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Sun Q, Ning Q, Li T, Jiang Q, Feng S, Tang N, Cui D, Wang K. Immunochromatographic enhancement strategy for SARS-CoV-2 detection based on nanotechnology. NANOSCALE 2023; 15:15092-15107. [PMID: 37676509 DOI: 10.1039/d3nr02396f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
The global outbreak of coronavirus disease 2019 (COVID-19) has been catastrophic to both human health and social development. Therefore, developing highly reliable and sensitive point-of-care testing (POCT) for detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a priority. Among all available POCTs, the lateral flow immunoassay (LFIA, also known as immunochromatography) has proved to be effective due to its accuracy, portability, convenience, and speed. In areas with a scarcity of laboratory resources and medical personnel, the LFIA provides an affordable option for the diagnosis of COVID-19. This review offers a comprehensive overview of methods for improving the sensitivity of SARS-CoV-2 detection using immunochromatography based on nanotechnology, sorted according to the different detection targets (antigens, antibodies, and nucleic acids). It also looks into the performance and properties of the various sensitivity enhancement strategies, before delving into the remaining challenges in COVID-19 diagnosis through LFIA. Ultimately, it seeks to provide helpful guidance in selecting an appropriate strategy for SARS-CoV-2 immunochromatographic detection based on nanotechnology.
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Affiliation(s)
- Qingwen Sun
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Key Laboratory of Thin Film and Microfabrication Technology (Ministry of Education), Shanghai, 200240, China.
| | - Qihong Ning
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Key Laboratory of Thin Film and Microfabrication Technology (Ministry of Education), Shanghai, 200240, China.
| | - Tangan Li
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Key Laboratory of Thin Film and Microfabrication Technology (Ministry of Education), Shanghai, 200240, China.
| | - Qixia Jiang
- Department of Cardiology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, 200336, China
| | - Shaoqing Feng
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China
| | - Ning Tang
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Key Laboratory of Thin Film and Microfabrication Technology (Ministry of Education), Shanghai, 200240, China.
| | - Daxiang Cui
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Key Laboratory of Thin Film and Microfabrication Technology (Ministry of Education), Shanghai, 200240, China.
| | - Kan Wang
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Key Laboratory of Thin Film and Microfabrication Technology (Ministry of Education), Shanghai, 200240, China.
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2
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Boehm AB, Wolfe MK, Wigginton KR, Bidwell A, White BJ, Hughes B, Duong D, Chan-Herur V, Bischel HN, Naughton CC. Human viral nucleic acids concentrations in wastewater solids from Central and Coastal California USA. Sci Data 2023; 10:396. [PMID: 37349355 PMCID: PMC10287720 DOI: 10.1038/s41597-023-02297-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023] Open
Abstract
We measured concentrations of SARS-CoV-2, influenza A and B virus, respiratory syncytial virus (RSV), mpox virus, human metapneumovirus, norovirus GII, and pepper mild mottle virus nucleic acids in wastewater solids at twelve wastewater treatment plants in Central California, USA. Measurements were made daily for up to two years, depending on the wastewater treatment plant. Measurements were made using digital droplet (reverse-transcription-) polymerase chain reaction (RT-PCR) following best practices for making environmental molecular biology measurements. These data can be used to better understand disease occurrence in communities contributing to the wastewater.
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Affiliation(s)
- Alexandria B Boehm
- Department of Civil & Environmental Engineering, School of Engineering and Doerr School of Sustainability, Stanford University, Stanford, CA, USA.
| | - Marlene K Wolfe
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Krista R Wigginton
- Department of Civil and Environmental Engineering, University of Michigan, Ann Arbor, 48109, Michigan, USA
| | - Amanda Bidwell
- Department of Civil & Environmental Engineering, School of Engineering and Doerr School of Sustainability, Stanford University, Stanford, CA, USA
| | | | | | | | | | - Heather N Bischel
- Department of Civil and Environmental Engineering, University of California Davis, Davis, CA, 95616, USA
| | - Colleen C Naughton
- Department of Civil and Environmental Engineering, University of California Merced, Merced, CA, 95343, USA
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Bujang MA. An Elaboration on Sample Size Planning for Performing a One-Sample Sensitivity and Specificity Analysis by Basing on Calculations on a Specified 95% Confidence Interval Width. Diagnostics (Basel) 2023; 13:diagnostics13081390. [PMID: 37189491 DOI: 10.3390/diagnostics13081390] [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: 01/11/2023] [Revised: 02/06/2023] [Accepted: 02/16/2023] [Indexed: 05/17/2023] Open
Abstract
Sample size calculation based on a specified width of 95% confidence interval will offer researchers the freedom to set the level of accuracy of the statistics that they aim to achieve for a particular study. This paper provides a description of the general conceptual context for performing sensitivity and specificity analysis. Subsequently, sample size tables for sensitivity and specificity analysis based on a specified 95% confidence interval width is then provided. Such recommendations for sample size planning are provided based on two different scenarios: one for a diagnostic purpose and another for a screening purpose. Further discussion on all the other relevant considerations for the determination of a minimum sample size requirement and on how to draft the sample size statement for performing sensitivity and specificity analysis are also provided.
