Result for
Topic: Testing and Treatment
August 10, 2020
Comparing Nasopharyngeal Swab and Early Morning Saliva for the Identification of SARS-CoV-2
Among 217 asymptomatic adult males who had tested positive for SARS-CoV-2 and had subsequently been isolated at a quarantine center for 8 to 10 days, 160 (74%) tested positive again based on saliva, nasopharyngeal swab, or both. The detection rate for SARS-CoV-2 was higher in saliva compared to nasopharyngeal swab testing (93% vs. 53%). Concordance between the two tests was 46%. Rao…
August 6, 2020
Rapid GMP-Compliant Expansion of SARS-CoV-2-Specific T Cells from Convalescent Donors for Use as an Allogeneic Cell Therapy for COVID-19
[Preprint, not peer-reviewed] Cooper et al. isolated CD4 and CD8 memory T cells specific to SARS-CoV-2 spike, nucleocapsid, and membrane antigens from convalescent plasma donors who had recovered from mild SARS-CoV-2 infection. They report that these T cells can be rapidly expanded to therapeutic doses while maintaining the desired central memory phenotype required for protective immune responses against severe COVID-19 infections. Cooper et al. (Aug 5, 2020). Rapid GMP-Compliant Expansion of SARS-CoV-2-Specific…
August 5, 2020
SARS-CoV-2 Virus Culture and Subgenomic RNA for Respiratory Specimens from Patients with Mild Coronavirus Disease
SARS-CoV-2 viral culture data from patients with predominantly mild COVID-19 (n=35) suggests that patients with mild to moderate illness might be less contagious 8 days after symptom onset. Perera et al. found that 16/68 specimens were positive by viral culture, and that all of the positive specimens came from the first 8 days following symptom onset, although participants continued to have detectable viral RNA by PCR for up to 67 days. They conclude that…
Challenges in Use of Saliva for Detection of SARS CoV-2 RNA in Symptomatic Outpatients
Landry et al. found that real-time RT-PCR of pure saliva samples had an overall sensitivity for SARS CoV-2 RNA detection of 85.7 % when compared to simultaneously collected nasopharyngeal swab samples. More than 33% of the saliva samples were initially too thick or stringy to be pipetted efficiently, requiring an additional sample preparation step before testing. The…
August 4, 2020
Antibody Response against SARS-CoV-2 Spike Protein and Nucleoprotein Evaluated by 4 Automated Immunoassays and 3 ELISAs
To measure sensitivity of antibody response against SARS-CoV-2 spike protein and nucleoprotein, 4 automated immunoassays (Roche Abbott, Diasorin, and Snibe) and 3 ELISAs (2 from Euroimmun and Mikrogen) were evaluated using samples from 114 patients with moderate, severe, or critical COVID-19 and 113 pre-pandemic samples. Three weeks post-symptom onset, sensitivity was 100%. Specificity varied from 94.7% to 100%; using a ROC curve to estimate cut-offs corresponding to specificities of 95% and 97.5%, the Roche assay (all…
Evaluation of Serological SARS-CoV-2 Lateral Flow Assays for Rapid Point of Care Testing
[pre-print, not peer-reviewed] Conklin et al. evaluated 15 different rapid point-of-care tests for SARS-CoV-2 antibodies from 40 SARS-CoV-2 infected, convalescent individuals (average 45 days post-symptom onset) and 60 pre-pandemic samples from negative control individuals (known to be infected with other respiratory viruses; rhinoviruses and coronaviruses). Overall, sensitivity ranged from 55-97%, and specificity ranged from 78-100%. Sensitivity and specificity values were higher for IgG alone than for IgM alone. Cross–reactivity was more pronounced…
Interim Results of a Phase II/III Multicenter Randomized Clinical Trial of AVIFAVIR in Hospitalized Patients with COVID-19
[pre–print, not peer-reviewed] Ivashchenko et al. report on a phase II/III randomized clinical trial of the antiviral agent favipiravir. Hospitalized patients with pneumonia and confirmed SARS-CoV-2 infection (n=60) were randomized in a 1:1:1 ratio to receive low-dose favipiravir, high-dose favipiravir, or standard of care (SOC). Patients receiving favipiravir (both arms combined) were more likely than patients in SOC arm to have viral clearance by day 5 (63% vs 30%) and have lower median time to fever resolution (2 vs 4 days). Improvements in chest CT…
August 3, 2020
Drug Treatments for Covid-19: Living Systematic Review and Network Meta-Analysis
A network meta-analysis of 23 RCTs evaluating treatments for COVID-19 found that glucocorticoids were the only intervention with evidence for a reduction in mortality compared with standard care (risk difference 37 fewer per 1000 patients, 95%CI 11-63) and need for mechanical ventilation (31 fewer per 1000 patients, 95%CI 9-47). Three drugs might reduce symptom duration compared with standard care: hydroxychloroquine (mean difference -4.5…
Utility of Repeat Testing for COVID-19: Lab Stewardship When the Stakes Are High
There may be little benefit of repeat SARS-CoV-2 PCR testing within 7 days after a negative test in patients who present early in their illness in a low-prevalence setting. Among 275 patients with initially negative (94%) or inconclusive (6%) nasopharyngeal PCR tests in Omaha, Nebraska who were tested serially between March-April 2020, only 1 (1/275) was positive on the 2nd test, and only 1…
July 31, 2020
Pooled RNA Sample Reverse Transcriptase Real Time PCR Assay for SARS CoV-2 Infection: A Reliable, Faster and Economical Method
Gupta et al. demonstrate that pool testing with 8 RNA samples analyzed with RT-qPCR can achieve a sensitivity of 95.4%, a specificity of 100% (280 samples tested: 40 positive and 240 negative). The authors conclude that the results of pool testing are not affected by the number of positive samples in a pool, suggesting the utility of pooled testing at…
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