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Topic: Testing and Treatment
December 17, 2020
Inclusion of Pregnant Women in COVID-19 Treatment Trials: A Review and Global Call to Action
A review of COVID-19 treatment trials throughout different timepoints in the pandemic found that a substantial portion of trials listed pregnancy as an exclusion criterion. A review in April found that 80% (124/155) of trials excluded pregnant persons, with a similar finding of 75% (538/722) in July. Among studies focusing on therapeutic drugs (including remdesivir),…
The Accuracy of Healthcare Worker versus Self Collected (2-in-1) Oropharyngeal and Bilateral Mid-Turbinate (OPMT) Swabs and Saliva Samples for SARS-CoV-2
A diagnostic accuracy study (n=401 patients with confirmed COVID-19 diagnosis) found that self-collected oropharynx and mid-turbinate (OMPT) and saliva samples had lower detection rates (75.1% and 74.3%, respectively) than healthcare worker (HCW)-collected OPMT swabs (82.8%). However, the combination of self-collected OMPT and saliva samples performed similarly (86.5% detection rate). The sensitivity of self-collected samples increased…
December 14, 2020
Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19
Receiving baricitinib, a kinase inhibitor that blocks a cytokine signaling pathway, in addition to remdesivir, was associated with shorter recovery time (median 7 vs. 8 days, RR=1.2) and higher odds of improvement at day 15 (OR=1.3) in a double-blind, randomized, placebo-controlled trial involving 1,033 patients hospitalized with COVID-19. The estimate for the risk of death through…
Azithromycin in Hospitalised Patients with COVID-19 (RECOVERY) a Randomised Controlled Open-Label Platform Trial
[Preprint, not peer-reviewed] Receiving azithromycin in addition to usual care was not associated with 28-day mortality (19% vs. 19%) or the duration of hospitalization (12 days vs. 13 days) in a randomized, controlled trial among 7,764 patients hospitalized with COVID-19 in the UK. Results were consistent across subgroups of age, sex, ethnicity, level of respiratory…
December 11, 2020
Multicenter Evaluation of the Clinical Performance and the Neutralizing Antibody Activity Prediction Properties of ten high throughput serological assays used in Clinical Laboratories
In a study evaluating ten enzyme immunoassays and three lateral flow chromatography assays, seven immunoassays were shown to have excellent specificity (98 to 100%) and good to excellent positive predictive values (82 to 100%) when used in a low (5%) seroprevalence setting. Sensitivity values as low as 74% and as high as 95% at ≥15…
Efficacy and harms of remdesivir for the treatment of COVID-19: A systematic review and meta-analysis
A systematic review and meta-analysis found inconclusive results on the efficacy of remdesivir for treating patients with COVID-19 due to the lack of adequately powered and fully reported randomized trials evaluating efficacy and harms of its use in adult hospitalized COVID-19 patients. Piscoya et al. (Dec 10, 2020). Efficacy and harms of remdesivir for the…
Comparison of Estimated SARS-CoV-2 Seroprevalence through Commercial Laboratory Residual Sera Testing and a Community Survey
Estimates of seroprevalence of antibodies against SARS-CoV-2 among residents of metropolitan Atlanta during April-May 2020 ranged from 4.9% to 3.2%. These estimates were based on antibody tests conducted on residual sera from commercial laboratory samples (4.9% seroprevalence) and a community household survey (3.2% seroprevalence). Compared with more representative surveys, the authors conclude that that commercial…
False-negative results of initial RT-PCR assays for COVID-19: A systematic review
A systematic review of 34 studies (12,057 patients) on detection of SARS-CoV-2 by RT-PCR assays at first use estimated a false-negative rate of 13% (95% CI 9% to 19%), though identified substantial heterogeneity between studies, which ranged in their individual estimates from 1.8% to 58%. The authors were unable to investigate most potential sources of…
December 10, 2020
Multi-Center Evaluation of the Cepheid Xpert® Xpress SARS-CoV-2/Flu/RSV Test
Evaluation of the Xpert Xpress SARS-CoV-2/Flu/RSV panel test showed high sensitivity and accuracy to distinguish SARS-CoV-2 from influenza and respiratory syncytial virus (RSV). Among 319 nasopharyngeal swab specimens (n=228 positive for SARS-CoV-2, influenza, or RSV; n=91 negative for all 3 infections), positive agreement for SARS-CoV-2 was 98.7% (n=74/75) and negative agreement was 100% (n=91), while…
December 8, 2020
Dynamics and Correlation Among Viral Positivity, Seroconversion, and Disease Severity in COVID-19
Being critically ill was an independent risk factor of longer PCR-confirmed viral positivity in a retrospective study of 2,142 COVID-19 patients in Wuhan, China. The observed median duration of PCR-confirmed viral positivity was 24 days among critically ill patients and 18 days among non-critically ill-patients, with 20% of samples remaining positive after 5 weeks. Seroconversion…
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