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Affiliation(s)
- Mohamad Adam Bujang
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health Malaysia, Kuching 93586, Malaysia
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4
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Moku P, Marshall C, Dougherty C, Messner C, Chau M, Medina D, Exten C. Utilizing student-led contact tracing initiative to alleviate COVID-19 disease burden in central Pennsylvania. Ann Epidemiol 2023; 77:31-36. [PMID: 36334807 PMCID: PMC9628232 DOI: 10.1016/j.annepidem.2022.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 07/04/2022] [Accepted: 10/19/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE Contact tracing elicits probable contacts from COVID-19 cases. Our student-led contact tracing initiative promoted isolation of both confirmed and probable cases and quarantine of contacts to reduce disease in Central Pennsylvania. METHODS Close contacts of COVID-19 cases were contacted by tracers, advised to quarantine, and monitored for 14 days for symptoms. Symptomatic contacts were classified as probable cases and advised to isolate. Data was collected from March 24, 2020 to May 26, 2020. Poisson regression and linear regression were utilized to examine the relationships between case and number of contacts and proportion of symptomatic contacts. RESULTS Study sample comprised of 346 confirmed and 157 probable cases. Our results indicate a significant difference in percent of household contacts who became symptomatic between confirmed and probable cases (22% vs. 3%; adjusted P<.01). Similarly, probable cases had significantly fewer non-household contacts compared to confirmed cases (0.87 vs. 0.55; adjusted P<.01). CONCLUSIONS Timely notification of exposure to a COVID-19 positive individual by student contact tracers allowed for probable cases to quarantine early in the disease process. Our data suggests that early quarantine and/or isolation may have directly contributed to probable cases having fewer non-household contacts and a smaller proportion of symptomatic household-contacts compared to confirmed cases.
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Affiliation(s)
- Prashanth Moku
- The Warren Alpert Medical School of Brown University, Providence, RI,Corresponding author
| | | | | | | | | | | | - Cara Exten
- Ross & Carol Nese College of Nursing, Pennsylvania State University, University Park, PA
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5
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Standiford TC, Farlow JL, Brenner MJ, Blank R, Rajajee V, Baldwin NR, Chinn SB, Cusac JA, De Cardenas J, Malloy KM, McDonough KL, Napolitano LM, Sjoding MW, Stoneman EK, Washer LL, Park PK. COVID-19 Transmission to Health Care Personnel During Tracheostomy Under a Multidisciplinary Safety Protocol. Am J Crit Care 2022; 31:452-460. [PMID: 35953441 DOI: 10.4037/ajcc2022538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Tracheostomies are highly aerosolizing procedures yet are often indicated in patients with COVID-19 who require prolonged intubation. Robust investigations of the safety of tracheostomy protocols and provider adherence and evaluations are limited. OBJECTIVES To determine the rate of COVID-19 infection of health care personnel involved in COVID-19 tracheostomies under a multidisciplinary safety protocol and to investigate health care personnel's attitudes and suggested areas for improvement concerning the protocol. METHODS All health care personnel involved in tracheostomies in COVID-19-positive patients from April 9 through July 11, 2020, were sent a 22-item electronic survey. RESULTS Among 107 health care personnel (80.5%) who responded to the survey, 5 reported a positive COVID-19 test result (n = 2) or symptoms of COVID-19 (n = 3) within 21 days of the tracheostomy. Respondents reported 100% adherence to use of adequate personal protective equipment. Most (91%) were familiar with the tracheostomy protocol and felt safe (92%) while performing tracheostomy. Suggested improvements included creating dedicated tracheostomy teams and increasing provider choices surrounding personal protective equipment. CONCLUSIONS Multidisciplinary engagement in the development and implementation of a COVID-19 tracheostomy protocol is associated with acceptable safety for all members of the care team.
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Affiliation(s)
- Taylor C Standiford
- Taylor C. Standiford is a second-year resident, Department of Otolaryngology-Head & Neck Surgery, University of California, San Francisco
| | - Janice L Farlow
- Janice L. Farlow is a head and neck surgical oncology fellow, Department of Otolaryngology-Head & Neck Surgery, The Ohio State University, Columbus
| | - Michael J Brenner
- Michael J. Brenner is an associate professor, Department of Otolaryngology-Head & Neck Surgery, University of Michigan, Ann Arbor
| | - Ross Blank
- Ross Blank is an assistant professor, Department of Anesthesiology, University of Michigan, Ann Arbor
| | - Venkatakrishna Rajajee
- Venkata-krishna Rajajee is a professor, Department of Neurosurgery, University of Michigan, Ann Arbor
| | - Noel R Baldwin
- Noel R. Baldwin is a registered nurse, Critical Care Medicine Unit, University of Michigan, Ann Arbor
| | - Steven B Chinn
- Steven B. Chinn is an assistant professor, Department of Otolaryngology-Head & Neck Surgery, University of Michigan, Ann Arbor
| | - Jessica A Cusac
- Jessica A. Cusac is a respiratory therapist, clinical specialist, University Hospital/Cardiovascular Center, University of Michigan, Ann Arbor
| | - Jose De Cardenas
- Jose De Cardenas is an associate professor, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan, Ann Arbor
| | - Kelly M Malloy
- Kelly M. Malloy is an associate professor, Department of Otolaryngology-Head & Neck Surgery, University of Michigan, Ann Arbor
| | - Kelli L McDonough
- Kelli L. McDonough is a clinical research project manager, Department of Surgery, University of Michigan, Ann Arbor
| | - Lena M Napolitano
- Lena M. Napolitano is a professor, Department of Surgery, University of Michigan, Ann Arbor
| | - Michael W Sjoding
- Michael W. Sjoding is an assistant professor, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan, Ann Arbor
| | - Emily K Stoneman
- Emily K. Stoneman is an associate professor, Division of Infectious Disease, Department of Medicine, University of Michigan, Ann Arbor
