Alliance for Pandemic Preparedness

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Topic: Testing and Treatment


May 6, 2020

Test Agreement Between Roche Cobas 6800 and Cepheid GeneXpert Xpress SARS-CoV-2 Assays at High Cycle Threshold Ranges

Broder et al. compared the positive test agreement between the Roche cobas 6800 assay and the Cepheid GeneXpert Xpress SARS-CoV-2 assay. Thirty-five nasopharyngeal samples with low viral loads (cycle threshold values >30) from the cobas 6800 were run on the GeneXpert platform. The close agreement between the two tests conducted on samples with low viral concentration indicates that the two assays could be used interchangeable in accordance with testing algorithms.  Broder et al. (May…


Tocilizumab for the Treatment of Severe COVID-19

Alattar et al. report a case series from 25 patients who had severe COVID-19 and received tocilizumab therapy, an interleukin-6 inhibitor that may ameliorate the inflammatory manifestations. During the 14 days of follow-up, tocilizumab was associated with dramatic decline in inflammatory markers, radiological improvement, and reduced ventilator support requirements. However, the majority (92%) of patients experienced at least one adverse event. Adequately…


May 5, 2020

Evaluation of a COVID-19 IgM and IgG Rapid Test; an Efficient Tool for Assessment of Past Exposure to SARS-CoV-2

Hoffman et al. evaluated a commercially available test developed for rapid (<15 minutes) detection of SARS-CoV-2 antibodies – the COVID-19 IgG/IgM Rapid Test Cassette. Among 19 RT-PCR confirmed COVID-19 cases and 124 negative controls, the authors estimated the assay to have 69% and 93.1% sensitivity for IgM and IgG, respectively. The assay specificities were 100% and…


May 4, 2020

Early Detection of SARS-CoV-2 Antibodies in COVID-19 Patients as a Serologic Marker of Infection

Using CHO cell expressed full length SARS-CoV-2 S1 protein as capturing antigen, Zhao et al. develop and validate a rapid COVID-19 serology ELISA kit able to detect SARS-CoV-2 antibody 1 day after the onset of COVID-19. The reported specificity and sensitivity of the ELISA kit was 97.5% and 97.1%, respectively, with overall accuracy rate of 97.3% (based on…


Evaluation of COVID-19 RT-QPCR Test in Multi-Sample Pools

Many healthcare systems are experiencing shortages of reagents for SARS-CoV-2 diagnostic testing. These authors were able to detect a single positive sample in pools of up to 32 negative samples, either before or after RNA extraction, with an estimated false negative rate of 10%. Single positive samples could also be recovered from pools of 64 (the highest…


Remdesivir in Adults with Severe COVID-19 : A Randomised, double-blind, placebo-controlled, multicentre trial

A randomized, double-blind, placebo controlled multicenter trial at ten hospitals in Hubei, China with 237 participants (158 randomized to remdesivir, 79 to placebo) demonstrated that time to clinical improvement did not differ by study arm, with 21 days (IQR 13-28 days) in the remdesivir group versus 23 days (IQR 15-28 days) in the placebo group (HR 1.23, 95% CI 0.87 – 1.75). Overall frequency of adverse events was similar in both…


Risk of QT Interval Prolongation Associated With Use of Hydroxychloroquine With or Without Concomitant Azithromycin Among Hospitalized Patients Testing Positive for Coronavirus Disease 2019 (COVID-19)

Use of hydroxychloroquine can increase the risk of corrected QT (QTc) prolongation, a type of cardiac arrhythmia. Among 90 patients in an academic tertiary care center in Boston with at least one positive test for SARS-CoV-2, QTc was significantly longer after initiation of hydroxychloroquine, and this effect stronger for patients receiving both hydroxychloroquine and azithromycin. The authors recommend judicious…


Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19

Using medical records from 169 hospitals in Asia, Europe, and North America, from 8,910 COVID-19 patients with known discharge status, these authors found the following factors were positively association with risk of death (i.e., higher value of the factor associated with higher risk of death): age >65 years, coronary artery disease, heart failure, cardiac arrhythmia, COPD, current smoking. Odds ratio were between 1.79 and 2.95 for all factors. For…


May 3, 2020

Direct Diagnostic Testing of SARS-CoV-2 without the Need for Prior RNA Extraction

[pre-print, not peer reviewed] Wei et al. report on a novel method for nucleic acid amplification testing (NAAT) for point-of-care SARS-CoV-2 diagnostic testing [Loop-mediated isothermal amplification (LAMP)]. This assay can be run directly on transport media following a nasopharyngeal swab without requiring an RNA extraction step prior to amplification of the viral RNA, and provides results in 30 minutes. The…


May 1, 2020

Estimating Seroprevalence with Imperfect Serological Tests: A Cutoff-Free Approach

Serological tests, which measure antibody responses against pathogens, are useful for retroactively determining the total number of cumulative SARS-CoV-2 infections that have occurred within a population (i.e. seroprevalence). Bouman et al. propose a likelihood-based method for estimating population-level seroprevalence that may overcome the deficits of serological tests for SARS-CoV-2 with low sensitivity. They use simulations…



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