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Zahra S, Saleem MK, Ejaz KF, Akbar A, Jadoon SK, Hussain S, Ali AI, Ifty M, Jannati SZ, Armin F, Sarker D, Islam DZ, Khandker SS, Khan MS, Alvi S. Prevalence of nephropathy among diabetic patients in North American region: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e39759. [PMID: 39312314 PMCID: PMC11419527 DOI: 10.1097/md.0000000000039759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 08/29/2024] [Indexed: 09/25/2024] Open
Abstract
BACKGROUND Nephropathy is one of the most common microvascular impediments of diabetes mellitus. In this study, we aimed to estimate the prevalence of nephropathy in diabetic patients across the North American region. METHODS Eligible studies were screened out from 3 electronic databases, for example, PubMed, Google Scholar, and ScienceDirect using specific search keywords based on the eligibility criteria. Extracting the data from the included studies publication bias, quality assessment, outlier investigation, and meta-analysis was done followed by the subgroup analysis. A total of 11 studies met the study inclusion criteria. Meta-analysis was performed with the extracted data. RESULTS Pooled prevalence of 28.2% (95% confidence interval [CI]: 19.7-36.7) with a high rate of heterogeneity (I2 = 100%) was identified. The pooled prevalence of nephropathy among diabetic patients in the United States of America, Canada, and Mexico was 24.2% (95% CI: 13.8-34.5), 31.2% (95% CI: 25.8-36.5), and 31.1% (95% CI: 20.8-41.5), respectively. CONCLUSION The prevalence of nephropathy among diabetic patients was found lower in the United States of America as compared to Canada and Mexico. Besides, the pooled prevalence of the North American region was found to be lower as compared to the African, European, and Asian regions. Minimizing the pathogenic factors, sufficient diagnostic, healthcare facilities, and awareness are recommended to improve the situation.
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Affiliation(s)
- Sabahat Zahra
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | - Muhammad Khurram Saleem
- General Internal Medicine, University Hospital, Bristol and Weston NHS Foundation Trust, Royal College of Physicians and Surgeons of Glasgow, Glasgow, United Kingdom
| | | | - Amna Akbar
- District Headquarter Hospital Jhelum Valley, Muzaffarabad, AJK, Pakistan
| | | | - Shoukat Hussain
- Medicine (AJKMC), Fellow Endocrinology Capital Hospital Islamabad, Islamabad, Pakistan
| | - Amir Iqbal Ali
- Consultant Surgeon, Combined Military Hospital/SKBZ, Muzaffarabad, AJK, Pakistan
| | | | | | - Fariza Armin
- School of Pharmacy, Brac University, Dhaka, Bangladesh
| | | | | | - Shahad Saif Khandker
- Department of Microbiology, Gonoshasthaya Samaj Vittik Medical College, Dhaka, Bangladesh
| | | | - Sarosh Alvi
- Teaching Faculty, University of Khartoum, Khartoum, Sudan
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2
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Hu J, Hu J, Jin L, Hu D, Nicholls PK, Wang T, Ren Y, Hu D, Ma B. Use of high-resolution fluorescence in situ hybridization for fast and robust detection of SARS-CoV-2 RNAs. Sci Rep 2024; 14:20906. [PMID: 39245656 PMCID: PMC11381525 DOI: 10.1038/s41598-024-70980-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 08/22/2024] [Indexed: 09/10/2024] Open
Abstract
Early, rapid, and accurate diagnostic tests play critical roles not only in the identification/management of individuals infected by SARS-CoV-2, but also in fast and effective public health surveillance, containment, and response. Our aim has been to develop a fast and robust fluorescence in situ hybridization (FISH) detection method for detecting SARS-CoV-2 RNAs by using an HEK 293 T cell culture model. At various times after being transfected with SARS-CoV-2 E and N plasmids, HEK 293 T cells were fixed and then hybridized with ATTO-labeled short DNA probes (about 20 nt). At 4 h, 12 h, and 24 h after transfection, SARS-CoV-2 E and N mRNAs were clearly revealed as solid granular staining inside HEK 293 T cells at all time points. Hybridization time was also reduced to 1 h for faster detection, and the test was completed within 3 h with excellent results. In addition, we have successfully detected 3 mRNAs (E mRNA, N mRNA, and ORF1a (-) RNA) simultaneously inside the buccal cells of COVID-19 patients. Our high-resolution RNA FISH might significantly increase the accuracy and efficiency of SARS-CoV-2 detection, while significantly reducing test time. The method can be conducted on smears containing cells (e.g., from nasopharyngeal, oropharyngeal, or buccal swabs) or smears without cells (e.g., from sputum, saliva, or drinking water/wastewater) for detecting various types of RNA viruses and even DNA viruses at different timepoints of infection.
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Affiliation(s)
- Jiapei Hu
- Tangshan Clinical Medical College, Hebei Medical University, Tangshan, Hebei, China
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jiayi Hu
- Tangshan Clinical Medical College, Hebei Medical University, Tangshan, Hebei, China
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Li Jin
- Tangshan Clinical Medical College, Hebei Medical University, Tangshan, Hebei, China
- Graduate School, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Dakang Hu
- Department of Laboratory Medicine, Taizhou Municipal Hospital, Taizhou, Zhejiang, China
| | - Philip K Nicholls
- School of Medical, Molecular and Forensic Sciences, Murdoch University, 90 South Street, Murdoch, WA, 6149, Australia
| | - Tao Wang
- Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA, Australia
- Medical School, University of Western Australia, Nedlands, WA, Australia
| | - Yonglin Ren
- School of Agricultural Science, Murdoch University, Murdoch, WA, Australia
| | - Dailun Hu
- Department of Pathogenic Biology, Hebei Medical University, 361 Zhongshan East Road, Shijiazhuang, 050017, Hebei, China.
| | - Bin Ma
- School of Medical, Molecular and Forensic Sciences, Murdoch University, 90 South Street, Murdoch, WA, 6149, Australia.
- Centre for Healthy Aging, Health Futures Institute, Murdoch University, Murdoch, WA, Australia.
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3
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Gezahagne HF, Jin DS, Vogel EM. The influence of charge on the translation of the sandwich ELISA approach to electronic biosensors. J Colloid Interface Sci 2024; 668:223-231. [PMID: 38677211 DOI: 10.1016/j.jcis.2024.04.139] [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: 02/23/2024] [Revised: 04/16/2024] [Accepted: 04/20/2024] [Indexed: 04/29/2024]
Abstract
The sandwich approach, whereby an antigen is captured by a primary antibody and detected by a secondary antibody, is commonly used to improve the selectivity and sensitivity of enzyme-linked immunosorbent assays (ELISA). This work details the experimental factors that impact the reliable translation of this sandwich approach to two commonly used electronic biosensors, namely potentiometric and impedimetric biosensors. Previous studies have demonstrated the Debye screening limitations associated with potentiometric biosensors. However, the correlation between the ionic strength of the measurement buffer and the impedimetric biosensing response has not been studied. Potentiometric biosensors were able to successfully detect the primary antibody and the target antigen by decreasing the ionic strength of the phosphate buffered saline (PBS) measurement buffer from 1x PBS to 0.01x PBS. However, the secondary antibody used for the selective signal amplification was not reliably detected. Therefore, the sandwich approach is not viable for potentiometric sensing at biologically relevant ionic strengths, due to the Debye screening effect. Alternatively, decreasing the ionic strength of the measurement buffer allowed for the successful translation of the sandwich approach to impedimetric biosensors. Impedimetric biosensing literature typically attributes a measured increase in the charge transfer resistance to an increase in the thickness of the immobilized biolayer. However, this work highlights the influence that both the charge and thickness of the biolayer have on the transport of the redox couple. Decreasing the ionic strength of the measurement buffer lowers the molecular charge screening effect. This permits the transport of a positively charged redox probe through a negatively charged immobilized biolayer via migration and diffusion. The results demonstrate that the use of a buffer at a lower, yet biologically relevant ionic strength allows for the successful translation of the sandwich approach to impedimetric biosensors.
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Affiliation(s)
- Hilena F Gezahagne
- School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Decarle S Jin
- School of Materials Science and Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Eric M Vogel
- School of Materials Science and Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA.
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4
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Hong SA. Toward better pandemic governance and preparedness: South Korea's whole-of-nation approach to COVID-19. BMC Public Health 2024; 24:2126. [PMID: 39107756 PMCID: PMC11302091 DOI: 10.1186/s12889-024-19655-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 07/30/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND The profound impact of coronavirus disease (COVID-19) has led to an increased demand for sustainable pandemic governance practices. This study explored emerging hybrid governance practices that provide robust evidence on how to address the complex challenges of pandemics effectively. South Korea, which was severely affected by COVID-19, has implemented a novel governance approach using a whole-of-nation (WoN) model. This hybrid pandemic governance approach, which integrates both whole-of-government and whole-of-society approaches, has enabled synergistic and cohesive multi-sectoral coordination among all stakeholders (public authorities, private enterprises, and civil society) to address multifaceted challenges collectively and strengthen their resilience capacity. This study investigated South Korea's WoN practices and their embedded context and identified key governance enablers facilitating this approach. METHODS This study employed a case study design based on an extensive analysis of policy and program documents, drawing on South Korea's publicly available data from January 1, 2020 to March 30, 2023. It assessed six system-level collaborative pandemic governance practices and key enablers, all of which were intended to fortify the country's pandemic response. RESULTS The primary areas of the country's WoN governance practices for COVID-19 control were (i) whole-of-government policy-making and response, (ii) COVID-19 testing system, (iii) digital surveillance of COVID-19, (iv) COVID-19 triage and treatment system, (v) domestic vaccine production, and (vi) community engagement. Key governance enablers for implementing the WoN model were establishing a legal foundation, ensuring decisive and strong governance and leadership, increasing public investment, applying a whole-of-health approach with augmented investment in public health, enhancing crisis communication, and mobilizing local leaders and civil society organizations in the national public health response. CONCLUSIONS In exploring innovative approaches to pandemic governance for increased efficacy, responsiveness, and impact, the WoN approach emerged as highly relevant. This example of emerging practice allows policy-makers to re-evaluate their governance strategies and initiatives to improve multi-agency partnerships across the country in their pandemic-preparedness planning.
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Affiliation(s)
- Shin Ae Hong
- Crisis, Disaster and Risk Management, College of Natural Science, Sungkyunkwan University, Seoul, South Korea.
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5
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Saleem S, Rehman A, Akbar A, Ali AI, Jadoon SK, Khattak MI, Mehraj A. Meta-Analysis of the Global Mortality Rate Due to Infection in Burn Patients Admitted for Plastic Surgery. Cureus 2024; 16:e67425. [PMID: 39310591 PMCID: PMC11415252 DOI: 10.7759/cureus.67425] [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] [Accepted: 08/21/2024] [Indexed: 09/25/2024] Open
Abstract
Burn patients are generally prone to infection, which causes the patient's condition to be even worse. However, there is no study regarding the difference between the mortality rate of infected and non-infected patients. Therefore, the aim was to identify and compare the global mortality rate between infected and non-infected patients who were admitted to plastic surgery units. We searched PubMed, ScienceDirect, and Google Scholar and finally included five articles for this meta-analysis. We determined the odds ratio (OR) value by forest plot and assessed the study bias by a funnel plot. We also analyzed the quality and heterogeneity. The OR was determined as 0.43 (95%CI: 0.07-2.60), indicating a higher mortality rate in infected burn patients as compared to non-infected patients. The funnel plot showed no significant study bias. The quality of the studies was assessed high as well, and the heterogeneity was determined significant (I2>75%). The sensitivity analysis with the fixed effect model reconfirmed our main outcome. However, as a study limitation, we could not specifically determine the impact of strain-specific infection on the mortality rate and could not find more relevant research regarding this issue. We conclude that the overall non-infected burn patient mortality rate is lower as compared to the infected burn patients; however, non-infected patients can be prone to death if the burn degree is higher, the respiratory organ is injured, or the treatment is poor or delayed.
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Affiliation(s)
- Shahan Saleem
- Cosmetic, Reconstructive and Burn Surgery, Jinnah Burn and Reconstructive Surgery Center, Lahore, PAK
| | - Ayesha Rehman
- Surgery, Divisional Headquarters Teaching Hospital, Mirpur, PAK
| | - Amna Akbar
- Emergency and Accident, District Headquarter Hospital, Muzaffarabad, PAK
| | - Amir Iqbal Ali
- General Surgery, Combined Military Hospitals, Muzaffarabad, PAK
| | | | | | - Adnan Mehraj
- Surgery, Azad Jammu Kashmir Medical College, Muzaffarabad, PAK
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6
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Omonkhua AA, Faneye A, Akinwande KS, Evaezi O, Shehu NY, Onayade A, Ochu CL, Popoola M, Emmanuel N, Ojo T, Ohonsi C, Abubakar A, Odeh E, Akinduti P, Folarin O, Bimba JS, Igumbor E, Elimian K, Edem VF, Pam D. L, Olusola T, Ntoimo L, Olugbile M, Opayele AV, Kida I, David S, Onyeaghala A, Igbarumah I, Maduka O, Mahmoud MA, El-Fulatty AR, Olaleye DO, Simon O, Osaigbovo II, Obaseki DE, Tolulupe A, Happi C, Jibrin YB, Okonofua F, Eliya T, Simji G, Abi IJ, Ameh E, Maigari IM, Alhaji S, Adetifa I, Salako B, Bogoro S, Ihekweazu C, Odaibo GN. Performance evaluation of SARS-CoV-2 rapid diagnostic tests in Nigeria: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003371. [PMID: 39008485 PMCID: PMC11249252 DOI: 10.1371/journal.pgph.0003371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 05/28/2024] [Indexed: 07/17/2024]
Abstract
The COVID-19 pandemic challenged health systems globally. Reverse transcription polymerase chain reaction (RT-PCR) is the gold standard for detecting the presence of SARS-CoV-2 in clinical samples. Rapid diagnostic test (RDT) kits for COVID-19 have been widely used in Nigeria. This has greatly improved test turnover rates and significantly decreased the high technical demands of RT-PCR. However, there is currently no nationally representative evaluation of the performance characteristics and reliability of these kits. This study assessed the sensitivity, specificity, and predictive values of ten RDT kits used for COVID-19 testing in Nigeria. This large multi-centred cross-sectional study was conducted across the 6 geo-political zones of Nigeria over four months. Ten antigen (Ag) and antibody (Ab) RDT kits were evaluated, and the results were compared with RT-PCR. One thousand, three hundred and ten (1,310) consenting adults comprising 767 (58.5%) males and 543 (41.5%) females participated in the study. The highest proportion, 757 (57.7%), were in the 20-39 years' age group. In terms of diagnostic performance, Lumira Dx (61.4, 95% CI: 52.4-69.9) had the highest sensitivity while MP SARS and Panbio (98.5, 95% CI: 96.6-99.5) had the highest specificity. For predictive values, Panbio (90.7, 95% CI: 79.7-96.9) and Lumira Dx (81.2, 95% CI: 75.9-85.7) recorded the highest PPV and NPV respectively. Ag-RDTs had better performance characteristics compared with Ab-RDTs; however, the sensitivities of all RDTs in this study were generally low. The relatively high specificity of Ag-RDTs makes them useful for the diagnosis of infection in COVID-19 suspected cases where positive RDT may not require confirmation by molecular testing. There is therefore the need to develop RDTs in-country that will take into consideration the unique environmental factors, interactions with other infectious agents, and strains of the virus circulating locally. This may enhance the precision of rapid and accurate diagnosis of COVID-19 in Nigeria.