| | - Laraine L Washer
- Laraine L. Washer is a professor, Division of Infectious Disease, Department of Medicine, University of Michigan, Ann Arbor
| | - Pauline K Park
- Pauline K. Park is a professor, Department of Surgery, University of Michigan, Ann Arbor
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6
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O'Hara RW, Brown B, Hughes A, McEwan A, Birtles A, Hawker A, Davies E, Farooq HZ, Tilston P, Haigh D, Hesketh L, Dodgson A, Dodgson K, Shazaad A, Guiver M, Machin N. Evaluation of the artus® Prep&Amp UM RT-PCR for detection of SARS-CoV-2 from nasopharyngeal swabs without prior nucleic acid eluate extraction. JOURNAL OF CLINICAL VIROLOGY PLUS 2022; 2:100098. [PMID: 35874465 PMCID: PMC9287855 DOI: 10.1016/j.jcvp.2022.100098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/11/2022] [Accepted: 07/15/2022] [Indexed: 11/24/2022] Open
Abstract
Here we describe a retrospective clinical evaluation of the QIAGEN artus® SARS-CoV-2 Prep&Amp UM RT-PCR assay that detects SARS-CoV-2 RNA without the need for a nucleic acid eluate extraction procedure. Using Roche SARS-CoV-2 RT-PCR on the cobas® 8800 platform as a reference standard, a total of 225 confirmed SARS-CoV-2 positive and 320 negative nasopharyngeal swabs in viral transport media, were used to evaluate the artus® assay. Using the RT-PCR cycle threshold as a semi-quantitative marker of viral load, an assessment of over 370,000 SARS-CoV-2 RT-PCR positive results was used in the design of the reference positive specimen cohort. The viral load of all reference positive specimens used in the evaluation was a unique and accurate representation of the range and levels of SARS-CoV-2 positivity observed over a 13-month period of the COVID-19 pandemic. The artus® RT-PCR detects the presence of SARS-CoV-2 RNA, an internal control, and the human RNase P gene to ensure specimen quality. The diagnostic sensitivity of artus® was 92.89% with a specificity of 100%. To assess the analytical sensitivity, a limit of detection was performed using the 1st WHO NIBSC SARS-CoV-2 international standard, recording a 95% LOD of 1.1 × 103 IU/ml. The total invalid rate of specimens was 7.34% due to a lack of detectable RNase P (Ct >35). The artus® SARS-CoV-2 Prep&Amp UM RT-PCR assay is a new rapid RT-PCR assay, which may be considered to produce acceptable levels of diagnostic sensitivity and specificity whilst potentially halving the laboratory processing time.
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Affiliation(s)
- Robert William O'Hara
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Virology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - Benjamin Brown
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Virology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - Angela Hughes
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Virology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - Ashley McEwan
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Virology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - Andrew Birtles
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Virology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - Adam Hawker
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Virology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - Emma Davies
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Virology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - Hamzah Z Farooq
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Infectious Diseases & Tropical Medicine, North Manchester General Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Peter Tilston
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Virology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - Dominic Haigh
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Virology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - Louise Hesketh
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Virology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - Andrew Dodgson
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Virology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
- University of Manchester, Manchester, UK
| | - Kirsty Dodgson
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Virology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
- University of Manchester, Manchester, UK
| | - Ahmad Shazaad
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Virology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
- University of Manchester, Manchester, UK
| | - Malcolm Guiver
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Virology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
- University of Manchester, Manchester, UK
| | - Nicholas Machin
- Department of Virology, UK Health Security Agency Manchester, Oxford Road, Manchester M13 9WL, UK
- Department of Virology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
- University of Manchester, Manchester, UK
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7
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Maximising the Use of Scarce qPCR Master Mixes. Int J Mol Sci 2022; 23:ijms23158486. [PMID: 35955620 PMCID: PMC9368830 DOI: 10.3390/ijms23158486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/24/2022] [Accepted: 07/28/2022] [Indexed: 02/01/2023] Open
Abstract
The COVID-19 pandemic resulted in a universal, immediate, and vast demand for comprehensive molecular diagnostic testing, especially real-time quantitative (qPCR)-based methods. This rapidly triggered a global shortage of testing capacity, equipment, and reagents. Even today, supply times for chemicals from date of order to delivery are often much longer than pre-pandemic. Furthermore, many companies have ratcheted up the price for minimum volumes of reaction master mixes essential for qPCR assays, causing additional problems for academic laboratories often operating on a shoestring. We have validated two strategies that stretch reagent supplies and, whilst particularly applicable in case of scarcity, can readily be incorporated into standard qPCR protocols, with appropriate validation. The first strategy demonstrates equivalent performance of a selection of “past expiry date” and newly purchased master mixes. This approach is valid for both standard and fast qPCR protocols. The second validates the use of these master mixes at less than 1x final concentration without loss of qPCR efficiency or sensitivity.
