Multicenter evaluation of the Panbio™ COVID-19 rapid antigen-detection test for the diagnosis of SARS-CoV-2 infection

ObjectivesThe standard RT-PCR assay for coronavirus disease 2019 (COVID-19) is laborious and time-consuming, limiting testing availability. Rapid antigen-detection tests are faster and less expensive; however, the reliability of these tests must be validated before they can be used widely. The objective of this study was to determine the performance of the Panbio? COVID-19 Ag Rapid Test Device (PanbioRT) (Abbott) in detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in nasopharyngeal swab specimens.MethodsThis prospective multicentre study was carried out in ten Spanish university hospitals and included individuals with clinical symptoms or epidemiological criteria of COVID-19. Only individuals with ≤7 days from the onset of symptoms or from exposure to a confirmed case of COVID-19 were included. Two nasopharyngeal samples were taken to perform the PanbioRT as a point-of-care test and a diagnostic RT-PCR test.ResultsAmong the 958 patients studied, 325 (90.5%) had true-positive results. The overall sensitivity and specificity for the PanbioRT were 90.5% (95%CI 87.5–93.6) and 98.8% (95%CI 98–99.7), respectively. Sensitivity in participants who had a threshold cycle (C_T) < 25 for the RT-PCR test was 99.5% (95%CI 98.4–100), and in participants with ≤5 days of the clinical course it was 91.8% (95%CI 88.8–94.8). Agreement between techniques was 95.7% (κ score 0.90; 95%CI 0.88–0.93).ConclusionsThe PanbioRT performs well clinically, with even more reliable results for patients with a shorter clinical course of the disease or a higher viral load. The results must be interpreted based on the local epidemiological context.     

Field evaluation of a rapid antigen test (Panbio™ COVID-19 Ag Rapid Test Device) for COVID-19 diagnosis in primary healthcare centres

ObjectivesTo our knowledge no previous study has assessed the performance of a rapid antigen diagnostic immunoassay (RAD) conducted at the point of care (POC). We evaluated the Panbio? COVID-19 Ag Rapid Test Device for diagnosis of coronavirus 2019 disease (COVID-19) in symptomatic patients (n = 412) attending primary healthcare centres.MethodsRAD was performed immediately after sampling following the manufacturer's instructions (reading at 15 min). RT-PCRs were carried out within 24 h of specimen collection. Samples displaying discordant results were processed for culture in Vero E6 cells. Presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in cell cultures was confirmed by RT-PCR.ResultsOut of 412 patients, 43 (10.4%) tested positive by RT-PCR and RAD, and 358 (86.9%) tested negative by both methods; discordant results (RT-PCR+/RAD–) were obtained in 11 patients (2.7%). Overall specificity and sensitivity of rapid antigen detection (RAD) was 100% (95%CI 98.7–100%) and 79.6% (95%CI 67.0–88.8%), respectively, taking RT-PCR as the reference. Overall RAD negative predictive value for an estimated prevalence of 5% and 10% was 99% (95%CI 97.4–99.6%) and 97.9% (95%CI 95.9–98.9), respectively. SARS-CoV-2 could not be cultured from specimens yielding RT-PCR+/RAD– results (n = 11).ConclusionThe Panbio? COVID-19 Ag Rapid Test Device performed well as a POC test for early diagnosis of COVID-19 in primary healthcare centres. More crucially, the data suggested that patients with RT-PCR-proven COVID-19 testing negative by RAD are unlikely to be infectious.     

COVID-19 or not COVID-19? Compared characteristics of patients hospitalized for suspected COVID-19

European Journal of Clinical Microbiology & Infectious Diseases - During an epidemic period, we compared patients hospitalized for initial suspicion of COVID-19 but for whom an alternative...     

Immunological characteristics govern the transition of COVID-19 to endemicity

We are currently faced with the question of how the CoV-2 severity may change in the years ahead.Our analysis of immunological and epidemiological data on endemic human coronaviruses(HCoVs)shows that infection-blocking immunity wanes rapidly,but disease-reducing immunity is long-lived.Our model,incorporating these components of immunity,recapitulates both the current severity of CoV-2 and the benign nature of HCoVs,suggesting that once the endemic phase is reached and primary exposure is in childhood,CoV-2 may be no more virulent than the common cold.     