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Affiliation(s)
- Akhere A. Omonkhua
- Centre of Excellence in Reproductive Health Innovation (CERHI), University of Benin, Benin City, Nigeria
- Department of Medical Biochemistry, University of Benin, Benin City, Nigeria
| | - Adedayo Faneye
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Kazeem S. Akinwande
- Department of Chemical Pathology and Immunology, Federal Medical Centre Abeokuta, Abeokuta, Nigeria
| | - Okpokoro Evaezi
- International Research Centre of Excellence, Institute of Human Virology, Abuja, Nigeria
| | - Nathan Y. Shehu
- West African Center for Emerging Infectious Diseases (WAC-EID), Jos University Teaching Hospital, Jos, Nigeria
| | - Adedeji Onayade
- Institute of Public Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Chinwe Lucia Ochu
- Nigeria Centre for Disease Control & Prevention, Abuja Nigeria
- Nigeria COVID-19 Research Coalition, Abuja, Nigeria
| | - Mustapha Popoola
- Nigeria COVID-19 Research Coalition, Abuja, Nigeria
- Tertiary Education Trust Fund, Abuja, Nigeria
| | - Nnadi Emmanuel
- Plateau State University, Bokkos, Plateau State, Nigeria
| | - Temitope Ojo
- Institute of Public Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Cornelius Ohonsi
- Nigeria Centre for Disease Control & Prevention, Abuja Nigeria
- Nigeria COVID-19 Research Coalition, Abuja, Nigeria
| | - Abdullahi Abubakar
- International Research Centre of Excellence, Institute of Human Virology, Abuja, Nigeria
| | - Elizabeth Odeh
- Federal University Teaching Hospital, Abakiliki, Ebonyi State, Nigeria
| | - Paul Akinduti
- Department of Microbiology, Covenant University, Ota, Ogun State, Nigeria
| | - Onikepe Folarin
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemers University, Ede, Nigeria
| | | | - Ehimario Igumbor
- Nigeria COVID-19 Research Coalition, Abuja, Nigeria
- Centre for Infectious Disease Research, Nigerian Institute of Medical Research, Lagos, Nigeria
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
- Department of Public Health, Walter Sisulu University, Mthatha, South Africa
| | - Kelly Elimian
- Department of Microbiology, Faculty of Life Sciences, University of Benin, Benin City, Edo State, Nigeria
| | | | - Luka Pam D.
- National Veterinary Research Institute (NVRI), Vom, Plateau State, Nigeria
| | - Tunde Olusola
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Loretta Ntoimo
- Centre of Excellence in Reproductive Health Innovation (CERHI), University of Benin, Benin City, Nigeria
- Department of Demography and Social Statistics, Federal University, Oye-Ekiti, Ekiti State, Nigeria
| | | | | | - Ibrahim Kida
- University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
| | - Shwe David
- West African Center for Emerging Infectious Diseases (WAC-EID), Jos University Teaching Hospital, Jos, Nigeria
| | | | - Isaac Igbarumah
- Molecular Virology Laboratory, University of Benin Teaching Hospital, Benin City, Nigeria
| | - Omosivie Maduka
- University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | | | | | - David O. Olaleye
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Omale Simon
- University of Jos, Jos, Plateau State, Nigeria
| | - Iriagbonse Iyabo Osaigbovo
- Department of Medical Microbiology, School of Medicine, College of Medical Sciences, University of Benin, Benin City, Nigeria
| | - Darlington Ewaen Obaseki
- Office of the Chief Medical Director, University of Benin Teaching Hospital, Benin City, Nigeria
| | | | - Christian Happi
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemers University, Ede, Nigeria
| | - Yusuf Bara Jibrin
- Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH), Bauchi, Nigeria
| | - Friday Okonofua
- Centre of Excellence in Reproductive Health Innovation (CERHI), University of Benin, Benin City, Nigeria
- Department of Obstetrics and Gynaecology, University of Benin, Benin City, Nigeria
| | - Timan Eliya
- Zankli Research Centre, Bingham University, Karu, Nigeria
| | | | - Izang, Joy Abi
- West African Center for Emerging Infectious Diseases (WAC-EID), Jos University Teaching Hospital, Jos, Nigeria
| | - Emmanuel Ameh
- West African Center for Emerging Infectious Diseases (WAC-EID), Jos University Teaching Hospital, Jos, Nigeria
| | | | - Sulaiman Alhaji
- Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH), Bauchi, Nigeria
| | - Ifedayo Adetifa
- Nigeria Centre for Disease Control & Prevention, Abuja Nigeria
- Nigeria COVID-19 Research Coalition, Abuja, Nigeria
| | - Babatunde Salako
- Nigeria COVID-19 Research Coalition, Abuja, Nigeria
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Suleiman Bogoro
- Nigeria COVID-19 Research Coalition, Abuja, Nigeria
- Tertiary Education Trust Fund, Abuja, Nigeria
| | - Chikwe Ihekweazu
- Nigeria COVID-19 Research Coalition, Abuja, Nigeria
- World Health Organization Hub for Pandemic and Epidemic Intelligence, Berlin, Germany
| | - Georgina N. Odaibo
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Kiani P, Hendriksen PA, Kim AJ, Garssen J, Verster JC. Comparative Analysis of the Clinical Presentation of Individuals Who Test Positive or Negative for SARS-CoV-2: Results from a Test Street Study. Viruses 2024; 16:1031. [PMID: 39066194 PMCID: PMC11281701 DOI: 10.3390/v16071031] [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: 05/03/2024] [Revised: 06/17/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024] Open
Abstract
The common cold, the flu, and the 2019 coronavirus disease (COVID-19) have many symptoms in common. As such, without testing for severe-acute-respiratory-syndrome-related coronavirus 2 (SARS-CoV-2), it is difficult to conclude whether or not one is infected with SARS-CoV-2. The aim of the current study was to compare the presence and severity of COVID-19-related symptoms among those who tested positive or negative for the beta variant of SARS-CoV-2 (B.1.351) and identify the clinical presentation with the greatest likelihood of testing positive for SARS-CoV-2. n = 925 individuals that were tested for SARS-CoV-2 at Dutch mass testing sites (i.e., test streets) were invited to complete a short online survey. The presence and severity of 17 COVID-19-related symptoms were assessed. In addition, mood, health correlates, and quality of life were assessed for the week before the test. Of the sample, n = 88 tested positive and n = 837 tested negative for SARS-CoV-2. Individuals who tested positive for SARS-CoV-2 reported experiencing a significantly greater number, as well as greater overall symptom severity, compared to individuals who tested negative for SARS-CoV-2. A binary logistic regression analysis revealed that increased severity levels of congestion, coughing, shivering, or loss of smell were associated with an increase in the odds of testing positive for SARS-CoV-2, whereas an increase in the severity levels of runny nose, sore throat, or fatigue were associated with an increase in the odds of testing negative for SARS-CoV-2. No significant differences in mood or health correlates were found between those who tested positive or negative for SARS-CoV-2, except for a significantly higher stress score among those who tested negative for SARS-CoV-2. In conclusion, individuals that tested positive for SARS-CoV-2 experienced a significantly greater number and more severe COVID-19-related symptoms compared to those who tested negative for SARS-CoV-2. Experiencing shivering and loss of smell may be the best indicators for increased likelihood of testing positive for SARS-CoV-2.
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Affiliation(s)
- Pantea Kiani
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (P.A.H.); (J.G.)
| | - Pauline A. Hendriksen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (P.A.H.); (J.G.)
| | - Andy J. Kim
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Str., Halifax, NS B3H 4R2, Canada;
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (P.A.H.); (J.G.)
- Danone, Global Research & Innovation Center, 3584CT Utrecht, The Netherlands
| | - Joris C. Verster
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (P.A.H.); (J.G.)
- Centre for Mental Health and Brain Sciences, Swinburne University, Melbourne, VIC 3122, Australia
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8
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Phamonpon W, Hinestroza JP, Puthongkham P, Rodthongkum N. Surface-engineered natural fibers: Emerging alternative substrates for chemical sensor applications: A review. Int J Biol Macromol 2024; 269:132185. [PMID: 38723830 DOI: 10.1016/j.ijbiomac.2024.132185] [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: 02/25/2024] [Revised: 04/26/2024] [Accepted: 05/06/2024] [Indexed: 05/14/2024]
Abstract
Natural fiber has become one of the most widely used alternative materials for chemical sensor fabrication due to its advantages, such as biocompatibility, flexibility, and self-microfluidic properties. Enhanced natural fiber surface has been used as a substrate in colorimetric and electrochemical sensors. This review focuses on improving the natural fiber properties for preparation as a substrate for chemical sensors. Various methods for natural fiber extraction are discussed and compared. Bleaching and decolorization is important for preparation of colorimetric sensors, while carbonization and nanoparticle doping are favorable for increasing their electrical conductivity for electrochemical sensor fabrication. Also, example fabrications and applications of natural fiber-based chemical sensors for chemical and biomarker detection are discussed. The selectivity of the sensors can be introduced and improved by surface modification of natural fiber, such as enzyme immobilization and biorecognition element functionalization, illustrating the adaptability of natural fiber as a smart sensing device, e.g., wearable and portable sensors. Ultimately, the high performances of natural fiber-based chemical sensors indicate the potential uses of natural fiber as a renewable and eco-friendly substrate material in the field of chemical sensors and biosensors for clinical diagnosis and environmental monitoring.
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Affiliation(s)
- Wisarttra Phamonpon
- Nanoscience and Technology Program, Graduate School, Chulalongkorn University, Phayathai Road, Pathumwan, Bangkok 10330, Thailand
| | - Juan P Hinestroza
- Department of Fiber Science, College of Human Ecology, Cornell University, Ithaca, NY 14850, United States
| | - Pumidech Puthongkham
- Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand; Center of Excellence in Responsive Wearable Materials, Chulalongkorn University, Soi Chula 12, Phayathai Road, Pathumwan, Bangkok 10330, Thailand.
| | - Nadnudda Rodthongkum
- Metallurgy and Materials Science Research Institute, Chulalongkorn University, Soi Chula 12, Phayathai Road, Pathumwan, Bangkok 10330, Thailand; Center of Excellence in Responsive Wearable Materials, Chulalongkorn University, Soi Chula 12, Phayathai Road, Pathumwan, Bangkok 10330, Thailand.
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9
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Manten K, Katzenschlager S, Brümmer LE, Schmitz S, Gaeddert M, Erdmann C, Grilli M, Pollock NR, Macé A, Erkosar B, Carmona S, Ongarello S, Johnson CC, Sacks JA, Faehling V, Bornemann L, Weigand MA, Denkinger CM, Yerlikaya S. Clinical accuracy of instrument-based SARS-CoV-2 antigen diagnostic tests: a systematic review and meta-analysis. Virol J 2024; 21:99. [PMID: 38685117 PMCID: PMC11059670 DOI: 10.1186/s12985-024-02371-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, antigen diagnostic tests were frequently used for screening, triage, and diagnosis. Novel instrument-based antigen tests (iAg tests) hold the promise of outperforming their instrument-free, visually-read counterparts. Here, we provide a systematic review and meta-analysis of the SARS-CoV-2 iAg tests' clinical accuracy. METHODS We systematically searched MEDLINE (via PubMed), Web of Science, medRxiv, and bioRxiv for articles published before November 7th, 2022, evaluating the accuracy of iAg tests for SARS-CoV-2 detection. We performed a random effects meta-analysis to estimate sensitivity and specificity and used the QUADAS-2 tool to assess study quality and risk of bias. Sub-group analysis was conducted based on Ct value range, IFU-conformity, age, symptom presence and duration, and the variant of concern. RESULTS We screened the titles and abstracts of 20,431 articles and included 114 publications that fulfilled the inclusion criteria. Additionally, we incorporated three articles sourced from the FIND website, totaling 117 studies encompassing 95,181 individuals, which evaluated the clinical accuracy of 24 commercial COVID-19 iAg tests. The studies varied in risk of bias but showed high applicability. Of 24 iAg tests from 99 studies assessed in the meta-analysis, the pooled sensitivity and specificity compared to molecular testing of a paired NP swab sample were 76.7% (95% CI 73.5 to 79.7) and 98.4% (95% CI 98.0 to 98.7), respectively. Higher sensitivity was noted in individuals with high viral load (99.6% [95% CI 96.8 to 100] at Ct-level ≤ 20) and within the first week of symptom onset (84.6% [95% CI 78.2 to 89.3]), but did not differ between tests conducted as per manufacturer's instructions and those conducted differently, or between point-of-care and lab-based testing. CONCLUSION Overall, iAg tests have a high pooled specificity but a moderate pooled sensitivity, according to our analysis. The pooled sensitivity increases with lower Ct-values (a proxy for viral load), or within the first week of symptom onset, enabling reliable identification of most COVID-19 cases and highlighting the importance of context in test selection. The study underscores the need for careful evaluation considering performance variations and operational features of iAg tests.
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Affiliation(s)
- Katharina Manten
- Department of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Stephan Katzenschlager
- Department of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - Lukas E Brümmer
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Stephani Schmitz
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
- Department of Developmental Biology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Mary Gaeddert
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Maurizio Grilli
- Library, University Medical Center Mannheim, Mannheim, Germany
| | - Nira R Pollock
- Department of Laboratory Medicine, Boston Children's Hospital, Boston, MA, USA
| | | | | | | | | | - Cheryl C Johnson
- Global HIV, Hepatitis and STIs Programmes, World Health Organization, Geneva, Switzerland
| | - Jilian A Sacks
- Department of Epidemic and Pandemic Preparedness and Prevention, World Health Organization, Geneva, Switzerland
| | - Verena Faehling
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Linus Bornemann
- Institute of Virology, Faculty of Medicine, University Medical Centre, University of Freiburg, Freiburg, Germany
| | - Markus A Weigand
- Department of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - Claudia M Denkinger
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
- German Center for Infection Research (DZIF), partner site Heidelberg University Hospital, Heidelberg, Germany
| | - Seda Yerlikaya
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany.
- German Center for Infection Research (DZIF), partner site Heidelberg University Hospital, Heidelberg, Germany.
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10
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Johnston A, Wong A, Appo C, Eley R, Staib A. Modelling a two-stream emergency department segregation and admission system from COVID-19 early rapid antigen testing: A pilot study. Emerg Med Australas 2024; 36:283-287. [PMID: 38030404 DOI: 10.1111/1742-6723.14351] [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: 06/14/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE Many factors influence patient flow through an ED, including streaming, treatment spaces and staff resources. This pilot study explored and compared real time patient flow using a single-stream system versus varying configurations of possible two-stream systems using computer simulation. METHODS Simulation modelling was used to assess the delay in treatment of a rapid-antigen-tested-based, two-stream model for patient flow through ED during the peak phase of the COVID pandemic. RESULTS Modelling two-stream configuration for all patients (minimum time to be seen for both COVID-positive and COVID-negative patients) showed that in the case study ED, a two-stream system and linked changes in bed configuration for managing the risks of infection can impact delays in treatment. CONCLUSIONS Data-driven modelling within specific clinical settings can inform the (in)efficiency of patient flow processes and help clinicians and managers make evidence-based decisions about patient transition through EDs. This can assist with reconfiguration of ED patient streaming particularly during periods of unique need, such as the recent COVID-19 pandemic.
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Affiliation(s)
- Amy Johnston
- Department of Emergency Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Andy Wong
- Department of Emergency Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Casey Appo
- Department of Emergency Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Robert Eley
- Department of Emergency Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Andrew Staib
- Department of Emergency Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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11
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Saleem MK, Sattar K, Ejaz KF, Rehman MU, Saleem H, Khursheed S, Akbar A, Ahmed J, Tariq M, Jadoon SK, Saleem Khan M, Tasneem S, Khandker SS, Kundu S, Alvi S. Use of telemedicine to tackle health problems in South Asia during the COVID-19 era and beyond: a systematic review. Ann Med Surg (Lond) 2024; 86:1012-1020. [PMID: 38333256 PMCID: PMC10849386 DOI: 10.1097/ms9.0000000000001649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/11/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction Telemedicine (TM) and teleconsultation services flourished during coronavirus disease 2019 (COVID-19) transmission to avoid COVID-19 infection and physical contact. Many physicians switched to the virtual treatment mode and nearly all types of health disciplines were covered. Through this systematic review, the authors tried to explore the strengths and weaknesses of TM, identify the barriers to adopting TM by population, and explain the limitations of this healthcare delivery model. Methods and results In this systematic review, 28 studies were included (>53% high-quality studies) as eligible, where nearly 75% (n=21) of the studies were from India, and the remaining 25% (n=7) were from Pakistan, Bangladesh, Sri Lanka, and Nepal. Advice related to cancer, autoimmune diseases, and neurological diseases were the most common among the health disciplines in which TM was used. A peak in teleconsultation was observed during the high transmission phase of COVID-19, although major queries were associated with existing health complications and comorbidities. Conclusion Other than a few concerns regarding connectivity, privacy, and diagnosis, TM was in fact affordable, timesaving, feasible, and accurate, which ensured a highly satisfying experience among the participants (>80%).