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8
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Choi D, Nielsen J, Waller LA, Patel SA. The US Coronavirus Disease 2019 (COVID-19) Surveillance Environment: An Ecological Analysis of the Relationship of Testing Adequacy in the Context of Vaccination. Clin Infect Dis 2022; 76:e385-e390. [PMID: 35747911 PMCID: PMC9278188 DOI: 10.1093/cid/ciac419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/07/2022] [Accepted: 05/20/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) testing is a critical component of public health surveillance and pandemic control, especially among the unvaccinated, as the nation resumes in-person activities. This study examined the relationships between COVID-19 testing rates, testing positivity rates, and vaccination coverage across US counties. METHODS Data from the Health and Human Services' Community Profile Report and 2016-2020 American Community Survey 5-Year Estimates were used. A total of 3114 US counties were analyzed from January through September 2021. Associations among the testing metrics and vaccination coverage were estimated using multiple linear regression models with fixed effects for states and adjusted for county demographics. COVID-19 testing rates (polymerase chain reaction [PCR] testing per 1000), testing positivity (percentage of all PCR tests that were positive), and vaccination coverage (percentage of county population that was fully vaccinated) were determined. RESULTS Nationally, median daily COVID-19 testing rates were highest in January and September (35.5 and 34.6 tests per capita, respectively) and lowest in July (13.2 tests per capita). Monthly testing positivity was between 0.03 and 0.12 percentage points lower for each percentage points of vaccination coverage, and monthly testing rates were between 0.08 and 0.22 tests per capita higher for each percentage point of vaccination coverage. CONCLUSIONS The quantity of COVID-19 testing was associated with vaccination coverage, implying counties having populations with relatively lower protection against the virus are conducting less testing than counties with relatively more protection. Monitoring testing practices in relation to vaccination coverage may be used to monitor the sufficiency of COVID-19 testing based on population susceptibility to the virus.
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Affiliation(s)
- Daesung Choi
- Correspondence: Daesung Choi, Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, CNR 7040-J, Atlanta, GA 30322, USA ()
| | - Jannie Nielsen
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Lance A Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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9
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Paap KC, van Loon AM, Koene FM, van Buul LW, Jurriaans S, Smalbrugge M, de Jong MD, Hertogh CMPM. Clinical evaluation of single-swab sampling for rapid COVID-19 detection in outbreak settings in Dutch nursing homes. Eur Geriatr Med 2022; 13:711-718. [PMID: 34797552 PMCID: PMC8602523 DOI: 10.1007/s41999-021-00584-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/01/2021] [Indexed: 11/12/2022]
Abstract
PURPOSE To assess whether one swab can be used to perform both the antigen-detection rapid diagnostic test (Ag-RDT) and reverse transcriptase polymerase chain reaction (RT-PCR) for COVID-19 detection during an outbreak in the nursing home (NH) setting. METHODS The single-swab method (SSM), where the Ag-RDT is performed with the transport medium used for RT-PCR, was evaluated in three Dutch NHs and compared to the laboratory setting. We collected Ag-RDT and RT-PCR results, NH resident characteristics and symptomatology. In addition, two focus groups were held with the involved care professionals to gain insight into the feasibility of the SMM in the NH setting. RESULTS In the NH setting, the SSM had a sensitivity of 51% and a specificity of 89% compared to RT-PCR. These were lower than in the laboratory setting (69% and 100% respectively). Yet, when stratified for cycle threshold values, the sensitivity became comparable between the settings. Symptoms occurred more frequent in the Ag-RDT+ group than Ag-RDT- group. Resident characteristics did not differ between these groups. Based on the focus groups, the SSM was feasible to perform if certain requirements, such as availability of staff, equipment and proper training, were met. However, the rapid availability of the test results were perceived as a dilemma. CONCLUSION The advantages and disadvantages need to be considered before implementation of the SSM can be recommended in the NH setting. For the vulnerable NH residents, it is important to find the right balance between effective testing policy and the burden this imposes.
