specimens were analyzed for SARS-CoV-2 using real-time multiplex reverse transcriptase PCR (RT-PCR) with a laboratory-developed test (LDT) and two commercial kits (PerkinElmer SARS-CoV-2 and PerkinElmer SARS-CoV-2 Plus) for several target genes. Among the 250 participants, 246 had respiratory symptoms. With LDT, SARS-CoV-2 was detected in 135 and 134 participants from NPS and saliva, respectively. Of the 250 specimens, 11 gave a discordant outcome, resulting in excellent agreement between the specimen types (Cohen's kappa coefficient of 0.911; P = 0.763). The cycle threshold (CT) values of LDT and commercial kit target genes were significantly lower from NPS than from saliva. A total of 172 (69%) participants assessed saliva sampling as more tolerable than NPS (P < 0.0001). Our findings present saliva as an applicable alternative for SARS-CoV-2 diagnostics. However, the lower CT values obtained from NPS indicate that NPS may be a slightly more sensitive specimen type. Participants preferred saliva sampling, although delivering an adequate volume of saliva was challenging for some participants. IMPORTANCE The extensive testing of SARS-CoV-2 is vital in controlling the spread of COVID-19. The reference standard for specimen collection is a nasopharyngeal swab (NPS). However, the discomfort of NPS sampling, the risk of nosocomial infections, and global material shortages have accelerated the development of alternative testing methods. Our study demonstrates that patients tolerate saliva sampling better than NPS. Of importance, although the RT-PCR qualitative test results seem to correspond between NPS and saliva, we show significantly lower CT values for NPS, compared to saliva, thus contradicting the suggested superiority of the saliva specimen over NPS in the detection of the Omicron variants of SARS-CoV-2. Future research is still required to enable individual planning for specimen collection and to determine the effects of different SARS-CoV-2 variants on the sensitivity of the saliva matrix.
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Affiliation(s)
- Jaakko Ahti
- Department of Paediatrics and Adolescent Medicine, University of Turku, Turku, Finland
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - Riikka Österback
- Department of Clinical Microbiology, Turku University Hospital, Turku, Finland
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Anniina Keskitalo
- Department of Clinical Microbiology, Turku University Hospital, Turku, Finland
- Institute of Biomedicine, University of Turku, Turku, Finland
| | | | | | | | - Tytti Vuorinen
- Department of Clinical Microbiology, Turku University Hospital, Turku, Finland
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Ville Peltola
- Department of Paediatrics and Adolescent Medicine, University of Turku, Turku, Finland
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - Antti J. Hakanen
- Department of Clinical Microbiology, Turku University Hospital, Turku, Finland
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Matti Waris
- Department of Clinical Microbiology, Turku University Hospital, Turku, Finland
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Miia Laine
- Department of Clinical Microbiology, Turku University Hospital, Turku, Finland
- Institute of Biomedicine, University of Turku, Turku, Finland
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Fang C, Luo Y, Chuah C, Naidu R. Identification of microplastic fibres released from COVID-19 test swabs with Raman imaging. ENVIRONMENTAL SCIENCES EUROPE 2023; 35:34. [PMID: 37193314 PMCID: PMC10162899 DOI: 10.1186/s12302-023-00737-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/23/2023] [Indexed: 05/18/2023]
Abstract
Background COVID-19 pandemic is not yet over, and it has been generating lots of plastic wastes that become a big concern. To catch the virus, for example, no matter via antigen or PCR test, swab is generally used for sampling. Unfortunately, the swab tip is commonly made of plastics, and thus it can be a potential source of microplastics. This study aims to propose and optimise several Raman imaging to identify the microplastic fibres released from different COVID-19 test swabs. Results The results show that Raman imaging can effectively identify and visualise the microplastic fibres released from the swabs. In the meantime, on the surface of the fibres, additives such as titanium oxide particles are also captured for some brands of swabs. To increase the result certainty, scanning electron microscope (SEM) is first employed to get the morphology of the released microplastic fibres, along with Energy-dispersive X-ray spectroscopy (EDS) to confirm the presence of titanium element. Then, Raman imaging is advanced to identify and visualise the microplastics and titanium oxide particles, from different characteristic peaks in the scanning spectrum matrix. To further increase the imaging certainty, these images can be merged and cross-checked using algorithms, or the raw data from the scanning spectrum matrix can be analysed and decoded via chemometrics, such as principal component analysis (PCA). Beyond the advantages, the disadvantages of the confocal Raman imaging (affected by focal height) and algorithms (non-supervised calculation) are also discussed and intentionally corrected. In brief, the imaging analysis (particularly the combined SEM with Raman) is recommended to avoid the possible result bias that might be generated from the single spectrum analysis at a selective but random position. Conclusions Overall, the results indicate that Raman imaging can be a useful tool to detect microplastics. The results also send us a strong warning that, if we worry about the potential microplastics contamination, we should be cautious to select the suitable COVID-19 testing kits. Supplementary Information The online version contains supplementary material available at 10.1186/s12302-023-00737-0.