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Affiliation(s)
- Muhammad K. Saleem
- General Internal Medicine, Royal College of Physicians and Surgeons of Glasgow, Tipperary University Hospital, Ireland
| | - Komal Sattar
- Russell’s Hall Hospital Dudley, MRCP Royal College
| | | | | | | | | | - Amna Akbar
- Poonch Medical College, Rawalakot, Muzaffarabad
| | - Jahanzeb Ahmed
- Department of Gastrointestinal Surgery, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Maham Tariq
- Mohtarma Benazir Bhutto Shaheed Medical College Mirpur
| | | | | | - Sabahat Tasneem
- Public Health Professional (MSPH), Health Services Academy, Islamabad, Pakistan
| | | | - Shoumik Kundu
- Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Sarosh Alvi
- Teaching Faculty, University of Khartoum, Khartoum, Sudan
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12
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Wongchai T, Chuenchom N, Klayut W, Phetsuksiri B, Bhakdeenuan P, Bunchoo S, Srisungngam S, Rudeeaneksin J. Clinical Performance of the Reverse Transcription-Loop-Mediated Isothermal Amplification Assay for the Diagnosis of COVID-19 in a Thai Community Hospital at the Thailand-Myanmar Border. Cureus 2024; 16:e54447. [PMID: 38510857 PMCID: PMC10954319 DOI: 10.7759/cureus.54447] [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] [Accepted: 02/09/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) continues to be a global health threat and is a public health issue in Thailand and other countries. The extensive cross-border between Thailand and Myanmar is considered to be at a potentially high risk for COVID-19 distribution in this region. In this instance, simple and cost-effective tests for rapid and early detection of COVID-19 would be useful for effective patient management and control of the disease. METHODS This study was conducted at Mae Sot Hospital on the border of Thailand-Myanmar to evaluate the diagnostic performance of a simple colorimetric reverse transcription-loop-mediated isothermal amplification (RT-LAMP) assay developed recently for the rapid detection of SARS-CoV-2. Nasopharyngeal specimens were routinely collected and processed through automated nucleic acid extraction followed by real-time reverse transcription-polymerase chain reaction (rRT-PCR) using the Molaccu® COVID-19 Detection Kit. The RT-LAMP assay was further performed on remnant RNA samples, and the visual results were compared to those of rRT-PCR as a reference. RESULTS Of the 727 samples tested, the RT-LAMP assay could detect 322 out of 374 samples positive for SARS-CoV-2 by rRT-PCR with 100% (n = 353/353) negative agreement. The comparative analysis demonstrated the overall accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the RT-LAMP at 92.85% (n = 675/727, 95% CI: 90.73-94.61), 86.10% (n = 322/374, 95% CI: 82.17-89.44), 100% (n = 353/353, 95% CI: 98.96-100), 100% (n = 322/322, 95% CI: 98.86-100), and 87.16% (n = 353/405, 95% CI: 84.06-89.73), respectively. CONCLUSION This RT-LAMP assay showed good diagnostic performance in the hospital setting. It can increase laboratory capacity for rapid SARS-CoV-2 testing and has the potential for use as an alternative or a backup assay at the point of need, especially where alternatives are unavailable for any reason, such as a decline in COVID-19 cases.
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Affiliation(s)
- Thanee Wongchai
- Infectious Diseases, Mae Sot Hospital, Ministry of Public Health, Tak, THA
| | | | - Wiphat Klayut
- Infectious Diseases, National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, THA
| | - Benjawan Phetsuksiri
- Infectious Diseases, National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, THA
| | - Payu Bhakdeenuan
- Infectious Diseases, National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, THA
| | - Supranee Bunchoo
- Infectious Diseases, National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, THA
| | - Sopa Srisungngam
- Infectious Diseases, National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, THA
| | - Janisara Rudeeaneksin
- Infectious Diseases, National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, THA
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13
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Jiang KP, Bennett S, Heiniger EK, Kumar S, Yager P. UbiNAAT: a multiplexed point-of-care nucleic acid diagnostic platform for rapid at-home pathogen detection. LAB ON A CHIP 2024; 24:492-504. [PMID: 38164805 DOI: 10.1039/d3lc00753g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
The COVID-19 pandemic increased demands for respiratory disease testing to facilitate treatment and limit transmission, demonstrating in the process that most existing test options were too complex and expensive to perform in point-of-care or home scenarios. Lab-based molecular techniques can detect viral RNA in respiratory illnesses but are expensive and require trained personnel, while affordable antigen-based home tests lack sensitivity for early detection in newly infected or asymptomatic individuals. The few home RNA detection tests deployed were prohibitively expensive. Here, we demonstrate a point-of-care, paper-based rapid analysis device that simultaneously detects multiple viral RNAs; it is demonstrated on two common respiratory viruses (COVID-19 and influenza A) spiked onto a commercial nasal swab. The automated device requires no sample preparation by the user after insertion of the swab, minimizing user operation steps. We incorporated lyophilized amplification reagents immobilized in a porous matrix, a novel thermally actuated valve for multiplexed fluidic control, a printed circuit board that performs on-device lysis and amplification within a cell-phone-sized disposable device. Reverse transcription loop-mediated isothermal amplification (RT-LAMP) products are visualized via fluorescent dyes using a modified cell phone, resulting in detection of as few as 104 viral copies per swab across both pathogens within 30 minutes. This integrated platform could be commercialized in a form that would be inexpensive, portable, and sensitive; it can readily be multiplexed to detect as many as 8 different RNA or DNA sequences, and adapted to any desired RNA or DNA detection assays.
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Affiliation(s)
- Kevin P Jiang
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA.
| | - Steven Bennett
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA.
| | - Erin K Heiniger
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA.
| | - Sujatha Kumar
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA.
| | - Paul Yager
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA.
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14
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Kim SW, Park Y, Kim D, Jeong SH. A single-center experience on long-term clinical performance of a rapid SARS-CoV-2 Antigen Detection Test, STANDARD Q COVID-19 Ag Test. Sci Rep 2023; 13:20777. [PMID: 38012319 PMCID: PMC10681986 DOI: 10.1038/s41598-023-48194-2] [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: 04/03/2023] [Accepted: 11/23/2023] [Indexed: 11/29/2023] Open
Abstract
The COVID-19 pandemic in Korea has dynamically changed with the occurrence of more easily transmissible variants. A rapid and reliable diagnostic tool for detection of SARS-CoV-2 is needed. While RT-PCR is currently the gold standard for detecting SARS-CoV-2, the procedure is time-consuming and requires expert technicians. The rapid antigen detection test (RADT) was approved as a confirmatory test on 14 March 2022 due to rapid dissemination of the Omicron variant. The benefits of the RADT are speed, simplicity, and point-of-care feasibility. The aim of our study was to evaluate the clinical performance of RADT compared to RT-PCR in a single center over 15 months, fully covering the SARS-CoV-2 'Variants of Concern (VOC).' A total of 14,194 cases was simultaneously tested by RT-PCR and RADT from January 2021 to March 2022 in Gangnam Severance Hospital and were retrospectively reviewed. PowerChek SARS-CoV-2, Influenza A&B Multiplex Real-time PCR Kit, and STANDARD Q COVID-19 Ag Test were used. Positive rates, sensitivities, specificities, positive predictive values (PPV), and negative predictive values (NPV) were estimated for five periods (3 months/period). Receiver operator characteristic curve (ROC) analysis was performed, and Spearman's rank test assessed the correlation between RT-PCR Ct values and semi-quantitative RADT results. The overall positive rate of RT-PCR was 4.64%. The overall sensitivity and specificity were 0.577 [95% confidence interval (CI) 0.539-0.614] and 0.991 [95% CI 0.989-0.993], respectively. ROC analysis resulted in an area under the curve of 0.786 (P < 0.0001, Yuden's index = 0.568). The PCR positive rates were estimated as 0.11%, 0.71%, 4.51%, 2.02%, and 13.72%, and PPV was estimated as 0.045, 0.421, 0.951, 0.720, and 0.798 in Periods 1, 2, 3, 4, and 5, respectively. A significant and moderate negative correlation between PCR Ct values and semi-quantitative RADT results was observed (Spearman's ρ = - 0.646, P < 0.0001). The RADT exhibited good performance in specimens with low Ct values (Ct ≤ 25.00) by RT-PCR. The PPV was significantly higher in Periods 3 and 5, which corresponds to rapid dissemination of the Delta and Omicron variants. The high PPV implies that individuals with a positive RADT result are very likely infected with SARS-CoV-2 and would require prompt quarantine rather than additional RT-PCR testing. The sensitivity of 0.577 indicates that RADT should not replace RT-PCR. Nonetheless, given the high PPV and the ability to track infected persons through rapid results, our findings suggest that RADT could play a significant role in control strategies for further SARS-CoV-2 variants.
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Affiliation(s)
- Seo Wan Kim
- Department of Laboratory Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, South Korea
| | - Yongjung Park
- Department of Laboratory Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, South Korea
| | - Dokyun Kim
- Department of Laboratory Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, South Korea.
- Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea.
| | - Seok Hoon Jeong
- Department of Laboratory Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, South Korea
- Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea
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15
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Krenn F, Dächert C, Badell I, Lupoli G, Öztan GN, Feng T, Schneider N, Huber M, Both H, Späth PM, Muenchhoff M, Graf A, Krebs S, Blum H, Durner J, Czibere L, Kaderali L, Keppler OT, Baldauf HM, Osterman A. Ten rapid antigen tests for SARS-CoV-2 widely differ in their ability to detect Omicron-BA.4 and -BA.5. Med Microbiol Immunol 2023; 212:323-337. [PMID: 37561225 PMCID: PMC10501931 DOI: 10.1007/s00430-023-00775-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/11/2023] [Indexed: 08/11/2023]
Abstract
Since late 2021, the variant landscape of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been dominated by the variant of concern (VoC) Omicron and its sublineages. We and others have shown that the detection of Omicron-BA.1 and -BA.2-positive respiratory specimens by rapid antigen tests (RATs) is impaired compared to Delta VoC-containing samples. Here, in a single-center retrospective laboratory study, we evaluated the performance of ten most commonly used RATs for the detection of Omicron-BA.4 and -BA.5 infections. We used 171 respiratory swab specimens from SARS-CoV-2 RNA-positive patients, of which 71 were classified as BA.4 and 100 as BA.5. All swabs were collected between July and September 2022. 50 SARS-CoV-2 PCR-negative samples from healthy individuals, collected in October 2022, showed high specificity in 9 out of 10 RATs. When assessing analytical sensitivity using clinical specimens, the 50% limit of detection (LoD50) ranged from 7.6 × 104 to 3.3 × 106 RNA copies subjected to the RATs for BA.4 compared to 6.8 × 104 to 3.0 × 106 for BA.5. Overall, intra-assay differences for the detection of these two Omicron subvariants were not significant for both respiratory swabs and tissue culture-expanded virus isolates. In contrast, marked heterogeneity was observed among the ten RATs: to be positive in these point-of-care tests, up to 443-fold (BA.4) and up to 56-fold (BA.5) higher viral loads were required for the worst performing RAT compared to the best performing RAT. True-positive rates for Omicron-BA.4- or -BA.5-containing specimens in the highest viral load category (Ct values < 25) ranged from 94.3 to 34.3%, dropping to 25.6 to 0% for samples with intermediate Ct values (25-30). We conclude that the high heterogeneity in the performance of commonly used RATs remains a challenge for the general public to obtain reliable results in the evolving Omicron subvariant-driven pandemic.
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Affiliation(s)
- Franziska Krenn
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Christopher Dächert
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
- German Center for Infection Research (DZIF), Partner Site, Munich, Germany
| | - Irina Badell
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Gaia Lupoli
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Gamze Naz Öztan
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Tianle Feng
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Nikolas Schneider
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Melanie Huber
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Hanna Both
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Patricia M. Späth
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Maximilian Muenchhoff
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
- German Center for Infection Research (DZIF), Partner Site, Munich, Germany
- COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, LMU München, Munich, Germany
| | - Alexander Graf
- Laboratory for Functional Genome Analysis, Gene Center, LMU München, Munich, Germany
| | - Stefan Krebs
- Laboratory for Functional Genome Analysis, Gene Center, LMU München, Munich, Germany
| | - Helmut Blum
- Laboratory for Functional Genome Analysis, Gene Center, LMU München, Munich, Germany
| | | | | | - Lars Kaderali
- Institute of Bioinformatics, University Medicine Greifswald, Greifswald, Germany
| | - Oliver T. Keppler
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
- German Center for Infection Research (DZIF), Partner Site, Munich, Germany
- COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, LMU München, Munich, Germany
| | - Hanna-Mari Baldauf
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
| | - Andreas Osterman
- Max von Pettenkofer Institute & Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Munich, Germany
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16
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Hongjaisee S, Kham-Kjing N, Musikul P, Daengkaokhew W, Kongson N, Guntala R, Jaiyapan N, Kline E, Panpradist N, Ngo-Giang-Huong N, Khamduang W. A Single-Tube Colorimetric Loop-Mediated Isothermal Amplification for Rapid Detection of SARS-CoV-2 RNA. Diagnostics (Basel) 2023; 13:3040. [PMID: 37835783 PMCID: PMC10572433 DOI: 10.3390/diagnostics13193040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/21/2023] [Accepted: 09/23/2023] [Indexed: 10/15/2023] Open
Abstract
Since SARS-CoV-2 is a highly transmissible virus, a rapid and accurate diagnostic method is necessary to prevent virus spread. We aimed to develop and evaluate a new rapid colorimetric reverse transcription loop--mediated isothermal amplification (RT-LAMP) assay for SARS-CoV-2 detection in a single closed tube. Nasopharyngeal and throat swabs collected from at-risk individuals testing for SARS-CoV-2 were used to assess the sensitivity and specificity of a new RT-LAMP assay against a commercial qRT-PCR assay. Total RNA extracts were submitted to the RT-LAMP reaction under optimal conditions and amplified at 65 °C for 30 min using three sets of specific primers targeting the nucleocapsid gene. The reaction was detected using two different indicator dyes, hydroxynaphthol blue (HNB) and cresol red. A total of 82 samples were used for detection with HNB and 94 samples with cresol red, and results were compared with the qRT-PCR assay. The sensitivity of the RT-LAMP-based HNB assay was 92.1% and the specificity was 93.2%. The sensitivity of the RT-LAMP-based cresol red assay was 80.3%, and the specificity was 97%. This colorimetric feature makes this assay highly accessible, low-cost, and user-friendly, which can be deployed for massive scale-up and rapid diagnosis of SARS-CoV-2 infection, particularly in low-resource settings.
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Affiliation(s)
- Sayamon Hongjaisee
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand;
- LUCENT International Collaboration, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (N.K.-K.); (N.P.); (N.N.-G.-H.)
| | - Nang Kham-Kjing
- LUCENT International Collaboration, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (N.K.-K.); (N.P.); (N.N.-G.-H.)