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Affiliation(s)
- Kelly C Paap
- Department of Medicine for Older People, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Amsta Healthcare Organization, Amsterdam, The Netherlands
| | - Anouk M van Loon
- Department of Medicine for Older People, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Fleur M Koene
- Department of Medical Microbiology, Amsterdam University Medical Center, 1105 AZ, Amsterdam, The Netherlands
- Public Health Laboratory, Department of Infectious Diseases, Public Health Service of Amsterdam, 1018 WT, Amsterdam, The Netherlands
| | - Laura W van Buul
- Department of Medicine for Older People, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Suzanne Jurriaans
- Department of Medical Microbiology, Amsterdam University Medical Center, 1105 AZ, Amsterdam, The Netherlands
| | - Martin Smalbrugge
- Department of Medicine for Older People, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Menno D de Jong
- Department of Medical Microbiology, Amsterdam University Medical Center, 1105 AZ, Amsterdam, The Netherlands
| | - Cees M P M Hertogh
- Department of Medicine for Older People, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
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10
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Klein C, Borsche M, Balck A, Föh B, Rahmöller J, Peters E, Knickmann J, Lane M, Vollstedt EJ, Elsner SA, Käding N, Hauswaldt S, Lange T, Hundt JE, Lehrian S, Giese J, Mischnik A, Niemann S, Maurer F, Homolka S, Paulowski L, Kramer J, Twesten C, Sina C, Gillessen-Kaesbach G, Busch H, Ehlers M, Taube S, Rupp J, Katalinic A. One-year surveillance of SARS-CoV-2 transmission of the ELISA cohort: A model for population-based monitoring of infection risk. SCIENCE ADVANCES 2022; 8:eabm5016. [PMID: 35427158 PMCID: PMC9012459 DOI: 10.1126/sciadv.abm5016] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
With newly rising coronavirus disease 2019 (COVID-19) cases, important data gaps remain on (i) long-term dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates in fixed cohorts (ii) identification of risk factors, and (iii) establishment of effective surveillance strategies. By polymerase chain reaction and antibody testing of 1% of the local population and >90,000 app-based datasets, the present study surveilled a catchment area of 300,000 inhabitants from March 2020 to February 2021. Cohort (56% female; mean age, 45.6 years) retention was 75 to 98%. Increased risk for seropositivity was detected in several high-exposure groups, especially nurses. Unreported infections dropped from 92 to 29% during the study. "Contact to COVID-19-affected" was the strongest risk factor, whereas public transportation, having children in school, or tourism did not affect infection rates. With the first SARS-CoV-2 cohort study, we provide a transferable model for effective surveillance, enabling monitoring of reinfection rates and increased preparedness for future pandemics.
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Affiliation(s)
- Christine Klein
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
- Corresponding author.
| | - Max Borsche
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Alexander Balck
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
- Department of Neurology, University of Lübeckand and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Bandik Föh
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
- Department of Medicine I, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Johann Rahmöller
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
- Department of Anesthesiology and Intensive Care, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Elke Peters
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Jan Knickmann
- Institute of Virology and Cell Biology, University of Lübeck, Lübeck, Germany
| | - Miranda Lane
- Institute of Virology and Cell Biology, University of Lübeck, Lübeck, Germany
| | - Eva-Juliane Vollstedt
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Susanne A. Elsner
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Nadja Käding
- Department of Infectious Diseases and Microbiology, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Susanne Hauswaldt
- Department of Infectious Diseases and Microbiology, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Tanja Lange
- Department of Rheumatology and Clinical Immunology, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Jennifer E. Hundt
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Selina Lehrian
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
| | - Julia Giese
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
| | | | - Stefan Niemann
- Research Center Borstel, Leibniz Lung Center, Borstel, Germany
- German Center for Infection Research (DZIF), Partner site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany
| | - Florian Maurer
- Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - Susanne Homolka
- Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - Laura Paulowski
- Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - Jan Kramer
- Institute of Virology and Cell Biology, University of Lübeck, Lübeck, Germany
- LADR Laboratory Group Dr. Kramer & Colleagues, Geesthacht, Germany
| | | | - Christian Sina
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
| | | | - Hauke Busch
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Marc Ehlers
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
| | - Stefan Taube
- Institute of Virology and Cell Biology, University of Lübeck, Lübeck, Germany
| | - Jan Rupp
- Department of Infectious Diseases and Microbiology, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
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11
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Wolfe MK, Archana A, Catoe D, Coffman MM, Dorevich S, Graham KE, Kim S, Grijalva LM, Roldan-Hernandez L, Silverman AI, Sinnott-Armstrong N, Vugia DJ, Yu AT, Zambrana W, Wigginton KR, Boehm AB. Scaling of SARS-CoV-2 RNA in Settled Solids from Multiple Wastewater Treatment Plants to Compare Incidence Rates of Laboratory-Confirmed COVID-19 in Their Sewersheds. ENVIRONMENTAL SCIENCE & TECHNOLOGY LETTERS 2021; 8:398-404. [PMID: 37566351 PMCID: PMC8056949 DOI: 10.1021/acs.estlett.1c00184] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/06/2021] [Accepted: 04/06/2021] [Indexed: 05/19/2023]
Abstract
Published and unpublished reports show that SARS-CoV-2 RNA in publicly owned treatment work (POTW) wastewater influent and solids is associated with new COVID-19 cases or incidence in associated sewersheds, but methods for comparing data collected from diverse POTWs to infer information about the relative incidence of laboratory-confirmed COVID-19 cases, and scaling to allow such comparisons, have not been previously established. Here, we show that SARS-CoV-2 N1 and N2 concentrations in solids normalized by concentrations of PMMoV RNA in solids can be used to compare incidence of laboratory confirmed new COVID-19 cases across POTWs. Using data collected at seven POTWs along the United States West Coast, Midwest, and East Coast serving ∼3% of the U.S. population (9 million people), we show that a 1 log change in N gene/PMMoV is associated with a 0.24 (range 0.19 to 0.29) log10 change in incidence of laboratory confirmed COVID-19. Scaling of N1 and N2 by PMMoV is consistent, conceptually, with a mass balance model relating SARS-CoV-2 RNA to the number of infected individuals shedding virus in their stool. This information should support the application of wastewater-based epidemiology to inform the response to the COVID-19 pandemic and potentially future viral pandemics.