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Affiliation(s)
- Cheng Fang
- Global Centre for Environmental Remediation (GCER), University of Newcastle, Callaghan NSW 2308, Newcastle, Australia
- Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), University of Newcastle, Callaghan NSW 2308, Newcastle, Australia
| | - Yunlong Luo
- Global Centre for Environmental Remediation (GCER), University of Newcastle, Callaghan NSW 2308, Newcastle, Australia
- Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), University of Newcastle, Callaghan NSW 2308, Newcastle, Australia
| | - Clarence Chuah
- Flinders Institute for NanoScale Science and Technology, College of Science and Engineering, Flinders University, Adelaide, South Australia 5042 Australia
| | - Ravi Naidu
- Global Centre for Environmental Remediation (GCER), University of Newcastle, Callaghan NSW 2308, Newcastle, Australia
- Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), University of Newcastle, Callaghan NSW 2308, Newcastle, Australia
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Crowe A, Lorenzo YP, Jardine D, Visvanathan K. Evaluation of A Novel Anterior Nasal Swab for the Detection of SARS-CoV-2. J Virol Methods 2023; 316:114713. [PMID: 36934898 PMCID: PMC10023209 DOI: 10.1016/j.jviromet.2023.114713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND During the course of the COVID-19 pandemic, nasopharyngeal swabs, combined throat and nose swabs and saliva samples have been evaluated for SARS-CoV-2 detection using nucleic acid amplification tests (NAT). Literature on anterior nasal swabs is limited and comparative studies often group anterior nasal and mid-turbinate swabs together (Tsang et al., 2021). We investigated a novel anterior nasal swab that has been designed to standardised self-collection, maximise sample uptake and improve user comfort. We used combined throat and nose swabs and neat saliva samples as the comparators. RESULTS The overall positive percentage agreement between the Rhinoswab™ and the combined throat and nose swab was 95.2% at day 2 post participant recruitment and 93.3% on day 4 post participant recruitment. This was favourable to the positive percentage agreement with saliva at the same time points. CONCLUSION In our study the Rhinoswab™ performed equally well in comparison to a combined throat and nose swab for the laboratory detection of SARS-CoV-2 using nucleic acid amplification techniques.
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Affiliation(s)
- Amy Crowe
- Department of Microbiology, St Vincent's Pathology, St Vincent's Hospital Melbourne; Department of Medicine, St Vincent's Hospital at the University of Melbourne.