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (P.M.); (W.D.); (N.K.); (N.J.)
| | - Piyagorn Musikul
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (P.M.); (W.D.); (N.K.); (N.J.)
| | - Wannaporn Daengkaokhew
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (P.M.); (W.D.); (N.K.); (N.J.)
| | - Nuntita Kongson
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (P.M.); (W.D.); (N.K.); (N.J.)
| | | | - Nitipoom Jaiyapan
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (P.M.); (W.D.); (N.K.); (N.J.)
| | - Enos Kline
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA;
| | - Nuttada Panpradist
- LUCENT International Collaboration, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (N.K.-K.); (N.P.); (N.N.-G.-H.)
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA;
- Department of Global Health, University of Washington, Seattle, WA 98195, USA
| | - Nicole Ngo-Giang-Huong
- LUCENT International Collaboration, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (N.K.-K.); (N.P.); (N.N.-G.-H.)
- Maladies Infectieuses et Vecteurs: Écologie, Génétique, Évolution et Contrôle (MIVEGEC), Agropolis University Montpellier, Centre National de la Recherche Scientifique (CNRS), Institut de Recherche Pour le Développement (IRD), 34394 Montpellier, France
- International Joint Laboratory PRESTO, Chiang Mai 50200, Thailand
| | - Woottichai Khamduang
- LUCENT International Collaboration, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (N.K.-K.); (N.P.); (N.N.-G.-H.)
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (P.M.); (W.D.); (N.K.); (N.J.)
- International Joint Laboratory PRESTO, Chiang Mai 50200, Thailand
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17
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Meller S, Caraguel C, Twele F, Charalambous M, Schoneberg C, Chaber AL, Desquilbet L, Grandjean D, Mardones FO, Kreienbrock L, de la Rocque S, Volk HA. Canine olfactory detection of SARS-CoV-2-infected humans-a systematic review. Ann Epidemiol 2023; 85:68-85. [PMID: 37209927 PMCID: PMC10195768 DOI: 10.1016/j.annepidem.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 03/06/2023] [Accepted: 05/02/2023] [Indexed: 05/22/2023]
Abstract
PURPOSE To complement conventional testing methods for severe acute respiratory syndrome coronavirus type 2 infections, dogs' olfactory capability for true real-time detection has been investigated worldwide. Diseases produce specific scents in affected individuals via volatile organic compounds. This systematic review evaluates the current evidence for canine olfaction as a reliable coronavirus disease 2019 screening tool. METHODS Two independent study quality assessment tools were used: the QUADAS-2 tool for the evaluation of laboratory tests' diagnostic accuracy, designed for systematic reviews, and a general evaluation tool for canine detection studies, adapted to medical detection. Various study design, sample, dog, and olfactory training features were considered as potential confounding factors. RESULTS Twenty-seven studies from 15 countries were evaluated. Respectively, four and six studies had a low risk of bias and high quality: the four QUADAS-2 nonbiased studies resulted in ranges of 81%-97% sensitivity and 91%-100% specificity. The six high-quality studies, according to the general evaluation system, revealed ranges of 82%-97% sensitivity and 83%-100% specificity. The other studies contained high bias risks and applicability and/or quality concerns. CONCLUSIONS Standardization and certification procedures as used for canine explosives detection are needed for medical detection dogs for the optimal and structured usage of their undoubtful potential.
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Affiliation(s)
- Sebastian Meller
- Department of Small Animal Medicine & Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.
| | - Charles Caraguel
- School of Animal and Veterinary Sciences, The University of Adelaide, Adelaide, South Australia, Australia; OIE Diagnostic Test Validation Science in the Asia-Pacific Region, The University of Melbourne, Melbourne, Victoria, Australia
| | - Friederike Twele
- Department of Small Animal Medicine & Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Marios Charalambous
- Department of Small Animal Medicine & Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Clara Schoneberg
- Department of Biometry, Epidemiology and Information Processing, WHO Collaborating Centre for Research and Training for Health in the Human-Animal-Environment Interface, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Anne-Lise Chaber
- School of Animal and Veterinary Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Loïc Desquilbet
- École Nationale Vétérinaire d'Alfort, IMRB, Université Paris-Est, Maisons-Alfort, France
| | - Dominique Grandjean
- École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Fernando O Mardones
- Escuela de Medicina Veterinaria, Facultad de Agronomía e Ingeniería Forestal, Facultad de Ciencias Biológicas y Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | - Lothar Kreienbrock
- Department of Biometry, Epidemiology and Information Processing, WHO Collaborating Centre for Research and Training for Health in the Human-Animal-Environment Interface, University of Veterinary Medicine Hannover, Hannover, Germany
| | | | - Holger A Volk
- Department of Small Animal Medicine & Surgery, University of Veterinary Medicine Hannover, Hannover, Germany; Center for Systems Neuroscience, Hannover, Germany
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18
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Hoffmann EDR, Balzan LDR, Inamine E, Pancotto LR, Gaboardi G, Cantarelli VV. Performance of Reverse Transcription Loop-Mediated Isothermal Amplification (RT-LAMP) Targeting the RNA Polymerase Gene for the Direct Detection of SARS-CoV2 in Nasopharyngeal Swabs. Int J Mol Sci 2023; 24:13056. [PMID: 37685863 PMCID: PMC10487735 DOI: 10.3390/ijms241713056] [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: 06/11/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 09/10/2023] Open
Abstract
In 2020, a global pandemic caused by SARS-CoV-2 was declared. Different institutes proposed diagnostic molecular methods to detect the virus in clinical samples. This study aims to validate and standardize the use of a loop-mediated isothermal amplification (LAMP)-based methodology targeting the viral RP gene, as a faster and low-cost diagnostic method for SARS-CoV-2 infections. The results obtained with RT-LAMP (Reverse Transcriptase) were compared to the results of real-time polymerase chain reaction (RT-PCR) to assess its sensitivity and specificity. In total, 115 samples (nasopharyngeal samples) were used for detecting SARS-CoV-2 by RT-LAMP, with 43 positives and 72 negatives. The study showed a positive predictive value (PPV) of 90.7% and a negative predictive value (VPN) of 100%. The LAMP assay also demonstrated a high sensitivity of 90.7% and a specificity of 100% (confidence interval 77.9-97.4%) when using the lower detection limit of 40 copies/µL. The RT-LAMP described here has the potential to detect even the new variants of SARS-CoV-2, suggesting that it may not be significantly affected by gene mutations. The RT-LAMP targeting the RP viral region is faster and less expensive than other molecular approaches, making it an alternative for developing countries.
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Affiliation(s)
- Elias da Rosa Hoffmann
- Basic Health Sciences Department, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre 90050-170, Brazil;
- Bom Pastor Laboratory, Molecular Biology Department, Igrejinha 95650-000, Brazil
| | | | - Everton Inamine
- Central Laboratory, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 90020-090, Brazil; (E.I.)
| | - Lisiane Rech Pancotto
- Central Laboratory, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 90020-090, Brazil; (E.I.)
| | - Guilherme Gaboardi
- Biomedical Sciences Department, Serra Gaúcha University Center (FSG), Caxias do Sul 95020-472, Brazil
| | - Vlademir Vicente Cantarelli
- Basic Health Sciences Department, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre 90050-170, Brazil;
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19
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Yang YP, Jiesisibieke ZL, Tung TH. Association Between Rapid Antigen Detection Tests and Real-Time Reverse Transcription-Polymerase Chain Reaction Assay for SARS-CoV-2: A Systematic Review and Meta-Analyses. Int J Public Health 2023; 68:1605452. [PMID: 37588042 PMCID: PMC10425602 DOI: 10.3389/ijph.2023.1605452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 07/11/2023] [Indexed: 08/18/2023] Open
Abstract
Objectives: We aimed to assess the association between rapid antigen detection tests and real-time reverse transcription-polymerase chain reaction assay for severe acute respiratory syndrome coronavirus 2. Methods: We searched PubMed, Cochrane Library, EMBASE, and the Web of Science from their inception to 31 May 2023. A random-effects meta-analysis was used to estimate false positives in the RADTs group, relative to those in the RT-PCR group, and subgroup analyses were conducted based on the different Ct value cut-offs (<40 or ≥40). We performed this study in accordance with the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: Fifty-one studies were included and considered to be of moderate quality. We found a satisfactory overall false positive rate (0.01, 95% CI: 0.00-0.01) for the RADTs compared to RT-PCR. In the stratified analysis, we also found that the false positive rates of the RADTs did not increase when Ct values of RT-PCR (Ct < 40, 0.01, 95% CI: 0.00-0.01; Ct ≥ 40, 0.01, 95% CI: 0.00-0.01). Conclusion: In conclusion, the best available evidence supports an association between RADTs and RT-PCR. When Ct-values were analyzed using cut-off <40 or ≥40, this resulted in an estimated false positive rate of only 1%.
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Affiliation(s)
- Yu-Pei Yang
- Department of Hematology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Zhu Liduzi Jiesisibieke
- School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Pokfulam, Hong Kong, Hong Kong SAR, China
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
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20
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Cristina Diaconu C, Madalina Pitica I, Chivu-Economescu M, Georgiana Necula L, Botezatu A, Virginia Iancu I, Iulia Neagu A, L. Radu E, Matei L, Maria Ruta S, Bleotu C. SARS-CoV-2 Variant Surveillance in Genomic Medicine Era. Infect Dis (Lond) 2023. [DOI: 10.5772/intechopen.107137] [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] [Indexed: 07/26/2024] Open
Abstract
In the genomic medicine era, the emergence of SARS-CoV-2 was immediately followed by viral genome sequencing and world-wide sequences sharing. Almost in real-time, based on these sequences, resources were developed and applied around the world, such as molecular diagnostic tests, informed public health decisions, and vaccines. Molecular SARS-CoV-2 variant surveillance was a normal approach in this context yet, considering that the viral genome modification occurs commonly in viral replication process, the challenge is to identify the modifications that significantly affect virulence, transmissibility, reduced effectiveness of vaccines and therapeutics or failure of diagnostic tests. However, assessing the importance of the emergence of new mutations and linking them to epidemiological trend, is still a laborious process and faster phenotypic evaluation approaches, in conjunction with genomic data, are required in order to release timely and efficient control measures.
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21
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Veroniki AA, Tricco AC, Watt J, Tsokani S, Khan PA, Soobiah C, Negm A, Doherty-Kirby A, Taylor P, Lunny C, McGowan J, Little J, Mallon P, Moher D, Wong S, Dinnes J, Takwoingi Y, Saxinger L, Chan A, Isaranuwatchai W, Lander B, Meyers A, Poliquin G, Straus SE. Rapid antigen-based and rapid molecular tests for the detection of SARS-CoV-2: a rapid review with network meta-analysis of diagnostic test accuracy studies. BMC Med 2023; 21:110. [PMID: 36978074 PMCID: PMC10049780 DOI: 10.1186/s12916-023-02810-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 02/27/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The global spread of COVID-19 created an explosion in rapid tests with results in < 1 hour, but their relative performance characteristics are not fully understood yet. Our aim was to determine the most sensitive and specific rapid test for the diagnosis of SARS-CoV-2. METHODS Design: Rapid review and diagnostic test accuracy network meta-analysis (DTA-NMA). ELIGIBILITY CRITERIA Randomized controlled trials (RCTs) and observational studies assessing rapid antigen and/or rapid molecular test(s) to detect SARS-CoV-2 in participants of any age, suspected or not with SARS-CoV-2 infection. INFORMATION SOURCES Embase, MEDLINE, and Cochrane Central Register of Controlled Trials, up to September 12, 2021. OUTCOME MEASURES Sensitivity and specificity of rapid antigen and molecular tests suitable for detecting SARS-CoV-2. Data extraction and risk of bias assessment: Screening of literature search results was conducted by one reviewer; data abstraction was completed by one reviewer and independently verified by a second reviewer. Risk of bias was not assessed in the included studies. DATA SYNTHESIS Random-effects meta-analysis and DTA-NMA. RESULTS We included 93 studies (reported in 88 articles) relating to 36 rapid antigen tests in 104,961 participants and 23 rapid molecular tests in 10,449 participants. Overall, rapid antigen tests had a sensitivity of 0.75 (95% confidence interval 0.70-0.79) and specificity of 0.99 (0.98-0.99). Rapid antigen test sensitivity was higher when nasal or combined samples (e.g., combinations of nose, throat, mouth, or saliva samples) were used, but lower when nasopharyngeal samples were used, and in those classified as asymptomatic at the time of testing. Rapid molecular tests may result in fewer false negatives than rapid antigen tests (sensitivity: 0.93, 0.88-0.96; specificity: 0.98, 0.97-0.99). The tests with the highest sensitivity and specificity estimates were the Xpert Xpress rapid molecular test by Cepheid (sensitivity: 0.99, 0.83-1.00; specificity: 0.97, 0.69-1.00) among the 23 commercial rapid molecular tests and the COVID-VIRO test by AAZ-LMB (sensitivity: 0.93, 0.48-0.99; specificity: 0.98, 0.44-1.00) among the 36 rapid antigen tests we examined. CONCLUSIONS Rapid molecular tests were associated with both high sensitivity and specificity, while rapid antigen tests were mainly associated with high specificity, according to the minimum performance requirements by WHO and Health Canada. Our rapid review was limited to English, peer-reviewed published results of commercial tests, and study risk of bias was not assessed. A full systematic review is required. REVIEW REGISTRATION PROSPERO CRD42021289712.
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Affiliation(s)
- Areti Angeliki Veroniki
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8 Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON Canada
| | - Andrea C. Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8 Canada
- Epidemiology Division & Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
- Queen’s Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, Canada
| | - Jennifer Watt
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8 Canada
| | - Sofia Tsokani
- School of Education, University of Ioannina, Ioannina, Greece
| | - Paul A. Khan
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8 Canada
| | - Charlene Soobiah
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8 Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON Canada
| | - Ahmed Negm
- University of Alberta, Edmonton, AB Canada
| | - Amanda Doherty-Kirby
- Patient Partner, Strategy for Patient Oriented-Research Evidence Alliance (SPOR EA), Toronto, Canada
| | - Paul Taylor
- Patient Partner, Strategy for Patient Oriented-Research Evidence Alliance (SPOR EA), Toronto, Canada
| | - Carole Lunny
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8 Canada
| | - Jessie McGowan
- University of Ottawa/Université d’Ottawa, Ottawa, ON Canada
| | - Julian Little
- University of Ottawa/Université d’Ottawa, Ottawa, ON Canada
| | | | - David Moher
- Ottawa Hospital Research Institute/Institut de Recherche de L’Hôpital d’Ottawa, Ottawa, ON Canada
| | - Sabrina Wong
- University of British Columbia, Vancouver, BC Canada
| | | | | | | | | | | | - Bryn Lander
- Health Canada (Ottawa)/Santé Canada (Ottawa), Ottawa, ON Canada
| | - Adrienne Meyers
- Public Health Agency of Canada/Agence de La Santé Publique du Canada, Ottawa, ON Canada
| | - Guillaume Poliquin
- Public Health Agency of Canada/Agence de La Santé Publique du Canada, Ottawa, ON Canada
| | - Sharon E. Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8 Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON Canada
- Department of Geriatric Medicine, University of Toronto, Toronto, ON Canada
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22
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Farkas CB, Dudás G, Babinszky GC, Földi L. Analysis of the Virus SARS-CoV-2 as a Potential Bioweapon in Light of International Literature. Mil Med 2023; 188:531-540. [PMID: 35569934 PMCID: PMC9384074 DOI: 10.1093/milmed/usac123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/06/2022] [Accepted: 04/18/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION As of early 2022, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic still represents a worldwide medical emergency situation. The ongoing vaccination programs can slow down the spread of the virus; however, from time to time, the newly emerging variants of concern and antivaccination movements carry the possibility for the disease to remain in our daily lives. After the appearance of SARS-CoV-2, there was scholarly debate whether the virus was of natural origin, or it emerged from a laboratory, some even thinking the agent's potential biological weapon properties suggest the latter scenario. Later, the bioweapon theory was dismissed by the majority of experts, but the question remains that despite its natural origin, how potent a biological weapon the SARS-CoV-2 virus can become over time. MATERIALS AND METHODS Based on 12 bioweapon threat assessment criteria already published in 2018, we performed a literature search and review, focusing on relevant potential bioweapon properties of the virus SARS-CoV-2. Instead of utilizing a survey among experts, we tried to qualify and quantify characteristics according to the available data found in peer-reviewed papers. We also identified other key elements not mentioned in the original 12 bioweapon criteria, which can play an important role in assessing future biological weapons. RESULTS According to the international literature we analyzed, SARS-CoV-2 is a moderately infectious agent (ID50 estimated between 100 and 1,000), with high infection-to-disease ratio (35%-45% rate of asymptomatic infected) and medium incubation period (1-34 days, mean 6-7 days). Its morbidity and mortality rate can be categorized as medium (high morbidity rate with significant mortality rate). It can be easily produced in large quantities, has high aerosol stability, and has moderate environmental stability. Based on laboratory experiments and statistical model analysis, it can form and is contagious with droplet nuclei, and with spray technique utilization, it could be weaponized effectively. Several prophylactic countermeasures are available in the form of vaccines; however, specific therapeutic options are much more limited. In connection with the original assessment criteria, the SARS-CoV-2 only achieved a "0" score on the ease of detection because of readily available, relatively sensitive, and specific rapid antigen tests. Based on the pandemic experience, we also propose three new assessment categories: one that establishes a mean to measure the necessary quarantine restrictions related to a biological agent, another one that can represent the personal protective equipment required to work safely with a particular agent, and a third one that quantifies the overall disruptive capability, based on previous real-life experiences. These factors could further specify the threat level related to potential biological weapons. CONCLUSIONS Our results show that the virus can become a potent bioweapon candidate in the future, achieving a total score of 24 out of 36 on the original 12 criteria. The SARS-CoV-2 has already proven its pandemic generating potential and, despite worldwide efforts, still remains an imminent threat. In order to be prepared for the future possibility of the virus arising as a bioweapon, we must remain cautious and take the necessary countermeasures.