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Affiliation(s)
- Marlene K. Wolfe
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Anand Archana
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - David Catoe
- Joint Initiative for Metrology in Biology,
SLAC National Accelerator Laboratory, Stanford, California
94305, United States
| | - Mhara M. Coffman
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Samuel Dorevich
- Division of Environmental and Occupational Health
Sciences, School of Public Health, University of Illinois,
Chicago, Illinois 60612, United States
| | - Katherine E. Graham
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Sooyeol Kim
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Lorelay Mendoza Grijalva
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Laura Roldan-Hernandez
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Andrea I. Silverman
- Department of Civil and Urban Engineering, Tandon
School of Engineering, New York University, Brooklyn, New York
11201, United States
- School of Global Public Health, New York
University, New York, New York 10003, United
States
| | - Nasa Sinnott-Armstrong
- Department of Genetics, Stanford University
School of Medicine, Stanford, California 94305, United
States
| | - Duc J. Vugia
- Infectious Diseases Branch, California
Department of Public Health, Richmond, California 94804, United
States
| | - Alexander T. Yu
- Infectious Diseases Branch, California
Department of Public Health, Richmond, California 94804, United
States
| | - Winnie Zambrana
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
| | - Krista R. Wigginton
- Department of Civil and Environmental Engineering,
University of Michigan,Ann Arbor, Michigan 48109,
United States
| | - Alexandria B. Boehm
- Department of Civil and Environmental Engineering,
Stanford University, 473 Via Ortega, Stanford, California
94305, United States
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12
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Shaffaf T, Ghafar-Zadeh E. COVID-19 Diagnostic Strategies. Part I: Nucleic Acid-Based Technologies. Bioengineering (Basel) 2021; 8:49. [PMID: 33920513 PMCID: PMC8072613 DOI: 10.3390/bioengineering8040049] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 12/11/2022] Open
Abstract
The novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused respiratory infection, resulting in more than two million deaths globally and hospitalizing thousands of people by March 2021. A considerable percentage of the SARS-CoV-2 positive patients are asymptomatic or pre-symptomatic carriers, facilitating the viral spread in the community by their social activities. Hence, it is critical to have access to commercialized diagnostic tests to detect the infection in the earliest stages, monitor the disease, and follow up the patients. Various technologies have been proposed to develop more promising assays and move toward the mass production of fast, reliable, cost-effective, and portable PoC diagnostic tests for COVID-19 detection. Not only COVID-19 but also many other pathogens will be able to spread and attach to human bodies in the future. These technologies enable the fast identification of high-risk individuals during future hazards to support the public in such outbreaks. This paper provides a comprehensive review of current technologies, the progress in the development of molecular diagnostic tests, and the potential strategies to facilitate innovative developments in unprecedented pandemics.
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Affiliation(s)
- Tina Shaffaf
- Biologically Inspired Sensors and Actuators Laboratory (BioSA), York University, Toronto, ON M3J1P3, Canada;
- Faculty of Science, Department of Biology, York University, Toronto, ON M3J1P3, Canada
| | - Ebrahim Ghafar-Zadeh
- Biologically Inspired Sensors and Actuators Laboratory (BioSA), York University, Toronto, ON M3J1P3, Canada;
- Faculty of Science, Department of Biology, York University, Toronto, ON M3J1P3, Canada
- Lassonde School of Engineering, Department of Electrical Engineering and Computer Science, York University, Toronto, ON M3J1P3, Canada
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13
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Nitecki M, Taran B, Ketko I, Geva G, Yosef R, Toledo I, Twig G, Avramovitch E, Gordon B, Derazne E, Fink N, Furer A. Self-reported symptoms in healthy young adults to predict potential coronavirus disease 2019. Clin Microbiol Infect 2021; 27:618-623. [PMID: 33418018 PMCID: PMC7837233 DOI: 10.1016/j.cmi.2020.12.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/15/2020] [Accepted: 12/21/2020] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To assess the utility of self-reported symptoms in identifying positive coronavirus disease 2019 (COVID-19) cases among predominantly healthy young adults in a military setting. METHODS A questionnaire regarding COVID-19 symptoms and exposure history was administered to all individuals contacting the Israeli Defence Forces Corona call-centre, before PCR testing. Surveyed symptoms included cough, fever, sore throat, rhinorrhoea, loss of taste or smell, chest pain and gastrointestinal symptoms. Factors were compared between positive and negative cases based on confirmatory test results, and positive likelihood ratios (LR) were calculated. Results were stratified by sex, body mass index, previous medical history and dates of questioning, and a multivariable analysis for association with positive test was conducted. RESULTS Of 24 362 respondents, 59.1% were men with a median age of 20.5 years (interquartile range 19.6-22.4 years). Significant positive LRs were associated with loss of taste or smell (LR 3.38, 95% CI 3.01-3.79), suspected exposure (LR 1.33, 95% CI 1.28-1.39) and fever (LR 1.26, 95% CI 1.17-1.36). Those factors were also associated with positive PCR result in a multivariable analysis (OR 3.51, 95% CI 3.04-4.06; OR 1.86, 95% CI 1.65-2.09; and OR 1.34, 95% CI 1.19-1.51, respectively). Reports of loss of taste or smell increased gradually over time and were significantly more frequent during the late period of the study (63/5231, 1.21%; 156/7941, 1.96%; and 1505/11 190, 13.45%: p < 0.001). CONCLUSION Loss of taste or smell, report of a suspicious exposure and fever (>37.5°C) were consistently associated with positive LRs for a positive SARS-CoV-2 PCR test result, in a population of predominantly young and healthy adults.