| | - Yves Poy Lorenzo
- Department of Medicine, St Vincent's Hospital at the University of Melbourne; Department of Pharmacy, St Vincent's Hospital Melbourne
| | - Darren Jardine
- Department of Microbiology, St Vincent's Pathology, St Vincent's Hospital Melbourne
| | - Kumar Visvanathan
- Department of Medicine, St Vincent's Hospital at the University of Melbourne
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Comparative Performance of Serological (IgM/IgG) and Molecular Testing (RT-PCR) of COVID-19 in Three Private Universities in Cameroon during the Pandemic. Viruses 2023; 15:v15020407. [PMID: 36851621 PMCID: PMC9966400 DOI: 10.3390/v15020407] [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: 12/22/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND COVID-19 remains a rapidly evolving and deadly pandemic worldwide. This necessitates the continuous assessment of existing diagnostic tools for a robust, up-to-date, and cost-effective pandemic response strategy. We sought to determine the infection rate (PCR-positivity) and degree of spread (IgM/IgG) of SARS-CoV-2 in three university settings in Cameroon Method: Study volunteers were recruited from November 2020 to July 2021 among COVID-19 non-vaccinated students in three Universities from two regions of Cameroon (West and Centre). Molecular testing was performed by RT-qPCR on nasopharyngeal swabs, and IgM/IgG antibodies in plasma were detected using the Abbott Panbio IgM/IgG rapid diagnostic test (RDT) at the Virology Laboratory of CREMER/IMPM/MINRESI. The molecular and serological profiles were compared, and p < 0.05 was considered statistically significant. RESULTS Amongst the 291 participants enrolled (mean age 22.59 ± 10.43 years), 19.59% (57/291) were symptomatic and 80.41% (234/291) were asymptomatic. The overall COVID-19 PCR-positivity rate was 21.31% (62/291), distributed as follows: 25.25% from UdM-Bangangte, 27.27% from ISSBA-Yaounde, and 5% from IUEs/INSAM-Yaounde. Women were more affected than men (28.76% [44/153] vs. 13.04% [18/138], p < 0.0007), and had higher seropositivity rates to IgM+/IgG+ (15.69% [24/153] vs. 7.25% [10/138], p < 0.01). Participants from Bangangté, the nomadic, and the "non-contact cases" primarily presented an active infection compared to those from Yaoundé (p= 0.05, p = 0.05, and p = 0.01, respectively). Overall IgG seropositivity (IgM-/IgG+ and IgM+/IgG+) was 24.4% (71/291). A proportion of 26.92% (7/26) presenting COVID-19 IgM+/IgG- had negative PCR vs. 73.08% (19/26) with positive PCR, p < 0.0001. Furthermore, 17.65% (6/34) with COVID-19 IgM+/IgG+ had a negative PCR as compared to 82.35% with a positive PCR (28/34), p < 0.0001. Lastly, 7.22% (14/194) with IgM-/IgG- had a positive PCR. CONCLUSION This study calls for a rapid preparedness and response strategy in higher institutes in the case of any future pathogen with pandemic or epidemic potential. The observed disparity between IgG/IgM and the viral profile supports prioritizing assays targeting the virus (nucleic acid or antigen) for diagnosis and antibody screening for sero-surveys.
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Cross-Sectional Study on Lateral Skull Radiographs to Design a New Nasopharyngeal Swab for Simplified COVID-19 and Respiratory Infections Diagnostic Testing in Children. J Clin Med 2022; 12:jcm12010213. [PMID: 36615013 PMCID: PMC9821314 DOI: 10.3390/jcm12010213] [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: 08/20/2022] [Revised: 12/16/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
Nasopharyngeal swab sample collection is the first-line testing method for diagnosing COVID-19 infection and other respiratory infections. Current information on how to properly perform nasopharyngeal swabbing in children is largely defective. This study aimed at collecting nostril to nasopharynx distance measurements on lateral skull radiographs of children and adolescents to design a nasopharyngeal swab meant to standardize and facilitate the sample collection procedure. A total of 323 cephalograms of 152 male and 171 female children aged 4-14 years taken for orthodontic reasons were selected. On each cephalogram, the shortest distance between the most anterosuperior point of the nostril contour and the nasopharynx outline was measured in mm parallel to the palatal plane. Descriptive statistics of the measurements were calculated for each age group. The lower limit of the 95% confidence intervals of the measurements was taken as a reference to design a swab shaft with marks that, at each age, delimitate a safety boundary for swab progression up to the posterior nasopharyngeal wall. The simplification of the procedure enabled by the newly designed nasopharyngeal swab is valuable to help healthcare providers perform specimen collection on children in a safe and effective way, perhaps under the less-than-ideal conditions possibly occurring in 'point-of-need' contexts.