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Affiliation(s)
- Csaba Bence Farkas
- Department of Pathology, Medical Centre, Hungarian Defence Forces, Budapest 1134, Hungary
| | - Gábor Dudás
- Mobile Biological Laboratory, Medical Centre, Hungarian Defence Forces, Budapest 1134, Hungary
| | - Gergely Csaba Babinszky
- Mobile Biological Laboratory, Medical Centre, Hungarian Defence Forces, Budapest 1134, Hungary
| | - László Földi
- Department of Operations and Support, Faculty of Military Sciences and Officer Training, University of Public Service, Budapest 1101, Hungary
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23
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Alhabbab RY. Economical and Easily Obtainable Tools to Manually Develop Lateral Flow Immunoassay Strips. ACS OMEGA 2023; 8:9170-9178. [PMID: 36936315 PMCID: PMC10018695 DOI: 10.1021/acsomega.2c07014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
The development of inexpensive and highly functional lateral flow devices, which utilize simple and affordable tools, can make them accessible to many populations with insufficient resources. Therefore, this study aims to provide a method to overcome the cost challenges associated with using expensive manufacturing technologies and machinery, particularly during pandemics and upon urgent need. Here, in-house lateral flow strips to detect serum antibodies were developed using low-priced and easily available tools such as adhesive tape and CytoSep layers. The developed lateral flow immunoassay strips presented here produced signals with 93.3 and 96.6% sensitivity for SARS-CoV-2 nucleocapsid protein-specific IgM and IgG antibodies, respectively. The specificity obtained from the developed strips was 96.6% for SARS-CoV-2 nucleocapsid protein-specific IgM and 100% for the IgG antibodies by applying only 5 μL from the serum samples. The proposed design was entirely made manually to ensure a method that would make lateral flow devices available to many populations in need around the globe.
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Affiliation(s)
- Rowa Y. Alhabbab
- Vaccines
and Immunotherapy Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department
of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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24
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Mohammadie ZE, Akhlaghi S, Samaeinasab S, Shaterzadeh-Bojd S, Jamialahmadi T, Sahebkar A. Clinical performance of rapid antigen tests in comparison to RT-PCR for SARS-COV-2 diagnosis in Omicron variant: A systematic review and meta-analysis. Rev Med Virol 2023; 33:e2428. [PMID: 36790832 DOI: 10.1002/rmv.2428] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/21/2023] [Accepted: 01/29/2023] [Indexed: 02/16/2023]
Abstract
The Omicron variant of concern has a high level of mutations in different genes that has raised awareness about the performance of immunological products such as vaccines and antigen detection kits. In this systematic review and meta-analysis, we investigated whether Omicron had a significant influence on rapid antigen test (RAT) performance in comparison to PCR. We registered this systematic review and meta-analysis in PROSPERO with the registration number CRD42022355510. We searched PubMed, Scopus, Embase, and Web of Science databases systematically to 1 August 2022. After article screening, we assessed the quality of the included studies based on the JBI checklist. Following data extraction, we performed a meta-analysis using R software. We included 18 qualified articles presenting sufficient data about RATs performance in comparison to RT-PCR in Omicron infections. The pooled specificity and sensitivity of RATs were 1.000 (0.997-1.000) and 0.671 (0.595-0.721), respectively. The FDA-approved kits showed a better performance than WHO-approved ones with a sensitivity of 0.728 (0.620-0.815). The use of RATs with nasal swabs showed a higher sensitivity compared with nasopharyngeal swabs. The sensitivity for samples with a CT-value >25 was 0.108 (0.048-0.227). Rapid antigen tests show impaired performance for COVID-19 diagnosis when the Omicron variant is circulating, particularly in samples with low viral loads.
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Affiliation(s)
- Zahra Eslami Mohammadie
- Student Research Committee, Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Akhlaghi
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Samaeinasab
- Immunology Board for Transplantation and Cell-Based Therapeutics (Immuno_TACT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Shakiba Shaterzadeh-Bojd
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tannaz Jamialahmadi
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Medicine, The University of Western Australia, Perth, Australia.,Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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25
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Bourgin M, Durand S, Kroemer G. Diagnostic, Prognostic and Mechanistic Biomarkers of COVID-19 Identified by Mass Spectrometric Metabolomics. Metabolites 2023; 13:metabo13030342. [PMID: 36984782 PMCID: PMC10056171 DOI: 10.3390/metabo13030342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/14/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
A number of studies have assessed the impact of SARS-CoV-2 infection and COVID-19 severity on the metabolome of exhaled air, saliva, plasma, and urine to identify diagnostic and prognostic biomarkers. In spite of the richness of the literature, there is no consensus about the utility of metabolomic analyses for the management of COVID-19, calling for a critical assessment of the literature. We identified mass spectrometric metabolomic studies on specimens from SARS-CoV2-infected patients and subjected them to a cross-study comparison. We compared the clinical design, technical aspects, and statistical analyses of published studies with the purpose to identify the most relevant biomarkers. Several among the metabolites that are under- or overrepresented in the plasma from patients with COVID-19 may directly contribute to excessive inflammatory reactions and deficient immune control of SARS-CoV2, hence unraveling important mechanistic connections between whole-body metabolism and the course of the disease. Altogether, it appears that mass spectrometric approaches have a high potential for biomarker discovery, especially if they are subjected to methodological standardization.
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Affiliation(s)
- Mélanie Bourgin
- Metabolomics and Cell Biology Platforms, Institut Gustave Roussy, 94805 Villejuif, France
- Centre de Recherche des Cordeliers, Equipe Labellisée par la Ligue Contre le Cancer, Université de Paris Cité, Sorbonne Université, Inserm U1138, Institut Universitaire de France, 75005 Paris, France
- Correspondence:
| | - Sylvère Durand
- Metabolomics and Cell Biology Platforms, Institut Gustave Roussy, 94805 Villejuif, France
- Centre de Recherche des Cordeliers, Equipe Labellisée par la Ligue Contre le Cancer, Université de Paris Cité, Sorbonne Université, Inserm U1138, Institut Universitaire de France, 75005 Paris, France
| | - Guido Kroemer
- Metabolomics and Cell Biology Platforms, Institut Gustave Roussy, 94805 Villejuif, France
- Centre de Recherche des Cordeliers, Equipe Labellisée par la Ligue Contre le Cancer, Université de Paris Cité, Sorbonne Université, Inserm U1138, Institut Universitaire de France, 75005 Paris, France
- Institut du Cancer Paris CARPEM, Department of Biology, Hôpital Européen Georges Pompidou, AP-HP, 75610 Paris, France
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The global prevalence of vestibular dysfunction in children and adolescents: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2023; 280:2663-2674. [PMID: 36715738 DOI: 10.1007/s00405-023-07842-z] [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: 11/29/2022] [Accepted: 01/13/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND Vestibular dysfunction has been extensively studied amongst the older population. Recently, conditions and management of vestibular dysfunction among children and adolescent has gained attention. Yet, a lack of awareness and expertise in managing children and adolescents with vestibular dysfunction has led to a delay in diagnosis as well as a trifling prevalence rate. AIM To conduct a systematic review and meta-analyses to estimate the overall pooled prevalence of vestibular dysfunction in children and adolescents. METHODS PubMed, Scopus, and Web of Science databases were searched to identify studies published until 29 April 2022. We used a random-effects model to estimate the pooled prevalence with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2 statistic and Cochran's Q test. The robustness of the pooled estimates was checked by different subgroups and sensitivity analyses. RESULTS We identified 1811 studies, of which 39 studies (n = 323,663) were included in the meta-analysis. Overall, the pooled prevalence of children and adolescents with VD was 30.4% [95% CI 28.5-32.3%]. The age of the participants ranged from 1 to 19 years. Participants of the included 39 studies were from 15 countries. Among the studies, 34 were cross-sectional, and five were case-control designed. There were discrepancies found in the studies with objective (higher prevalence) versus subjective (lower prevalence) evaluations. CONCLUSION The prevalence of VD among children and adolescents was found to be 30.4% based on high-quality evidence. Due to the subjective assessment of most studies pooled in the analysis, the results should be interpreted cautiously until future comparative studies with objective assessments are carried out.
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Lippi G, Henry BM, Plebani M. An overview of the most important preanalytical factors influencing the clinical performance of SARS-CoV-2 antigen rapid diagnostic tests (Ag-RDTs). Clin Chem Lab Med 2023; 61:196-204. [PMID: 36343376 DOI: 10.1515/cclm-2022-1058] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022]
Abstract
Due to the many technical limitations of molecular biology, the possibility to sustain enormous volumes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostic testing relies strongly on the use of antigen rapid diagnostic tests (Ag-RDTs). Besides a limited analytical sensitivity, the manually intensive test procedures needed for performing these tests, very often performed by unskilled personnel or by the patients themselves, may contribute to considerably impair their diagnostic accuracy. We provide here an updated overview on the leading preanalytical drawbacks that may impair SARS-CoV-2 Ag-RDT accuracy, and which encompass lower diagnostic sensitivity in certain age groups, in asymptomatic subjects and those with a longer time from symptoms onset, in vaccine recipients, in individuals not appropriately trained to their usage, in those recently using oral or nasal virucidal agents, in oropharyngeal swabs and saliva, as well as in circumstances when instructions provided by the manufacturers are unclear, incomplete or scarcely readable and intelligible. Acknowledging these important preanalytical limitations will lead the way to a better, more clinically efficient and even safer use of this important technology, which represents an extremely valuable resource for management of the ongoing pandemic.
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Affiliation(s)
- Giuseppe Lippi
- IFCC Task Force on COVID-19, Milan, Italy
- IFCC Working Group on SARS-COV-2 Variants, Milan, Italy
- Section of Clinical Biochemistry and School of Medicine, University of Verona, Verona, Italy
| | - Brandon M Henry
- IFCC Task Force on COVID-19, Milan, Italy
- IFCC Working Group on SARS-COV-2 Variants, Milan, Italy
- Clinical Laboratory, Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Mario Plebani
- IFCC Working Group on SARS-COV-2 Variants, Milan, Italy
- University of Padova, Padova, Italy
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Abstract
BACKGROUND AND OBJECTIVES COVID-19 symptoms change after onset-some show early, others later. This article examines whether the order of occurrence of symptoms can improve diagnosis of COVID-19 before test results are available. METHODS In total, 483 individuals who completed a COVID-19 test were recruited through Listservs. Participants then completed an online survey regarding their symptoms and test results. The order of symptoms was set according to (a) whether the participant had a "history of the symptom" due to a prior condition; and (b) whether the symptom "occurred first," or prior to, other symptoms of COVID-19. Two LASSO (Least Absolute Shrinkage and Selection Operator) regression models were developed. The first model, referred to as "time-invariant," used demographics and symptoms but not the order of symptom occurrence. The second model, referred to as "time-sensitive," used the same data set but included the order of symptom occurrence. RESULTS The average cross-validated area under the receiver operating characteristic (AROC) curve for the time-invariant model was 0.784. The time-sensitive model had an AROC curve of 0.799. The difference between the 2 accuracy levels was statistically significant (α < .05). CONCLUSION The order of symptom occurrence made a statistically significant, but small, improvement in the accuracy of the diagnosis of COVID-19.
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Affiliation(s)
- Janusz Wojtusiak
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University
| | - Wejdan Bagais
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University
| | - Jee Vang
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University
| | - Amira Roess
- Department of Global and Community Health, College of Health and Human Services, George Mason University
| | - Farrokh Alemi
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University
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de la Fuente J. Art-science multidisciplinary collaborations to address the scientific challenges posed by COVID-19. Ann Med 2022; 54:2535-2548. [PMID: 36111779 PMCID: PMC9487962 DOI: 10.1080/07853890.2022.2123557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/26/2022] Open
Abstract
The ongoing coronavirus pandemic COVID-19 constitutes a scientific and social challenge. The application of mixed-methods research with multidisciplinary collaborations increases the success of experimental design and interpretation of results to approach scientific challenges. The objective is to develop and implement protean art algorithms with interactions between artists and scientists for scientific research in areas of molecular biology, immunology, ecology and biomedicine. In this perspective, artists were invited to contribute pieces related to the pandemic, and scientists were then challenged to contribute their view and proposed research inspired by artist contribution to face COVID-19 scientific challenges. Proposed research objectives inspired by artist contributions contribute to approach COVID-19 scientific and social challenges with results that may translate into new diagnosis and control interventions. The proposed research objectives approach vaccine protective mechanisms and the development of nutritional interventions with possible impact on boosting protective response to vaccination, the impact of fuel pollutants on host immunity and virus transmission, the possible role of ectoparasite vectors in the appearance of SARS-CoV-2 variants and virus transmission, collaboration between different sectors to contribute to virus surveillance and reduce risks of contagion, characterization of the incidence of zoonotic diseases during and after the COVID-19 pandemic in relation to modifications in the interactions between humans and reservoir animal species, evaluation of the risks associated with sexual or congenital transmission of SARS-CoV-2, development of new methods for the easy and rapid detection of very low SARS-CoV-2 virus amounts in infected but asymptomatic individuals, and understanding society perceptions about the socio-ecological relationships between decoupled environments and the risks and effects of pandemics. This approach may be used to promote social participation in science through combined scientific and artistic perspectives with impact on science and society.KEY MESSAGEMixed-methods research with multidisciplinary collaborations increases the success of experimental design and interpretation of results.Implementation of protean art algorithms through interactions between artists and scientists advances scientific research.Proposed research objectives inspired by artist contributions contribute to approach COVID-19 scientific and social challenges with results that may translate into new diagnosis and control interventions.