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Affiliation(s)
- Maya Nitecki
- Israel Defense Force Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Boris Taran
- Israel Defense Force Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Itay Ketko
- Israel Defense Force Medical Corps, Tel Hashomer, Ramat Gan, Israel; Heller Institute of Medical Research, Sheba Medical Center, Tel-Hashomer, Israel
| | - Gil Geva
- Israel Defense Force Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Roey Yosef
- Israel Defense Force Computer and IT Directorate, Tel Hashomer, Ramat Gan, Israel
| | - Itay Toledo
- Israel Defense Force Computer and IT Directorate, Tel Hashomer, Ramat Gan, Israel
| | - Gilad Twig
- Israel Defense Force Medical Corps, Tel Hashomer, Ramat Gan, Israel; Department of Military Medicine, Hebrew University, Jerusalem, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eva Avramovitch
- Israel Defense Force Medical Corps, Tel Hashomer, Ramat Gan, Israel; Department of Management, Bar-Ilan University, Israel
| | - Barak Gordon
- Israel Defense Force Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Estela Derazne
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noam Fink
- Israel Defense Force Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Ariel Furer
- Israel Defense Force Medical Corps, Tel Hashomer, Ramat Gan, Israel; Department of Military Medicine, Hebrew University, Jerusalem, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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14
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Machine learning is the key to diagnose COVID-19: a proof-of-concept study. Sci Rep 2021; 11:7166. [PMID: 33785852 PMCID: PMC8009887 DOI: 10.1038/s41598-021-86735-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/16/2021] [Indexed: 12/28/2022] Open
Abstract
The reverse transcription-polymerase chain reaction (RT-PCR) assay is the accepted standard for coronavirus disease 2019 (COVID-19) diagnosis. As any test, RT-PCR provides false negative results that can be rectified by clinicians by confronting clinical, biological and imaging data. The combination of RT-PCR and chest-CT could improve diagnosis performance, but this would requires considerable resources for its rapid use in all patients with suspected COVID-19. The potential contribution of machine learning in this situation has not been fully evaluated. The objective of this study was to develop and evaluate machine learning models using routine clinical and laboratory data to improve the performance of RT-PCR and chest-CT for COVID-19 diagnosis among post-emergency hospitalized patients. All adults admitted to the ED for suspected COVID-19, and then hospitalized at Rennes academic hospital, France, between March 20, 2020 and May 5, 2020 were included in the study. Three model types were created: logistic regression, random forest, and neural network. Each model was trained to diagnose COVID-19 using different sets of variables. Area under the receiving operator characteristics curve (AUC) was the primary outcome to evaluate model’s performances. 536 patients were included in the study: 106 in the COVID group, 430 in the NOT-COVID group. The AUC values of chest-CT and RT-PCR increased from 0.778 to 0.892 and from 0.852 to 0.930, respectively, with the contribution of machine learning. After generalization, machine learning models will allow increasing chest-CT and RT-PCR performances for COVID-19 diagnosis.
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15
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Igloi Z, Velzing J, van Beek J, van de Vijver D, Aron G, Ensing R, Benschop K, Han W, Boelsums T, Koopmans M, Geurtsvankessel C, Molenkamp R. Clinical Evaluation of Roche SD Biosensor Rapid Antigen Test for SARS-CoV-2 in Municipal Health Service Testing Site, the Netherlands. Emerg Infect Dis 2021; 27:1323-1329. [PMID: 33724916 PMCID: PMC8084500 DOI: 10.3201/eid2705.204688] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Rapid detection of infection is essential for stopping the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The Roche SD Biosensor rapid antigen test for SARS-CoV-2 was evaluated in a nonhospitalized symptomatic population. We rapid-tested a sample onsite and compared results with those from reverse transcription PCR and virus culture. We analyzed date of onset and symptoms using data from a clinical questionnaire. Overall test sensitivity was 84.9% (95% CI 79.1–89.4) and specificity was 99.5% (95% CI 98.7–99.8). Sensitivity increased to 95.8% (95% CI 90.5–98.2) for persons who sought care within 7 days of symptom onset. Test band intensity and time to result correlated strongly with viral load; thus, strong positive results could be read before the recommended time. Approximately 98% of all viable specimens with cycle threshold <30 were detected. Rapid antigen tests can detect symptomatic SARS-CoV-2 infections in the early phase of disease, thereby identifying the most infectious persons.
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16
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Vandenberg O, Martiny D, Rochas O, van Belkum A, Kozlakidis Z. Considerations for diagnostic COVID-19 tests. Nat Rev Microbiol 2021; 19:171-183. [PMID: 33057203 PMCID: PMC7556561 DOI: 10.1038/s41579-020-00461-z] [Citation(s) in RCA: 447] [Impact Index Per Article: 149.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2020] [Indexed: 02/07/2023]
Abstract
During the early phase of the coronavirus disease 2019 (COVID-19) pandemic, design, development, validation, verification and implementation of diagnostic tests were actively addressed by a large number of diagnostic test manufacturers. Hundreds of molecular tests and immunoassays were rapidly developed, albeit many still await clinical validation and formal approval. In this Review, we summarize the crucial role of diagnostic tests during the first global wave of COVID-19. We explore the technical and implementation problems encountered during this early phase in the pandemic, and try to define future directions for the progressive and better use of (syndromic) diagnostics during a possible resurgence of COVID-19 in future global waves or regional outbreaks. Continuous global improvement in diagnostic test preparedness is essential for more rapid detection of patients, possibly at the point of care, and for optimized prevention and treatment, in both industrialized countries and low-resource settings.