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Moura AV, de Oliveira DC, Silva AAR, da Rosa JR, Garcia PHD, Sanches PHG, Garza KY, Mendes FMM, Lambert M, Gutierrez JM, Granado NM, dos Santos AC, de Lima IL, Negrini LDDO, Antonio MA, Eberlin MN, Eberlin LS, Porcari AM. Urine Metabolites Enable Fast Detection of COVID-19 Using Mass Spectrometry. Metabolites 2022; 12:1056. [PMID: 36355139 PMCID: PMC9697918 DOI: 10.3390/metabo12111056] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/19/2022] [Accepted: 10/27/2022] [Indexed: 08/27/2023] Open
Abstract
The COVID-19 pandemic boosted the development of diagnostic tests to meet patient needs and provide accurate, sensitive, and fast disease detection. Despite rapid advancements, limitations related to turnaround time, varying performance metrics due to different sampling sites, illness duration, co-infections, and the need for particular reagents still exist. As an alternative diagnostic test, we present urine analysis through flow-injection-tandem mass spectrometry (FIA-MS/MS) as a powerful approach for COVID-19 diagnosis, targeting the detection of amino acids and acylcarnitines. We adapted a method that is widely used for newborn screening tests on dried blood for urine samples in order to detect metabolites related to COVID-19 infection. We analyzed samples from 246 volunteers with diagnostic confirmation via PCR. Urine samples were self-collected, diluted, and analyzed with a run time of 4 min. A Lasso statistical classifier was built using 75/25% data for training/validation sets and achieved high diagnostic performances: 97/90% sensitivity, 95/100% specificity, and 95/97.2% accuracy. Additionally, we predicted on two withheld sets composed of suspected hospitalized/symptomatic COVID-19-PCR negative patients and patients out of the optimal time-frame collection for PCR diagnosis, with promising results. Altogether, we show that the benchmarked FIA-MS/MS method is promising for COVID-19 screening and diagnosis, and is also potentially useful after the peak viral load has passed.
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Affiliation(s)
- Alexandre Varao Moura
- MSLife Laboratory of Mass Spectrometry, Health Sciences Postgraduate Program, São Francisco University, Bragança Paulista 12916-900, SP, Brazil
| | - Danilo Cardoso de Oliveira
- MSLife Laboratory of Mass Spectrometry, Health Sciences Postgraduate Program, São Francisco University, Bragança Paulista 12916-900, SP, Brazil
| | - Alex Ap. R. Silva
- MSLife Laboratory of Mass Spectrometry, Health Sciences Postgraduate Program, São Francisco University, Bragança Paulista 12916-900, SP, Brazil
| | - Jonas Ribeiro da Rosa
- MSLife Laboratory of Mass Spectrometry, Health Sciences Postgraduate Program, São Francisco University, Bragança Paulista 12916-900, SP, Brazil
| | - Pedro Henrique Dias Garcia
- MSLife Laboratory of Mass Spectrometry, Health Sciences Postgraduate Program, São Francisco University, Bragança Paulista 12916-900, SP, Brazil
| | - Pedro Henrique Godoy Sanches
- MSLife Laboratory of Mass Spectrometry, Health Sciences Postgraduate Program, São Francisco University, Bragança Paulista 12916-900, SP, Brazil
| | - Kyana Y. Garza
- Department of Chemistry, The University of Texas at Austin, Austin, TX 78712, USA
| | - Flavio Marcio Macedo Mendes
- MSLife Laboratory of Mass Spectrometry, Health Sciences Postgraduate Program, São Francisco University, Bragança Paulista 12916-900, SP, Brazil
| | - Mayara Lambert
- MSLife Laboratory of Mass Spectrometry, Health Sciences Postgraduate Program, São Francisco University, Bragança Paulista 12916-900, SP, Brazil
| | - Junier Marrero Gutierrez
- MSLife Laboratory of Mass Spectrometry, Health Sciences Postgraduate Program, São Francisco University, Bragança Paulista 12916-900, SP, Brazil
| | - Nicole Marino Granado
- MSLife Laboratory of Mass Spectrometry, Health Sciences Postgraduate Program, São Francisco University, Bragança Paulista 12916-900, SP, Brazil