Epidemiology of COVID-19: What changed in one year?

A coronavirus brought the first pandemic attack of this century as a flu virus did a hundred years ago. This greatest pandemic of the century brings us new opportunities to understand and explore the dynamics of a contagious disease. Nearly two years later, we are still collecting the evidence to understand the disease. Some basic epidemiological properties are still urgently needed. Not only the origin of the virus but also Ro value, possible transmission routes, epidemiologic curves, case fatality rates, seasonality, severity and mortality risk factor, effects on the risk groups, differences between countries and so on still require strong evidence prior to making final suggestions. In this review, we tried to evaluate the epidemiological evidence to scrutinize where exactly we are in this pandemic.     

COVID-19疫情中的生物力学问题

新型冠状病毒肺炎自爆发以来,已成为全球关注的焦点。由于疫情来势迅猛,给医疗制度体系、医疗资源、应急处置、医疗器械等提出了严峻的挑战,也暴露出其中诸多不足。以病毒的体外活性规律研究、气溶胶传播的生物力学问题、呼吸性疾病对心血管疾病影响的研究、公共交通和公共场所中通风方式的改进、医疗器械的生物力学研究为例,应用生物力学的原理、观点和方法,认识和剖析其中所存在和亟待改进的问题,期望生物力学能在疫情防控中发挥学科优势和力量,以此促进生物力学学科发展。     

The use of rapid test QuikRead go® Strep A in bacterial pharyngotonsillitis diagnosing and therapeutic decisions

Group A Streptococci (GAS) are the main causative agents of bacterial pharyngitis, which require antibiotic therapy. Rapid diagnostic tests detecting GAS combined with Centor/McIsaac score enable accurate differential diagnosis (viral vs. bacterial) and prompt commencement of targeted treatment. The aim of this study was to assess the specificity, sensitivity, PPV and NPV of QuikRead go® Strep A (Orion Diagnostica Oy, Finland) recommended for the detection of GAS in pharyngeal swabs. Quick diagnostic test results were compared with physical examination findings, Centor/McIsaac score and results of reference testing (conventional microbial cultures). The study group of 96 participants consisted of 44 women (46%) and 52 men (54%); children aged 3–14 years constituted 46% of the patients. S. pyogenes were cultured from 43 of 96 pharyngeal swabs. Almost half of all positive samples (47%, n = 20) were collected from children aged 3 to 14 years. Positive GAS cultures were confirmed in 33% of patients with Centor/McIsaac score of 2 points, 48% of patients with score of 3, and 50% of patients with score of 4–5. Microbial cultures confirmed the positive results of QuikRead go® Strep A test in 83% of cases. Test specificity and sensitivity were calculated for the entire study group, which were 85% and 91%, respectively. The PPV of the test was 83% and its NPV was 92%. Using quick tests to detect GAS antigens appears a good alternative to conventional microbial diagnosis of strep throat, as it enables making a diagnosis and deciding on treatment plan in one appointment.     

How Taiwan has responded to COVID-19 and how COVID-19 has affected Taiwan, 2020–2022

From January 2020 to December 2022, there was a total of 8,872,955 confirmed COVID-19 cases in Taiwan. In addition, a total of 15,253 COVID-19 related deaths were reported. During these three years, the government and health authority did many efforts to response this pandemic. In the early pandemic, Taiwan Central Epidemic Command Center was established in the early 2020 to organize associated resource, develop effective policy and implement strict intervention. In response to COVID-19 pandemic, many infection control policy and interventions, including universal mask wearing with increasing production of face mask, hand hygiene, border control, introduce of digital technology incorporating big data, quarantine of COVID-19 cases, travel and gathering restriction, were implemented. In the meanwhile, two COVID-19 vaccines, namely MVC-COV1901 and UB-612, have been developed under the support of government. Furthermore, MVC-COV1901 was taken into clinical practice after received emergency use approval. In addition, two traditional Chinese medicines, including NRICM101 and NRICM102 showed their promising effect against SARS-CoV-2 infection and were recommended as potential therapeutic options for COVID-19. During the pandemic, the nonpharmacologic intervention help reduce many infectious diseases, especially for airborne/droplet-transmitted diseases. However, COVID-19 exhibited some adverse impacts on the healthcare systems, such as emergency medical service on out of hospital cardiac arrest, cancer screening, HIV screening and prevention services, and public health, namely the psychosocial status of healthcare workers. Although the outbreak of SARS-CoV-2 infections may gradually subsided, we should keep monitoring its associated impact and appropriately response to this pandemic.     