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Affiliation(s)
- José de la Fuente
- Instituto de Investigación en Recursos Cinegéticos IREC-CSIC-UCLM-JCCM, SaBio, Ciudad Real, Spain
- Department of Veterinary Pathobiology, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA
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Duma Z, Ramsuran V, Chuturgoon AA, Edward VA, Naidoo P, Mkhize-Kwitshana ZL. Evaluation of Various Alternative Economical and High Throughput SARS-CoV-2 Testing Methods within Resource-Limited Settings. Int J Mol Sci 2022; 23:14350. [PMID: 36430827 PMCID: PMC9694816 DOI: 10.3390/ijms232214350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 11/22/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak posed a challenge for diagnostic laboratories worldwide, with low-middle income countries (LMICs) being the most affected. The polymerase chain reaction (PCR) is the gold standard method for detecting SARS-CoV-2 infection. However, the challenge with this method is that it is expensive, which has resulted in under-testing for SARS-CoV-2 infection in many LMICs. Hence, this study aimed to compare and evaluate alternative methods for the mass testing of SARS-CoV-2 infection in laboratories with limited resources to identify cost-effective, faster, and accurate alternatives to the internationally approved kits. A total of 50 residual nasopharyngeal swab samples were used for evaluation and comparison between internationally approved kits (Thermo Fisher PureLink™ RNA Isolation Kit and Thermo Fisher TaqPath™ COVID-19 Assay Kit) and alternative methods (three RNA extraction and four commercial SARS-CoV-2 RT-PCR assay kits) in terms of the cost analysis, diagnostic accuracy, and turnaround time. In terms of performance, all of the alternative RNA extraction methods evaluated were comparable to the internationally approved kits but were more cost-effective (Lucigen QuickExtract™ RNA Extraction Kit, Bosphore EX-Tract Dry Swab RNA Solution and Sonicator method) and four commercial SARS-CoV-2 RT-PCR assay kits (Nucleic Acid COVID-19 Test Kit (SARS-CoV-2), abTESTM COVID-19 qPCR I Kit, PCL COVID19 Speedy RT-PCR Kit, and PCLMD nCoV One-Step RT-PCR Kit) with a sensitivity range of 76-100% and specificity of 96-100%. The cost per sample was reduced by more than 50% when compared to internationally approved kits. When compared to the Thermo Fisher PureLink™ Kit and Thermo Fisher TaqPath™ COVID-19 Assay Kit, the alternative methods had a faster turnaround time, indicating that laboratories with limited resources may be able to process more samples in a day. The above-mentioned cost-effective, fast, and accurate evaluated alternative methods can be used in routine diagnostic laboratories with limited resources for mass testing for SARS-CoV-2 because these were comparable to the internationally approved kits, Thermo Fisher PureLink™ Kit and Thermo Fisher TaqPath™ COVID-19 Assay Kit. The implementation of alternative methods will be the most cost-effective option for testing SARS-CoV-2 infection in LMICs.
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Affiliation(s)
- Zamathombeni Duma
- Disciplines of Medical Microbiology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Umbilo, Durban 4041, South Africa
- Division of Research Capacity Development, South African Medical Research Council (SAMRC), Tygerberg, Cape Town 7505, South Africa
| | - Veron Ramsuran
- Disciplines of Medical Microbiology, Howard College, University of KwaZulu-Natal, Glenwood, Durban 4041, South Africa
| | - Anil A. Chuturgoon
- Disciplines of Medical Biochemistry, Howard College, University of KwaZulu-Natal, Glenwood, Durban 4041, South Africa
| | - Vinodh A. Edward
- The Aurum Institute, 29 Queens Road, Parktown, Johannesburg 2193, South Africa
- School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville, Durban 3629, South Africa
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06511, USA
| | - Pragalathan Naidoo
- Disciplines of Medical Microbiology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Umbilo, Durban 4041, South Africa
- Division of Research Capacity Development, South African Medical Research Council (SAMRC), Tygerberg, Cape Town 7505, South Africa
| | - Zilungile L. Mkhize-Kwitshana
- Disciplines of Medical Microbiology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Umbilo, Durban 4041, South Africa
- Division of Research Capacity Development, South African Medical Research Council (SAMRC), Tygerberg, Cape Town 7505, South Africa
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Alhabbab RY. Lateral Flow Immunoassays for Detecting Viral Infectious Antigens and Antibodies. MICROMACHINES 2022; 13:1901. [PMID: 36363922 PMCID: PMC9694796 DOI: 10.3390/mi13111901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 05/28/2023]
Abstract
Abundant immunological assays currently exist for detecting pathogens and identifying infected individuals, making detection of diseases at early stages integral to preventing their spread, together with the consequent emergence of global health crises. Lateral flow immunoassay (LFIA) is a test characterized by simplicity, low cost, and quick results. Furthermore, LFIA testing does not need well-trained individuals or laboratory settings. Therefore, it has been serving as an attractive tool that has been extensively used during the ongoing COVID-19 pandemic. Here, the LFIA strip's available formats, reporter systems, components, and preparation are discussed. Moreover, this review provides an overview of the current LFIAs in detecting infectious viral antigens and humoral responses to viral infections.
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Affiliation(s)
- Rowa Y. Alhabbab
- Vaccines and Immunotherapy Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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32
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Chen CC, Chen SY, Fang SB, Lu SC, Bai CH, Wang YH. Diagnostic accuracy of SARS-CoV-2 antigen test in the pediatric population: A systematic review and meta-analysis. Pediatr Neonatol 2022; 64:247-255. [PMID: 36344413 PMCID: PMC9597578 DOI: 10.1016/j.pedneo.2022.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused the global coronavirus disease 2019 (COVID-19) pandemic. Rapid identification and isolation of patients infected with SARS-CoV-2 are critical methods for blocking COVID-19 transmission. The advantages of antigen tests, such as their relatively low cost and short turnaround time, can contribute to the prompt identification of infectious individuals. However, the diagnostic accuracy of antigen tests for COVID-19 in children remains inconclusive. This meta-analysis aimed to evaluate the diagnostic performance of antigen tests for SARS-CoV-2 in the pediatric population. METHODS We conducted a literature search for relevant studies in the PubMed, Embase, Google Scholar, and Biomed Central databases. Studies evaluating the diagnostic accuracy of antigen tests for SARS-CoV-2 in pediatric patients were included. In addition, we included studies that provided sufficient data to construct a 2 × 2 table on a per-patient basis. The final literature search was performed on October 10, 2021. Days after symptom onset, asymptomatic and symptomatic individuals may have been potential sources of heterogeneity. The overall sensitivity and specificity of the antigen tests were generated using a bivariate random-effects model. RESULTS Five studies with 4400 participants were included. The meta-analysis of antigen tests generated a pooled sensitivity of 65.9% (95% CI: 52.8%-77.0%) and pooled specificity of 99.9% (95% CI: 98.9%-100.0%). A subgroup analysis of studies reporting antigen test data for symptomatic patients showed a pooled sensitivity of 64.5% and a pooled specificity of 99.7%. The subgroup analysis of studies that included 881 asymptomatic participants generated a pooled sensitivity of 48.4% and a pooled specificity of 99.5%. CONCLUSION Antigen tests exhibit moderate sensitivity and high specificity for detecting SARS-CoV-2 in children. Antigen tests might have moderate sensitivity for detecting SARS-CoV-2 in symptomatic children, and serial testing might effectively prevent further SARS-CoV-2 transmission.
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Affiliation(s)
- Cheng-Chieh Chen
- Department of Pathology and Laboratory Medicine, Shin Kong Wu Ho-Su Memorial, Hospital, Taipei, Taiwan,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shih-Yen Chen
- Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan,Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Shiuh-Bin Fang
- Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan,Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan,Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Shou-Cheng Lu
- Department of Laboratory Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chyi-Huey Bai
- Department of Public Health, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yuan-Hung Wang
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
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Samsunder N, de Vos M, Ngcapu S, Giandhari J, Lewis L, Kharsany ABM, Cawood C, de Oliveira T, Karim QA, Karim SA, Naidoo K, Escadafal C, Sivro A. Clinical Evaluation of Severe Acute Respiratory Syndrome Coronavirus 2 Rapid Antigen Tests During the Omicron Wave in South Africa. J Infect Dis 2022; 226:1412-1417. [PMID: 35921539 PMCID: PMC9384653 DOI: 10.1093/infdis/jiac333] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/02/2022] [Indexed: 11/14/2022] Open
Abstract
We evaluated the performance of nasal and nasopharyngeal Standard Q COVID-19 [coronavirus disease 2019] Ag tests (SD Biosensor) and the Panbio COVID-19 Ag Rapid Test Device (nasal; Abbott) against the Abbott RealTime severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) assay during the Omicron (clades 21M, 21K, and 21L) wave in South Africa. Overall, all evaluated tests performed well, with high sensitivity (range, 77.78%-81.42%) and excellent specificity values (>99%). The sensitivity of rapid antigen tests increased above 90% in samples with cycle threshold <20, and all 3 tests performed best within the first week after symptom onset.
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Affiliation(s)
- Natasha Samsunder
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | | | - Sinaye Ngcapu
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
- Department of Medical Microbiology, University of KwaZulu-Natal, Durban, South Africa
| | - Jennifer Giandhari
- KwaZulu-Natal Research Innovation and Sequencing Platform, Durban, South Africa
| | - Lara Lewis
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | - Ayesha B M Kharsany
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
- FIND, the Global Alliance for Diagnostics, Geneva, Switzerland
| | - Cherie Cawood
- Epicentre AIDS Risk Management, Durban, South Africa
| | - Tulio de Oliveira
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
- KwaZulu-Natal Research Innovation and Sequencing Platform, Durban, South Africa
- Centre for Epidemic Response and Innovation, School of Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
- Department of Global Health, University of Washington, Seattle, USA
| | - Quarraisha Abdool Karim
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
- Department of Epidemiology, Columbia University, New York City, USA
| | - Salim Abdool Karim
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
- Department of Epidemiology, Columbia University, New York City, USA
| | - Kogieleum Naidoo
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
- MRC-CAPRISA HIV-TB Pathogenesis and Treatment Research Unit, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | | | - Aida Sivro
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
- Department of Medical Microbiology, University of KwaZulu-Natal, Durban, South Africa
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Al-Hindawi A, AlDallal U, Waly YM, Hussain MH, Shelig M, Saleh ElMitwalli OSMM, Deen GR, Henari FZ. An Exploration of Nanoparticle-Based Diagnostic Approaches for Coronaviruses: SARS-CoV-2, SARS-CoV and MERS-CoV. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:3550. [PMID: 36296739 PMCID: PMC9608708 DOI: 10.3390/nano12203550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
The wildfire-like spread of COVID-19, caused by severe acute respiratory syndrome-associated coronavirus-2, has resulted in a pandemic that has put unprecedented stress on the world's healthcare systems and caused varying severities of socio-economic damage. As there are no specific treatments to combat the virus, current approaches to overcome the crisis have mainly revolved around vaccination efforts, preventing human-to-human transmission through enforcement of lockdowns and repurposing of drugs. To efficiently facilitate the measures implemented by governments, rapid and accurate diagnosis of the disease is vital. Reverse-transcription polymerase chain reaction and computed tomography have been the standard procedures to diagnose and evaluate COVID-19. However, disadvantages, including the necessity of specialized equipment and trained personnel, the high financial cost of operation and the emergence of false negatives, have hindered their application in high-demand and resource-limited sites. Nanoparticle-based methods of diagnosis have been previously reported to provide precise results within short periods of time. Such methods have been studied in previous outbreaks of coronaviruses, including severe acute respiratory syndrome-associated coronavirus and middle east respiratory syndrome coronavirus. Given the need for rapid diagnostic techniques, this review discusses nanoparticle use in detecting the aforementioned coronaviruses and the recent severe acute respiratory syndrome-associated coronavirus-2 to highlight approaches that could potentially be used during the COVID-19 pandemic.
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Affiliation(s)
| | | | | | | | | | | | - G. Roshan Deen
- School of Medicine, Royal College of Surgeons in Ireland (RCSI), Medical University of Bahrain, Adliya P.O. Box 15503, Bahrain
| | - Fryad Z. Henari
- School of Medicine, Royal College of Surgeons in Ireland (RCSI), Medical University of Bahrain, Adliya P.O. Box 15503, Bahrain
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35
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Ma X, Xu J, Zhou F, Ye J, Yang D, Wang H, Wang P, Li M. Recent advances in PCR-free nucleic acid detection for SARS-COV-2. Front Bioeng Biotechnol 2022; 10:999358. [PMID: 36277389 PMCID: PMC9585218 DOI: 10.3389/fbioe.2022.999358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
As the outbreak of Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory disease coronavirus 2 (SARS-COV-2), fast, accurate, and economic detection of viral infection has become crucial for stopping the spread. Polymerase chain reaction (PCR) of viral nucleic acids has been the gold standard method for SARS-COV-2 detection, which, however, generally requires sophisticated facilities and laboratory space, and is time consuming. This review presents recent advances in PCR-free nucleic acid detection methods for SARS-CoV-2, including emerging methods of isothermal amplification, nucleic acid enzymes, electrochemistry and CRISPR.
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Affiliation(s)
| | | | | | | | | | - Hua Wang
- Department of Laboratory Medicine, Institute of Molecular Medicine, Shanghai Key Laboratory for Nucleic Acid Chemistry and Nanomedicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Pengfei Wang
- Department of Laboratory Medicine, Institute of Molecular Medicine, Shanghai Key Laboratory for Nucleic Acid Chemistry and Nanomedicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Min Li
- Department of Laboratory Medicine, Institute of Molecular Medicine, Shanghai Key Laboratory for Nucleic Acid Chemistry and Nanomedicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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36
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Jain S, Bhowmick A, Pandey AK. A rapid One-Pot RNA isolation method for simplified clinical detection of SARS-COV-2 infection in India. Front Cell Infect Microbiol 2022. [DOI: 10.3389/fcimb.2022.962057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BackgroundWith the rapid increase in COVID-19 cases and the discovery of new viral variants within India over multiple waves, the expensive reagents and time-consuming sample pretreatment required for qPCR analysis have led to slower detection of the disease. The vast Indian population demands an inexpensive and competent sample preparation strategy for rapid detection of the disease facilitating early and efficient containment of the disease.MethodsIn this study, we have surveyed the spread of COVID-19 infection over Faridabad, Haryana, India for 6 months. We also devised a simple single-step method for total RNA extraction using a single tube and compared its efficacy with the commercially available RNA isolation kits.FindingsOur findings suggest that determining Ct values for samples subjected to the One Pot RNA extraction method was as efficient as the commercially available kits but delivers a subtle advantage in a way, by minimizing the cost, labor and sample preparation time.ConclusionThis novel crude RNA extraction method is stable and capable of operating in developing countries like India for low resource settings, without the use of expensive reagents and instruments. Additionally, this method can be further adapted to pooling samples strategies owing to its high sensitivity.
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Stokes W, Berenger BM, Venner AA, Deslandes V, Shaw JLV. Point of care molecular and antigen detection tests for COVID-19: current status and future prospects. Expert Rev Mol Diagn 2022; 22:797-809. [PMID: 36093682 DOI: 10.1080/14737159.2022.2122712] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Detection of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has been critical to support and management of the COVID-19 pandemic. Point of care testing (POCT) for SARS-CoV-2 has been a widely used tool for detection of SARS-CoV-2. AREAS COVERED POCT nucleic acid amplification tests (NAATs) and rapid antigen tests (RATs) have been the most readily used POCT for SARS-CoV-2. Here, current knowledge on the utility of POCT NAATs and RATs for SARS-CoV-2 are reviewed and discussed alongside aspects of quality assurance factors that must be considered for successful and safe implementation of POCT. EXPERT OPINION Use cases for implementation of POCT must be evidence based, regardless of the test used. A quality assurance framework must be in place to ensure accuracy and safety of POCT.
