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Topic: Testing and Treatment
February 5, 2021
Saliva is more sensitive than nasopharyngeal or nasal swabs for diagnosis of asymptomatic and mild COVID-19 infection
Saliva was found to be more sensitive for the detection of SARS-CoV-2 when compared to NP swab or self-administered nasal swab in a cohort of migrant workers in Singapore. Subjects who presented with acute respiratory infection, their asymptomatic roommates, and prior confirmed cases who were undergoing isolation at a community care facility underwent serial RT-PCR…
Large-scale analysis of SARS-CoV-2 spike-glycoprotein mutants demonstrates the need for continuous screening of virus isolates
[Pre-print, not peer reviewed] An analysis of SARS-CoV-2 genome sequences from around the world found that the overall rate of non-synonymous mutations in the spike protein was low. While only 14% of the samples contained no variation from the reference sequence, fewer than 10 non-synonymous mutations were found in 99.98% of samples. Recurrent variations were…
February 4, 2021
Rapid, Sensitive, and Specific Severe Acute Respiratory Syndrome Coronavirus 2 Detection: A Multicenter Comparison Between Standard Quantitative Reverse-Transcriptase Polymerase Chain Reaction and CRISPR-Based DETECTR
The DETECTR assay (a combination of RT-LAMP and RT-Cas12-RNP) was found to have similar sensitivity but superior specificity to detect SARS-CoV-2 when compared to qRT-PCR on 378 patient samples derived from routine testing. Since the DETECTR assay is not as susceptible to false negatives from N-gene mutations and not as resource intensive to perform, the…
February 3, 2021
The Limit of Detection Matters: The Case for Benchmarking Severe Acute Respiratory Syndrome Coronavirus 2 Testing
A study modeling the clinical sensitivity of assays to detect SARS-CoV-2 based on their limits of detection (LoD) found that each 10-fold increase in LoD was expected to lower the assay sensitivity by about 13%. Ct values were obtained from 4,700 SARS-CoV-2 positive patients using the Abbott SARS-CoV-2 EUA test. The authors argue that assays…
Azithromycin in Patients Admitted to Hospital with COVID-19 (RECOVERY): A Randomised, Controlled, Open-Label, Platform Trial
A randomized open-label trial (RECOVERY) of azithromycin for COVID-19 found no significant differences in survival (rate ratio=0.97), duration of hospital stay (median 10 vs 11 days), or proportion of patients discharged from the hospital alive within 28 days (RR=1.04) between participants receiving azithromycin versus usual care. Among patients not receiving mechanical ventilation at baseline, no…
February 2, 2021
Rapid Expert Consultation on Allocating COVID-19 Monoclonal Antibody Therapies and Other Novel Therapeutics (January 29, 2021)
Around 75% of the 641,000 COVID-19 monoclonal antibody (mAb) therapies allocated by the Department of Health and Human Services to states and local territories were not administered in the period before January 6, 2021. As a response, a rapid consultation by the National Academies of Sciences, Engineering, and Medicine identified potential barriers, including the limited…
January 29, 2021
Characteristics and outcomes of clinically diagnosed RT-PCR swab negative COVID-19: a retrospective cohort study
One in five symptomatic patients admitted to the medical department who had a negative SARS-CoV-2 swab received a clinical diagnosis of COVID-19 according to a retrospective cohort study from two large London hospitals. Swab-negative clinical COVID-19 cases were defined as (a) clinical COVID-19 or high level of suspicion as defined by the treating medical team…
A Rapid and Low-Cost protocol for the detection of B.1.1.7 lineage of SARS-CoV-2 by using SYBR Green-Based RT-qPCR
[Pre-print, not peer-reviewed] Abdel-Sater et al. reported the development of a rapid molecular test to identify the SARS-CoV-2 B.1.1.7 (UK) variant using a set of RT-PCR primers that were designed to confirm the deletion mutations Δ69/Δ70 in the spike and the Δ106/Δ107/Δ108 in the NSP6 gene. The large-scale screening method may help bypass the need…
January 28, 2021
Performance Characteristics of BinaxNOW COVID-19 Antigen Card for Screening Asymptomatic Individuals in a University Setting
The BinaxNow Antigen Card showed low analytical sensitivity (53%) for detecting SARS-CoV-2 infection in a population of asymptomatic or pre-symptomatic individuals when compared to RT-PCR testing for SARS-CoV-2. Okoye et al. (Jan 27, 2021). Performance Characteristics of BinaxNOW COVID-19 Antigen Card for Screening Asymptomatic Individuals in a University Setting. Journal of Clinical Microbiology. https://doi.org/10.1128/JCM.03282-20
Efficacy of Colchicine in Non-Hospitalized Patients with COVID-19
[Pre-print, not peer-reviewed] In a randomized, double-blinded, placebo-controlled trial (n=4,159), the anti-inflammatory medication colchicine reduced the rate of COVID-19-associated hospitalization or death among high-risk participants with COVID-19 who were not yet hospitalized. Participants who received colchicine for 30 days experienced 25% lower odds of hospitalization (95% CI 0.57-0.99), but not statistically significant lower odds for…
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