| | - Alicia Camacho dos Santos
- Department of Material Engineering and Nanotechnology, Mackenzie Presbyterian University, São Paulo 01302-907, SP, Brazil
| | - Iasmim Lopes de Lima
- Department of Material Engineering and Nanotechnology, Mackenzie Presbyterian University, São Paulo 01302-907, SP, Brazil
| | | | - Marcia Aparecida Antonio
- Integrated Unit of Pharmacology and Gastroenterology, UNIFAG, Bragança Paulista 12916-900, SP, Brazil
| | - Marcos N. Eberlin
- Department of Material Engineering and Nanotechnology, Mackenzie Presbyterian University, São Paulo 01302-907, SP, Brazil
| | - Livia S. Eberlin
- Department of Chemistry, The University of Texas at Austin, Austin, TX 78712, USA
- Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Andreia M. Porcari
- MSLife Laboratory of Mass Spectrometry, Health Sciences Postgraduate Program, São Francisco University, Bragança Paulista 12916-900, SP, Brazil
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Gagnon F, Bhatt M, Zemek R, Webster RJ, Johnson-Obaseki S, Harman S. Nasopharyngeal swabs vs. saliva sampling for SARS-CoV-2 detection: A cross-sectional survey of acceptability for caregivers and children after experiencing both methods. PLoS One 2022; 17:e0270929. [PMID: 35802720 PMCID: PMC9269879 DOI: 10.1371/journal.pone.0270929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/20/2022] [Indexed: 12/24/2022] Open
Abstract
Background Saliva sampling is a promising alternative to nasopharyngeal swabs for SARS-CoV-2 testing, but acceptability data is lacking. We characterize the acceptability of saliva sampling and nasopharyngeal swabs for primary decision makers and their children after experiencing both testing modalities. Methods We administered a cross-sectional survey to participants aged 6-to-17 years and their primary decision makers at an Ottawa community COVID-19 testing centre in March 2021. Included were participants meeting local guidelines for testing. Excluded were those identified prior to participation as having inability to complete the consent, sampling, or survey process. Acceptability in multiple hypothetical scenarios was rated using a 5-point Likert scale. Pain was measured using the Faces Pain Scale—Revised (FPS-R). Preference for testing was assessed with direct binary questions. Results 48 participants and 48 primary decision makers completed the survey. Nasopharyngeal swab acceptability differed between scenarios, ranging 79% [95%CI: 66, 88] to 100% [95%CI: 95, 100]; saliva sampling acceptability was similar across scenarios, ranging 92% [95%CI: 82, 97] to 98% [95%CI: 89, 99]. 58% of youth described significant pain with nasopharyngeal swabbing, versus none with saliva sampling. 90% of children prefer saliva sampling. 66% of primary decision makers would prefer nasopharyngeal swabbing if it were 10% more sensitive. Conclusion Though youth prefer saliva sampling over nasopharyngeal swabs, primary decision makers present for testing remain highly accepting of both. Acceptance of nasopharyngeal swabs, however, varies with the testing indication and is influenced by perceived test accuracy. Understanding factors that influence sampling acceptance will inform more successful testing strategies.
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Affiliation(s)
- François Gagnon
- Division of Pediatric Emergency Medicine, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- * E-mail:
| | - Maala Bhatt
- Division of Pediatric Emergency Medicine, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Roger Zemek
- Division of Pediatric Emergency Medicine, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Richard J. Webster
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | | | - Stuart Harman
- Division of Pediatric Emergency Medicine, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
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