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Affiliation(s)
- William Stokes
- Alberta Precision Laboratories, Alberta, Canada.,Department of Pathology and Laboratory Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Byron M Berenger
- Alberta Precision Laboratories, Alberta, Canada.,Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Allison A Venner
- Alberta Precision Laboratories, Alberta, Canada.,Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Vincent Deslandes
- Eastern Ontario Regional Laboratories Association, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, The University of Ottawa, Ottawa, Ontario, Canada
| | - Julie L V Shaw
- Eastern Ontario Regional Laboratories Association, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, The University of Ottawa, Ottawa, Ontario, Canada
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Veramuthu V, Munajat I, Islam MA, Mohd EF, Sulaiman AR. Prevalence of Avascular Necrosis Following Surgical Treatments in Unstable Slipped Capital Femoral Epiphysis (SCFE): A Systematic Review and Meta-Analysis. CHILDREN 2022; 9:children9091374. [PMID: 36138683 PMCID: PMC9497816 DOI: 10.3390/children9091374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/03/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022]
Abstract
The choice of treatment for unstable and severely displaced slipped capital femoral epiphysis (SCFE) is controversial. This meta-analysis was conducted to determine the prevalence of femoral head avascular necrosis (AVN) following various treatments for unstable SCFE. Various databases were searched to identify articles published until 4 February 2022. A random-effects model was used to examine prevalence as well as risk ratios with confidence intervals (CIs) of 95%. Thirty-three articles were analyzed in this study. The pooled prevalences of AVN in pinning in situ, pinning following intentional closed reduction, pinning following unintentional closed reduction, and open reduction via the Parsch method, subcapital osteotomy and the modified Dunn procedure were 18.5%, 23.0%, 27.6%, 9.9%, 18.6% and 19.9%, respectively. The risk of developing AVN in pinning following intentional closed reduction was found to be 1.62 times higher than pinning in situ; however, this result was not significant. The prevalence of AVN in open reduction was lowest when performed via the Parsch method; however, this finding should be interpreted with caution, since the majority of slips so-treated are of mild and moderate types as compared with the subcapital osteotomy and modified Dunn procedures, which are predominantly used to treat severely displaced slips. As the risk ratio between intentional closed reduction and the modified Dunn method showed no significant difference, we believe that the modified Dunn method has the advantage of meticulously preserving periosteal blood flow to the epiphysis, thus minimizing AVN risk. In comparison with intentional closed reduction, the modified Dunn method is used predominantly in cases of severe slips.
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Affiliation(s)
- Vijayanagan Veramuthu
- Department of Orthopaedics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Ismail Munajat
- Department of Orthopaedics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Correspondence: (I.M.); or (M.A.I.)
| | - Md Asiful Islam
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK
- Correspondence: (I.M.); or (M.A.I.)
| | - Emil Fazliq Mohd
- Department of Orthopaedics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Abdul Razak Sulaiman
- Department of Orthopaedics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
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Xie JW, He Y, Zheng YW, Wang M, Lin Y, Lin LR. Diagnostic accuracy of rapid antigen test for SARS-CoV-2: A systematic review and meta-analysis of 166,943 suspected COVID-19 patients. Microbiol Res 2022; 265:127185. [PMID: 36113309 PMCID: PMC9461282 DOI: 10.1016/j.micres.2022.127185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/30/2022] [Accepted: 09/05/2022] [Indexed: 12/19/2022]
Abstract
To assess the diagnostic accuracy of the rapid antigen test (RAT) compared with RT-PCR (reference standard) for SARS-CoV-2, we searched MEDLINE/PubMed and Web of Science for relevant records. The QUADAS-2 tool was used to assess study quality, and quantitative synthesis was conducted using a bivariate random-effects model. The meta-analysis included 135 studies (166,943 samples). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 0.76 (95%CI: 0.73-0.79), 1.00 (95%CI: 1.00-1.00), 276.1 (95% CI, 184.1-414.1), 0.24 (95% CI, 0.21-0.27), and 1171 (95% CI, 782-1755), respectively. Compared to other sample types, nasal samples had the best RAT sensitivity [0.79 (95%CI: 0.71-0.85)]. The sensitivities of the different RAT kits ranged from 0.41 (95%CI: 0.23-0.61) to 0.90 (95%CI: 0.70-0.97). Sensitivity was markedly better in samples with lower Ct, and RAT achieved excellent pooled sensitivity at 1.00 (95%CI: 0.70-1.00) among samples with Ct < 20. Testing within 10 days of symptom onset resulted in a high sensitivity. For ≤ 3, ≤ 7, and ≤ 10 days, the sensitivities were 0.91 (95%CI: 0.83-0.96), 0.89 (95%CI: 0.84-0.93), and 0.88 (95%CI: 0.83-0.92), respectively. RAT kits show high sensitivity and specificity in early infection, especially when the viral load is high. Moreover, using nasal samples for antigen testing, which are moderately sensitive and patient-friendly, is a reliable alternative to nasopharyngeal sampling. RAT might be effective for fighting the COVID-19 pandemic; however, it must be complemented by the careful handling of negative test results.
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Affiliation(s)
- Jia-Wen Xie
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Yun He
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Ya-Wen Zheng
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Mao Wang
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Yong Lin
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China.
| | - Li-Rong Lin
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China.
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Comparing Rapid Ag Test and PCR in SARS-CoV-2 Management in Rural Egypt. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.3.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Like elsewhere around the globe, SARS-CoV-2 infection is spreading in rural Egypt. Due to high sensitivity and specificity, the gold standard of diagnostics is reverse transcription polymerase chain reaction PCR (RT-PCR). Rural areas without access to certified laboratories cannot take advantage of RT-PCR testing, and thus are dependent upon rapid antigen testing, a point-of-care test that requires less training and can produce results within 15 minutes. Rapid antigen testing can give an advantage to medical teams in rural settings by affording effective and early control of SARS-CoV-2 infection spread. We sought to assess the contribution of different COVID-19 testing procedures in rural Egypt. We conducted a prospective cohort study in a rural lab in Giza, Egypt. Approximately 223 individuals with potential SARS-CoV-2 infection were involved in the study during the pandemic peak in Giza, Egypt, from March 4 – May 30, 2021. Subjects were subjected to RT-PCR and rapid antigen testing, and the performance of each testing procedure was compared. Between March 4 – May 30, 2021, approximately 223 symptomatic individuals were included in this study. 190 patients (85.2%) were indicated as PCR positive for SARS-CoV-2, while 33 (14.8%) were PCR negative. In comparison, a rapid antigen test showed 178 out of 223 patients (79.8%) were indicated as positive, or 94% of the PCR-positive individuals. In Giza, a rural area of Egypt, RT-PCR had an optimal balance of sensitivity and specificity, however, the turnaround time was a limiting factor. Antigen testing, performed as a rapid point-of-care test, can play an effective role in rural outbreak control due to its ease of use and rapid results.
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Sayabovorn N, Phisalprapa P, Srivanichakorn W, Washirasaksiri C, Auesomwang C, Sitasuwan T, Tinmanee R, Chayakulkeeree M, Phoompoung P, Mayurasakorn K, Sookrung N, Tungtrongchitr A, Wanitphakdeedecha R, Muangman S, Senawong S, Tangjittipokin W, Sanpawitayakul G, Woradetsittichai D, Nimitpunya P, Kositamongkol C, Nopmaneejumruslers C, Vamvanij V, Chaisathaphol T. Early diagnosis by antigen test kit and early treatment by antiviral therapy: An ambulatory management strategy during COVID-19 crisis in Thailand. Medicine (Baltimore) 2022; 101:e29888. [PMID: 35905240 PMCID: PMC9333083 DOI: 10.1097/md.0000000000029888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
This study aimed to assess the clinical characteristics of patients who registered at the Siriraj Favipiravir Clinic and to share our experiences in this comparatively unique clinical setting. This retrospective study included patients who registered at the Siriraj Favipiravir Clinic during August 11, 2021 to September 14, 2021. Included adult patients were those with severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID-19]) infection confirmed by antigen test kit (ATK) or real-time reverse transcription-polymerase chain reaction, no favipiravir contraindication, no prior COVID-19 treatment, and not receiving care from another medical facility. Demographic data and outcomes were collected and analyzed. Of the 1168 patients (mean age: 44.8 ± 16.4 years, 55.7% female) who registered at the clinic, 117 (10%) did not meet the treatment criteria, and 141 (12%) patients did not pick up their medication. One-third of patients had at least 1 symptom that indicated severe disease. Higher proportion of unvaccinated status (56.7% vs 47.5%, P = .005), higher proportion of persons with risk factors for disease progression (37.7% vs 31.3%, P = .028), and longer duration between the date of clinic registration and the date of positive diagnostic test (3 vs 2 days, P = .004) were significantly more commonly observed in the severe disease group compared to the nonsevere disease group. The duration between symptom onset and the date of clinic registration was significantly longer in the real-time reverse transcription-polymerase chain reaction group than in the ATK group (6 vs 4 days, P < .001). Most patients (90.0%) had completed favipiravir treatment regimen. The improvement and mortality rates were 86.7% and 1.2%, respectively. COVID-19 severity is associated with vaccination status, baseline risk factors, and timing between disease detection and treatment. The use of ATK influences patients to seek treatment significantly earlier in ambulatory setting. Our early diagnosis and antiviral treatment strategy yielded favorable results in an outpatient setting during a COVID-19 outbreak in Thailand.
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Affiliation(s)
- Naruemit Sayabovorn
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pochamana Phisalprapa
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Weerachai Srivanichakorn
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chaiwat Washirasaksiri
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chonticha Auesomwang
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tullaya Sitasuwan
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Rungsima Tinmanee
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Methee Chayakulkeeree
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pakpoom Phoompoung
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Korapat Mayurasakorn
- Siriraj Population Health and Nutrition Research Group, Department of Research Group and Research Network, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nitat Sookrung
- Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Anchalee Tungtrongchitr
- Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Saipin Muangman
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sansnee Senawong
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Watip Tangjittipokin
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Gornmigar Sanpawitayakul
- Division of Ambulatory Paediatrics, Department of Paediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Diana Woradetsittichai
- Department of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pongpol Nimitpunya
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chayanis Kositamongkol
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Cherdchai Nopmaneejumruslers
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Visit Vamvanij
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thanet Chaisathaphol
- Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- *Correspondence: Thanet Chaisathaphol, Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand (e-mail: )
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Global Prevalence and Risk of Local Recurrence following Cryosurgery of Giant Cell Tumour of Bone: A Meta-Analysis. Cancers (Basel) 2022; 14:cancers14143338. [PMID: 35884399 PMCID: PMC9318769 DOI: 10.3390/cancers14143338] [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: 06/12/2022] [Revised: 07/03/2022] [Accepted: 07/06/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Giant cell tumours are benign but locally aggressive and can potentially metastasise to the lungs. Reducing the risk of local recurrence while maintaining limb function and minimising adverse consequences is the best therapeutic strategy in treating giant cell tumours. Based on our observation through this meta-analysis, cryosurgery is one of the viable treatment options that can provide good oncologic and functional outcomes with minimal complication rates. Abstract The challenge in the surgical treatment of giant cell tumours of bone is the relatively high recurrence rate after curettage alone. The use of a local adjuvant following curettage, on the other hand, has lowered the rate of recurrence. This systematic review and meta-analysis aimed to investigate the prevalence and risk of local recurrence of giant cell tumours of the bone after cryosurgery and the subsequent complications. Web of Science, Scopus, ScienceDirect, PubMed, and Google Scholar were searched to identify articles published until 13 October 2021. A random-effects model was used to examine the pooled prevalence and risk ratio (RR) of local recurrence in patients with giant cell tumours after cryosurgery with 95% confidence intervals (CIs). This study was registered with PROSPERO (CRD42020211620). A total of 1376 articles were identified, of which 38 studies (n = 1373, 46.2% male) were included in the meta-analysis. Following cryosurgery, the pooled prevalence of local recurrence in giant cell tumours was estimated as 13.5% [95% CI: 9.3–17.8, I2 = 63%], where European subjects exhibited the highest prevalence (24.2%). Compared to other local adjuvants. The RR of local recurrence following cryosurgery was 0.85 (95% CI: 0.63–1.17, I2 = 15%), which was not statistically significant compared to other local adjuvants. We found 3.9% fracture, 4.0% infection, 2.1% nerve injury, and 1.5% skin necrosis as the common complications. Based on the sensitivity analyses, this study is robust and reliable. This meta-analysis estimated a low prevalence of local recurrence of giant cell tumours with low complications following cryosurgery. Thus, it can be one of the adjuvant options for treating giant cell tumours.
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Kim J, Sung H, Lee H, Kim JS, Shin S, Jeong S, Choi M, Lee HJ. Clinical Performance of Rapid and Point-of-Care Antigen Tests for SARS-CoV-2 Variants of Concern: A Living Systematic Review and Meta-Analysis. Viruses 2022; 14:1479. [PMID: 35891461 PMCID: PMC9324571 DOI: 10.3390/v14071479] [Citation(s) in RCA: 4] [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: 06/08/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 12/20/2022] Open
Abstract
Rapid antigen tests (RATs) for detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are widely used in the Coronavirus disease 2019 (COVID-19) pandemic caused by diverse variants. Information on the real-world performance of RATs for variants is urgently needed for decision makers. Systematic searches of the available literature and updates were conducted in PubMed, Ovid-MEDLINE, Ovid-EMBASE, CENTRAL, and KMBASE for articles evaluating the accuracy of instrument-free RATs for variants up until 14 March 2022. A bivariate random effects model was utilized to calculate pooled diagnostic values in comparison with real-time reverse transcription-polymerase chain reaction as the reference test. A total of 7562 samples from six studies were available for the meta-analysis. The overall pooled sensitivity and specificity of RATs for variants were 69.7% (95% confidence interval [CI] = 62.5% to 76.1%) and 100.0% (95% CI = 98.8% to 100.0%), respectively. When an additional 2179 samples from seven studies reporting sensitivities only were assessed, the pooled sensitivity dropped to 50.0% (95% CI = 44.0% to 55.0%). These findings suggest reassessment and monitoring of the diagnostic utility of RATs for variants, especially for the sensitivity aspect, to facilitate appropriate diagnosis and management of COVID-19 patients.
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Affiliation(s)
- Jimin Kim
- Division of Healthcare Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency, 400, Neungdong-ro, Gwangjin-gu, Seoul 04933, Korea; (J.K.); (M.C.); (H.-J.L.)
| | - Heungsup Sung
- Departments of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea;
| | - Hyukmin Lee
- Departments of Laboratory Medicine, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea;
| | - Jae-Seok Kim
- Department of Laboratory Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 150, Seongan-ro, Gangdong-gu, Seoul 05355, Korea;
| | - Sue Shin
- Departments of Laboratory Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea;
| | - Seri Jeong
- Departments of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea
| | - Miyoung Choi
- Division of Healthcare Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency, 400, Neungdong-ro, Gwangjin-gu, Seoul 04933, Korea; (J.K.); (M.C.); (H.-J.L.)
| | - Hyeon-Jeong Lee
- Division of Healthcare Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency, 400, Neungdong-ro, Gwangjin-gu, Seoul 04933, Korea; (J.K.); (M.C.); (H.-J.L.)
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Giberti I, Costa E, Domnich A, Ricucci V, De Pace V, Garzillo G, Guarona G, Icardi G. High Diagnostic Accuracy of a Novel Lateral Flow Assay for the Point-of-Care Detection of SARS-CoV-2. Biomedicines 2022; 10:biomedicines10071558. [PMID: 35884863 PMCID: PMC9312898 DOI: 10.3390/biomedicines10071558] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 12/27/2022] Open
Abstract
Highly accurate lateral flow immunochromatographic tests (LFTs) are an important public health tool to tackle the ongoing COVID-19 pandemic. The aim of this study was to assess the comparative diagnostic performance of the novel ND COVID-19 LFT under real-world conditions. A total of 400 nasopharyngeal swab specimens with a wide range of viral loads were tested in both reverse-transcription polymerase chain reaction and ND LFT. The overall sensitivity and specificity were 85% (95% CI: 76.7−90.7%) and 100% (95% CI: 98.7−100%), respectively. There was a clear association between the false-negative rate and sample viral load: the sensitivity parameters for specimens with cycle threshold values of <25 (>3.95 × 106 copies/mL) and ≥30 (≤1.29 × 105 copies/mL) were 100% and 50%, respectively. The performance was maximized in testing samples with viral loads ≥1.29 × 105 copies/mL. These findings suggest that the ND LFT is sufficiently accurate and useful for mass population screening programs, especially in high-prevalence and resource-constrained settings or during periods when the epidemic curve is rising. Other public health implications were also discussed.