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Affiliation(s)
- Olivier Vandenberg
- Innovation and Business Development Unit, Laboratoire Hospitalier Universtaire de Bruxelles - Universitair Laboratorium Brussel, Université Libre de Bruxelles, Brussels, Belgium.
- Center for Environmental Health and Occupational Health, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
- Division of Infection and Immunity, Faculty of Medical Sciences, University College London, London, UK.
| | - Delphine Martiny
- Department of Microbiology, Laboratoire Hospitalier Universtaire de Bruxelles - Universitair Laboratorium Brussel, Université Libre de Bruxelles, Brussels, Belgium
| | - Olivier Rochas
- Strategic Intelligence, Corporate Business Development, bioMérieux, Chemin de L'Orme, France
| | - Alex van Belkum
- Open Innovation and Partnerships, bioMérieux, La Balme Les Grottes, France.
| | - Zisis Kozlakidis
- Laboratory Services and Biobank Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
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17
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Oyewole AO, Barrass L, Robertson EG, Woltmann J, O’Keefe H, Sarpal H, Dangova K, Richmond C, Craig D. COVID-19 Impact on Diagnostic Innovations: Emerging Trends and Implications. Diagnostics (Basel) 2021; 11:182. [PMID: 33513988 PMCID: PMC7912626 DOI: 10.3390/diagnostics11020182] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 02/06/2023] Open
Abstract
Diagnostic testing remains the backbone of the coronavirus disease 2019 (COVID-19) response, supporting containment efforts to mitigate the outbreak. The severity of this crisis and increasing capacity issues associated with polymerase chain reaction (PCR)-based testing, accelerated the development of diagnostic solutions to meet demands for mass testing. The National Institute for Health Research (NIHR) Innovation Observatory is the national horizon scanning organization in England. Since March, the Innovation Observatory has applied advanced horizon scanning methodologies and tools to compile a diagnostic landscape, based upon data captured for molecular (MDx) and immunological (IDx) based diagnostics (commercialized/in development), for the diagnosis of SARS-CoV-2. In total we identified and tracked 1608 diagnostics, produced by 1045 developers across 54 countries. Our dataset shows the speed and scale in which diagnostics were produced and provides insights into key periods of development and shifts in trends between MDx and IDx solutions as the pandemic progressed. Stakeholders worldwide required timely and detailed intelligence to respond to major challenges, including testing capacity and regulatory issues. Our intelligence assisted UK stakeholders with assessing priorities and mitigation options throughout the pandemic. Here we present the global evolution of diagnostic innovations devised to meet changing needs, their regulation and trends across geographical regions, providing invaluable insights into the complexity of the COVID-19 phenomena.
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Affiliation(s)
- Anne O. Oyewole
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
| | - Lucy Barrass
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
| | - Emily G. Robertson
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
| | - James Woltmann
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
| | - Hannah O’Keefe
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle NE2 4AX, UK
| | - Harsimran Sarpal
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
| | - Kim Dangova
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
| | - Catherine Richmond
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle NE2 4AX, UK
| | - Dawn Craig
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle NE2 4AX, UK
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18
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Silva AF, Tavakoli M. Domiciliary Hospitalization through Wearable Biomonitoring Patches: Recent Advances, Technical Challenges, and the Relation to Covid-19. SENSORS (BASEL, SWITZERLAND) 2020; 20:E6835. [PMID: 33260466 PMCID: PMC7729497 DOI: 10.3390/s20236835] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/10/2020] [Accepted: 11/23/2020] [Indexed: 12/16/2022]
Abstract
This article reviews recent advances and existing challenges for the application of wearable bioelectronics for patient monitoring and domiciliary hospitalization. More specifically, we focus on technical challenges and solutions for the implementation of wearable and conformal bioelectronics for long-term patient biomonitoring and discuss their application on the Internet of medical things (IoMT). We first discuss the general architecture of IoMT systems for domiciliary hospitalization and the three layers of the system, including the sensing, communication, and application layers. In regard to the sensing layer, we focus on current trends, recent advances, and challenges in the implementation of stretchable patches. This includes fabrication strategies and solutions for energy storage and energy harvesting, such as printed batteries and supercapacitors. As a case study, we discuss the application of IoMT for domiciliary hospitalization of COVID 19 patients. This can be used as a strategy to reduce the pressure on the healthcare system, as it allows continuous patient monitoring and reduced physical presence in the hospital, and at the same time enables the collection of large data for posterior analysis. Finally, based on the previous works in the field, we recommend a conceptual IoMT design for wearable monitoring of COVID 19 patients.
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Affiliation(s)
| | - Mahmoud Tavakoli
- Institute of Systems and Robotics, Department of Electrical Engineering, University of Coimbra, 3030-290 Coimbra, Portugal;
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