COVID-19 in patients with pre-existing chronic liver disease – predictors of outcomes

Coronavirus disease 2019 (COVID-19) has affected patients with pre-existing chronic liver disease (CLD) in various ways. The maximum impact was seen on patients with underlying cirrhosis who have shown to have poor clinical outcomes in the form of increased risk of hepatic decompensation, acute-on-chronic liver failure, and even mortality. It is of paramount importance to identify various factors which are associated with unfavorable outcomes for prognostication and making informed management strategy. Many factors have been evaluated in different studies in patients with underlying CLD. Some of these factors include the severity of underlying chronic liver disease, comorbid conditions, age, and severity of COVID-19. Overall, the outcomes are not fav-orable in patients with cirrhosis as evidenced by data from various studies. The main purpose of this review is to identify the predictors of adverse clinical outcomes including mortality in patients with CLD for risk stratification, prognostication, and appropriate clinical management.     

Are Mechanically Ventilated Patients with COVID-19 More Likely to Die Than Those without COVID-19? Perhaps Not

How to cite this article: Divatia JV. Are Mechanically Ventilated Patients with COVID-19 More Likely to Die Than Those without COVID-19? Perhaps Not. Indian J Crit Care Med 2021;25(12):1341–1342.     

Characterizing Wuhan residents’ mask-wearing intention at early stages of the COVID-19 pandemic

ObjectiveAs an effective measure to prevent the COVID-19 pandemic, wearing mask is widely recommended in countries around the world. This study aims to identify factors that explain the behavioral intention of Wuhan City urban residents to wear masks.MethodsA theoretical model was extended on UTAUT by incorporating the feature on residents having relevant knowledge and sufficient awareness on the pandemic. During early stages of the COVID-19 outbreak, an online survey was conducted in Wuhan City and 728 valid samples were collected from 35 communities. Structural equations modeling and bootstrapping were applied.ResultsSample data present acceptable reliability and validity. Performance expectancy, effort expectancy, social influence, and knowledge about COVID-19 have positive effects on behavioral intention. Facilitating condition, knowledge, and behavioral intention have significant effects on use behavior. Gender, age, education, income, and current marital status are significant moderators in the theoretical model.ConclusionHaving relevant knowledge on the pandemic, together with performance expectancy, effort expectancy, social influence, and facilitating condition, affects behavioral intention and usage behavior of Wuhan residents to wear masks at early stages of the COVID-19 pandemic. Subgroups have different psychological mechanisms based on their demographic characteristics.Practice implicationsHealth policy makers should focus on enhancing residents’ knowledge on infectious disease and their awareness of the risk mitigation, and develop personalized measures for different subgroups.     

Reinfection risk of novel coronavirus (COVID-19): A systematic ‎review of current evidence

BACKGROUNDThere is recently a concern regarding the reinfection and reactivation of previously reCoVered coronavirus disease 2019 (CoVID-19) patients.AIMTo summarize the recent findings and reports of CoVID-19 reinfection in patients previously reCoVered from the disease.METHODSThis study was a systematic review of current evidence conducted in August 2020. The authors studied the probable reinfection risk of novel coronavirus (CoVID-19). We performed a systematic search using the keywords in online databases. The investigation adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to ensure the reliability and validity of this study and results.RESULTSWe reviewed 31 studies. Eight studies described reCoVered patients with reinfection. Only one study reported reinfected patients who died. In 26 studies, there was no information about the status of the patients. Several studies indicated that reinfection is not probable and that post-infection immunity is at least temporary and short.CONCLUSIONBased on our review, we concluded that a positive polymerase chain reaction retest could be due to several reasons and should not always be considered as reinfection or reactivation of the disease. Most relevant studies in positive retest patients have shown relative and probably temporary immunity after the reCoVery of the disease.     

The roles of nausea and vomiting in COVID-19: did we miss something?

The Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an international public health emergency. Although respiratory symptoms predominate the clinical manifestations of COVID-19, gastrointestinal symptoms have been observed in a subset of patients. Notably, some patients have nausea/vomiting as the first clinical manifestation of COVID-19, which is often overlooked by people. It is now clear that not only the lungs, the gastrointestinal tract could also be attacked by SARS-CoV-2. Its host receptor angiotensin-converting enzyme 2 (ACE2), which acts as a gateway to infection, has been found to be highly expressed in the gastrointestinal epithelium and may lead to the development of nausea/vomiting. Raise awareness of these symptoms and take timely intervention would help people combat the pandemic. This review discussed epidemiology, mechanisms, management, and prevention of COVID-19 related nausea and vomiting.     

Asymptomatic SARS-COV-2 carriage and sero-positivity in high risk contacts of COVID-19 cases’

PurposeIdentifying asymptomatic SARS-COV-2 carriage is one of the crucial factors in controlling the COVID 19 pandemic. The relationship between the asymptomatic viral carriage and the rate of seroconversion needs better understanding. The present study was conducted to identify the asymptomatic COVID-19 infection and seropositivity in high-risk contacts in the southern district of Delhi, India.MethodsFollowing the screening of 6961 subjects, a total of 407 asymptomatic high-risk subjects were selected. Demographic data, socioeconomic status, and history of COVID-19 related symptoms in the last 4 months were recorded. Blood samples and Nasopharyngeal/oropharyngeal swabs were collected for the detection of SARS-COV-2 RNA and anti-SARS-COV-2 antibodies.Results55 asymptomatic high-risk subjects (13.5%) tested positive for SARS-COV-2 infection and among them, 70.9% remained asymptomatic throughout their course of infection. The seropositivity among the subjects was 28.9% (n ?= ?118) and was found significantly higher among lower-middle socioeconomic strata (p ?= ?0.01). The antibody levels were significantly higher (p ?= ?0.033) in individuals with a previous history of COVID-19 like symptoms as compared to the subjects, who had no such history. Asymptomatic healthcare workers showed a significantly increased rate of SARS-COV-2 infection (p ?= ?0.004) and seropositivity (p ?= ?0.005) as compared to the non-healthcare workers. Subjects, who were exposed to infection at their workplace (non-hospital setting) had the least RT-PCR positivity rate (p ?= ?0.03).ConclusionsA large proportion of SARS-COV-2 infection remains completely asymptomatic. The rate of asymptomatic carriage and seropositivity is significantly higher in healthcare workers as compared to the general population. The level of SARS-COV-2 antibodies is directly related to the appearance of symptoms. These observations may contribute to redefining COVID 19 screening, infection control, and professional health practice strategies.     

COVID-19中国诊疗方案的机器学习智能分析方法

2019年底暴发的新型冠状病毒肺炎(COVID-19)疫情是人类史上一次重大突发公共卫生事件。中国医学工作者在短时间内,经历了对该未知病毒的逐步认识、证据积累和临床实践。截至目前,中国国家卫生健康委员会在数十天内密集发布了七个版本的《新型冠状病毒感染的肺炎诊疗方案》(简称《诊疗方案》)。然而,快速准确地比较各版本的异同和掌握新版本的重点对临床医护人员和非专业人员来说存在一定困难。本文提出一种基于机器学习的计算机辅助智能分析方法,对文本主题进行无监督学习,自动分析不同版本《诊疗方案》的异同,主动给医护人员推送新版本的关注重点,降低《诊疗方案》解读的专业难度,提高非专业人员对诊疗方案的认识水平。实验证明,与人工解读方式相比较,本文方法能自动计算文本主题,实现主题的精准匹配,准确率达100%,并可自动生成关键词和语句级别的解读报告,实现《诊疗方案》的计算机自动智能解读。     

IFN-λ防治COVID-19的潜力与风险

新型冠状病毒（severe acute respiratory syndrome coronavirus-2,SARS-CoV-2）感染引起的新型冠状病毒肺炎（coronavirus disease 2019,COVID-19）在世界范围内广泛流行,造成了前所未有的公共卫生灾难,找到有效的药物和治疗方案显得尤为迫切。本...