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Affiliation(s)
- Irene Giberti
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (I.G.); (E.C.); (G.G.); (G.I.)
| | - Elisabetta Costa
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (I.G.); (E.C.); (G.G.); (G.I.)
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.R.); (V.D.P.); (G.G.)
- Correspondence:
| | - Valentina Ricucci
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.R.); (V.D.P.); (G.G.)
| | - Vanessa De Pace
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.R.); (V.D.P.); (G.G.)
| | - Giada Garzillo
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (I.G.); (E.C.); (G.G.); (G.I.)
| | - Giulia Guarona
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.R.); (V.D.P.); (G.G.)
| | - Giancarlo Icardi
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (I.G.); (E.C.); (G.G.); (G.I.)
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (V.R.); (V.D.P.); (G.G.)
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Tapari A, Braliou GG, Papaefthimiou M, Mavriki H, Kontou PI, Nikolopoulos GK, Bagos PG. Performance of Antigen Detection Tests for SARS-CoV-2: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:1388. [PMID: 35741198 PMCID: PMC9221910 DOI: 10.3390/diagnostics12061388] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) initiated global health care challenges such as the necessity for new diagnostic tests. Diagnosis by real-time PCR remains the gold-standard method, yet economical and technical issues prohibit its use in points of care (POC) or for repetitive tests in populations. A lot of effort has been exerted in developing, using, and validating antigen-based tests (ATs). Since individual studies focus on few methodological aspects of ATs, a comparison of different tests is needed. Herein, we perform a systematic review and meta-analysis of data from articles in PubMed, medRxiv and bioRxiv. The bivariate method for meta-analysis of diagnostic tests pooling sensitivities and specificities was used. Most of the AT types for SARS-CoV-2 were lateral flow immunoassays (LFIA), fluorescence immunoassays (FIA), and chemiluminescence enzyme immunoassays (CLEIA). We identified 235 articles containing data from 220,049 individuals. All ATs using nasopharyngeal samples show better performance than those with throat saliva (72% compared to 40%). Moreover, the rapid methods LFIA and FIA show about 10% lower sensitivity compared to the laboratory-based CLEIA method (72% compared to 82%). In addition, rapid ATs show higher sensitivity in symptomatic patients compared to asymptomatic patients, suggesting that viral load is a crucial parameter for ATs performed in POCs. Finally, all methods perform with very high specificity, reaching around 99%. LFIA tests, though with moderate sensitivity, appear as the most attractive method for use in POCs and for performing seroprevalence studies.
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Affiliation(s)
- Anastasia Tapari
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece; (A.T.); (G.G.B.); (M.P.); (H.M.); (P.I.K.)
| | - Georgia G. Braliou
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece; (A.T.); (G.G.B.); (M.P.); (H.M.); (P.I.K.)
| | - Maria Papaefthimiou
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece; (A.T.); (G.G.B.); (M.P.); (H.M.); (P.I.K.)
| | - Helen Mavriki
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece; (A.T.); (G.G.B.); (M.P.); (H.M.); (P.I.K.)
| | - Panagiota I. Kontou
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece; (A.T.); (G.G.B.); (M.P.); (H.M.); (P.I.K.)
| | | | - Pantelis G. Bagos
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece; (A.T.); (G.G.B.); (M.P.); (H.M.); (P.I.K.)
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Tsao J, Kussman AL, Costales C, Pinsky BA, Abrams GD, Hwang CE. Accuracy of Rapid Antigen vs Reverse Transcriptase-Polymerase Chain Reaction Testing for SARS-CoV-2 Infection in College Athletes During Prevalence of the Omicron Variant. JAMA Netw Open 2022; 5:e2217234. [PMID: 35704320 PMCID: PMC9201670 DOI: 10.1001/jamanetworkopen.2022.17234] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This case series evaluates the performance of rapid antigen tests in detecting SARS-CoV-2 infection in college athletes during prevalence of a dominant Omicron variant.
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Affiliation(s)
- Jessica Tsao
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Andrea L. Kussman
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Cristina Costales
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Benjamin A. Pinsky
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Geoffrey D. Abrams
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Calvin E. Hwang
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
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47
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Keskin AU, Ciragil P, Topkaya AE. Clinical Accuracy of Instrument-Read SARS-CoV-2 Antigen Rapid Diagnostic Tests (Ag-IRRDTs). Int J Microbiol 2022; 2022:9489067. [PMID: 35586835 PMCID: PMC9110244 DOI: 10.1155/2022/9489067] [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: 12/03/2021] [Revised: 02/20/2022] [Accepted: 04/07/2022] [Indexed: 11/17/2022] Open
Abstract
This systematic review (PROSPERO registration number: CRD42021282476) aims to collect and analyse current evidence on real-world performance based on clinical accuracy of instrument-read rapid antigen diagnostic tests (Ag-IRRDTs) for SARS-CoV-2 identification. We used PRISMA Checklist and searched databases (PubMed, Web of Science Core Collection and FIND) for publications evaluating the accuracy of SARS-CoV-2 Ag-IRRDTs as of 30 September 2021, and included 40 independent clinical studies resulting in 48 Ag-IRRDT datasets with 137,770 samples. Across all datasets, pooled Ag-IRRDT sensitivity was 67.1% (95% CI: 65.9%-68.3%) and specificity was 99.4% with a tight CI. Pooled sensitivity and specificity of SARS-CoV-2 Ag-IRRDTs did not demonstrate a significant superiority over SARS-CoV-2 rapid antigen tests which do not require a reader instrument, even in the case where surveillance and screening datasets were excluded from the analysis. Nevertheless, they provide connectivity advantages and remove operator interface (in results-reading) issues. The lower sensitivity of certain brands of Ag-IRRDTs can be overcome in high prevalence areas with high frequency of testing. New SARS-CoV-2 variants are major concern for current and future diagnostic performance of these tests.
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Affiliation(s)
- Ali Umit Keskin
- Department of Biomedical Engineering, Yeditepe University, Istanbul, Turkey
| | - Pinar Ciragil
- Department of Microbiology, Yeditepe University Kozyatagi Hospital, Istanbul, Turkey
| | - Aynur Eren Topkaya
- Department of Microbiology, Yeditepe University Kosuyolu Hospital, Istanbul, Turkey
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48
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Szeghy RE, Stute NL, Province VM, Augenreich MA, Stickford JL, Stickford ASL, Ratchford SM. Six-month longitudinal tracking of arterial stiffness and blood pressure in young adults following SARS-CoV-2 infection. J Appl Physiol (1985) 2022; 132:1297-1309. [PMID: 35439042 PMCID: PMC9126215 DOI: 10.1152/japplphysiol.00793.2021] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can increase arterial stiffness 3–4 wk following infection, even among young, healthy adults. However, the long-term impacts of SARS-CoV-2 infection on cardiovascular health and the duration of recovery remain unknown. The purpose of this study was to elucidate potential long-lasting effects of SARS-CoV-2 infection on markers of arterial stiffness among young adults during the 6 mo following infection. Assessments were performed at months 1, 2, 3, 4, and ∼6 following SARS-CoV-2 infection. Doppler ultrasound was used to measure carotid-femoral pulse wave velocity (cfPWV) and carotid stiffness, and arterial tonometry was used to measure central blood pressures and aortic augmentation index at a heart rate of 75 beats·min−1 (AIx@HR75). Vascular (VCAM-1) and intracellular (ICAM-1) adhesion molecules were analyzed as circulating markers of arterial stiffness. From months 1–6, a significant reduction in cfPWV was observed (month 1: 5.70 ± 0.73 m·s−1; month 6: 4.88 ± 0.65 m·s−1; P < 0.05) without any change in carotid stiffness measures. Reductions in systolic blood pressure (month 1: 123 ± 8 mmHg; month 6: 112 ± 11 mmHg) and mean arterial pressure (MAP; month 1: 97 ± 6 mmHg; month 6: 86 ± 7 mmHg) were observed (P < 0.05), although AIx@HR75 did not change over time. The month 1–6 change in cfPWV and MAP were correlated (r = 0.894; P < 0.001). A reduction in VCAM-1 was observed at month 3 compared with month 1 (month 1: 5,575 ± 2,242 pg·mL−1; month 3: 4,636 ± 1,621 pg·mL−1; P < 0.05) without a change in ICAM-1. A reduction in cfPWV was related with MAP, and some indicators of arterial stiffness remain elevated for several months following SARS-CoV-2 infection, possibly contributing to prolonged recovery and increased cardiovascular health risks. NEW & NOTEWORTHY We sought to investigate potential long-lasting effects of SARS-CoV-2 infection on markers of arterial stiffness among young adults for 6 mo following infection. Carotid femoral pulse wave velocity was significantly reduced while carotid stiffness measures remained unaltered over the 6-mo period. These findings suggest several months of recovery from infection may be necessary for young adults to improve various markers of arterial stiffness, possibly contributing to cardiovascular health and recovery among those infected with SARS-CoV-2.
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Affiliation(s)
- Rachel E Szeghy
- Department of Health & Exercise Science, Appalachian State University, Boone, North Carolina
| | - Nina L Stute
- Department of Health & Exercise Science, Appalachian State University, Boone, North Carolina
| | - Valesha M Province
- Department of Health & Exercise Science, Appalachian State University, Boone, North Carolina
| | - Marc A Augenreich
- Department of Health & Exercise Science, Appalachian State University, Boone, North Carolina
| | - Jonathon L Stickford
- Department of Health & Exercise Science, Appalachian State University, Boone, North Carolina
| | - Abigail S L Stickford
- Department of Health & Exercise Science, Appalachian State University, Boone, North Carolina
| | - Stephen M Ratchford
- Department of Health & Exercise Science, Appalachian State University, Boone, North Carolina
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49
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Jamiruddin MR, Meghla BA, Islam DZ, Tisha TA, Khandker SS, Khondoker MU, Haq MA, Adnan N, Haque M. Microfluidics Technology in SARS-CoV-2 Diagnosis and Beyond: A Systematic Review. Life (Basel) 2022; 12:649. [PMID: 35629317 PMCID: PMC9146058 DOI: 10.3390/life12050649] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 12/22/2022] Open
Abstract
With the progression of the COVID-19 pandemic, new technologies are being implemented for more rapid, scalable, and sensitive diagnostics. The implementation of microfluidic techniques and their amalgamation with different detection techniques has led to innovative diagnostics kits to detect SARS-CoV-2 antibodies, antigens, and nucleic acids. In this review, we explore the different microfluidic-based diagnostics kits and how their amalgamation with the various detection techniques has spearheaded their availability throughout the world. Three other online databases, PubMed, ScienceDirect, and Google Scholar, were referred for articles. One thousand one hundred sixty-four articles were determined with the search algorithm of microfluidics followed by diagnostics and SARS-CoV-2. We found that most of the materials used to produce microfluidics devices were the polymer materials such as PDMS, PMMA, and others. Centrifugal force is the most commonly used fluid manipulation technique, followed by electrochemical pumping, capillary action, and isotachophoresis. The implementation of the detection technique varied. In the case of antibody detection, spectrometer-based detection was most common, followed by fluorescence-based as well as colorimetry-based. In contrast, antigen detection implemented electrochemical-based detection followed by fluorescence-based detection, and spectrometer-based detection were most common. Finally, nucleic acid detection exclusively implements fluorescence-based detection with a few colorimetry-based detections. It has been further observed that the sensitivity and specificity of most devices varied with implementing the detection-based technique alongside the fluid manipulation technique. Most microfluidics devices are simple and incorporate the detection-based system within the device. This simplifies the deployment of such devices in a wide range of environments. They can play a significant role in increasing the rate of infection detection and facilitating better health services.
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Affiliation(s)
| | - Bushra Ayat Meghla
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh; (B.A.M.); (D.Z.I.); (T.A.T.)
| | - Dewan Zubaer Islam
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh; (B.A.M.); (D.Z.I.); (T.A.T.)
| | - Taslima Akter Tisha
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh; (B.A.M.); (D.Z.I.); (T.A.T.)
| | - Shahad Saif Khandker
- Gonoshasthaya-RNA Molecular Diagnostic & Research Center, Dhanmondi, Dhaka 1205, Bangladesh; (S.S.K.); (M.A.H.)
| | - Mohib Ullah Khondoker
- Department of Community Medicine, Gonoshasthaya Samaj Vittik Medical College, Savar, Dhaka 1344, Bangladesh;
| | - Md. Ahsanul Haq
- Gonoshasthaya-RNA Molecular Diagnostic & Research Center, Dhanmondi, Dhaka 1205, Bangladesh; (S.S.K.); (M.A.H.)
| | - Nihad Adnan
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh; (B.A.M.); (D.Z.I.); (T.A.T.)
| | - Mainul Haque
- The Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sugai Besi, Kuala Lumpur 57000, Malaysia
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50
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Kessler HH, Prüller F, Hardt M, Stelzl E, Föderl-Höbenreich E, Pailer S, Lueger A, Kreuzer P, Zatloukal K, Herrmann M. Identification of contagious SARS-CoV-2 infected individuals by Roche's Rapid Antigen Test. Clin Chem Lab Med 2022; 60:778-785. [PMID: 35258234 DOI: 10.1515/cclm-2021-1276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/15/2022] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Rapid antigen tests (RAT) can provide valuable information on the presence or absence SARS-CoV-2 within 15 min without the need of a laboratory. The analytical and diagnostic characteristics of available RATs has led to the question whether they can safely distinguish between infectious and non-infectious patients in an acute care setting. METHODS Three nasopharyngeal swabs for the analysis by RAT, reverse transcriptase real time polymerase chain reaction (RT-qPCR), and a cell culture based infection assay were collected from 67 patients that presented to the emergency department of the University Hospital of Graz (Austria). The first swab was used for on-site RAT testing in the emergency department using the Roche SARS-CoV-2 RAT. The second swab was sent to the central laboratory of the hospital for RT-qPCR with two independent methods (Cepheid Xpert® Xpress SARS-CoV-2 assay and Roche Cobas SARS-CoV-2 Test) and repeat RAT testing using the same commercial test. With the third swab a cell culture-based infection assay was performed. RESULTS The RATs performed from independent samples showed substantial agreement (Cohen's-kappa: 0.73, p<0.001). All patients with a positive RAT had positive RT-qPCR with cycle threshold (ct) values <25. Fifteen out of 55 RAT-negative samples were RT-qPCR positive with ct values between 25 and 40. The inoculation of cell cultures with RT-qPCR negative swabs and RT-qPCR positive swabs with ct values >25 did not induce cytopathic effects that were related to SARS-CoV-2. The infection assays from four RAT-negative patients showed cytopathic effects that were induced by other pathogens. CONCLUSIONS The SARS-CoV-2 RAT from Roche Diagnostics is a valuable tool for managing symptomatic patients. RAT-negative patients may be regarded as non-contagious.
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Affiliation(s)
- Harald H Kessler
- Molecular Diagnostics Laboratory, Diagnostic and Research Institute of Hygiene,Microbiology, and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Florian Prüller
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Melina Hardt
- Diagnostic- and Research Center for Molecular Biomedicine, Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Evelyn Stelzl
- Molecular Diagnostics Laboratory, Diagnostic and Research Institute of Hygiene,Microbiology, and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Esther Föderl-Höbenreich
- Diagnostic- and Research Center for Molecular Biomedicine, Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Sabine Pailer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Andreas Lueger
- Division of Emergency Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Philipp Kreuzer
- Division of Emergency Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Kurt Zatloukal
- Diagnostic- and Research Center for Molecular Biomedicine, Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Markus Herrmann
- Molecular Diagnostics Laboratory, Diagnostic and Research Institute of Hygiene,Microbiology, and Environmental Medicine, Medical University of Graz, Graz, Austria
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