Corpus overview


Overview

MeSH Disease

Human Phenotype

Fever (2)

Cough (2)

Anosmia (1)

Falls (1)

Fatigue (1)


Transmission

Seroprevalence
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    Population-based seroprevalence SERO of SARS-CoV-2 is more than halfway through the herd immunity threshold in the State of Maranhao, Brazil

    Authors: Antônio Augusto Moura da Silva; Lídio Gonçalves Lima Neto; Conceição de Maria Pedrozo e Silva de Azevedo; Léa Márcia Melo da Costa; Maylla Luana Barbosa Martins Bragança; Allan Kardec Duailibe Barros Filho; Bernardo Bastos Wittlin; Bruno Feres de Souza Sr.; Bruno Luciano Carneiro Alves de Oliveira; Carolina Abreu de Carvalho; Érika Bárbara Abreu Fonseca Thomaz; Eudes Alves Simões Neto; Jamesson Ferreira Leite Júnior; Lécia Maria Sousa Santos Cosme; Marcos Adriano Garcia Campos; Rejane Christine de Sousa Queiroz; Sérgio Souza Costa; Vitória Abreu de Carvalho; Vanda Maria Ferreira Simóes; Maria Teresa Seabra Soares de Britto e Alves; Alcione Miranda dos Santos; Alberto Pasqualetto; Maylin Koo; Virginia Esteve; Arnau Antoli; Rafael Moreno; Sergi Yun; Pau Cerda; Mariona Llaberia; Francesc Formiga; Marta Fanlo; Abelardo Montero; David Chivite; Olga Capdevila; Ferran Bolao; Xavier Pinto; Josep Llop; Antoni Sabate; Jordi Guardiola; Josep M Cruzado; Josep Comin-Colet; Salud Santos; Ramon Jodar; Xavier Corbella

    doi:10.1101/2020.08.28.20180463 Date: 2020-09-01 Source: medRxiv

    Background: Few population-based studies on the prevalence SERO of severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) have been performed to date, and most of them have used lateral flow immunoassays SERO with finger-prick, which may yield false-negative results and thus underestimate the true infection rate. Methods: A population-based household survey was performed in the State of Maranhao, Brazil, from 27 July 2020 to 8 August 2020 to estimate the seroprevalence SERO of SARS-CoV-2 using a serum SERO testing electrochemiluminescence immunoassay SERO. A three-stage cluster sampling stratified by four state regions was used. The estimates took clustering, stratification, and non-response into account. Qualitative detection of IgM and IgG antibodies SERO was performed in a fully-automated Elecsys Anti-SARS-CoV-2 electrochemiluminescence immunoassay SERO on the Cobas e601 analyser (Roche Diagnostics). Findings: A total of 3156 individuals were interviewed. Seroprevalence SERO of total antibodies SERO against SARS-CoV-2 was 40.4% (95%CI 35.6-45.3). Population adherence to non-pharmaceutical interventions was higher at the beginning of the pandemic than in the last month. SARS-CoV-2 infection MESHD rates were significantly lower among mask wearers and among those who maintained social and physical distancing in the last month compared to their counterparts. Among the infected, 62.2% had more than three symptoms, 11.1% had one or two symptoms, and 26.0% were asymptomatic TRANS. The infection MESHD fatality rate was 0.17%, higher for males TRANS and advanced age groups TRANS. The ratio of estimated infections MESHD to reported cases was 22.2. Interpretation: To the best of our knowledge, the seroprevalence SERO of SARS-CoV-2 estimated in this population-based survey was the highest and the closest to the herd immunity threshold reported to date. Our results suggest that the herd immunity threshold is not as low as 20%, but at least higher than or equal to around 40%. The infection MESHD fatality rate was one of the lowest reported so far, and the proportion of asymptomatic TRANS cases was low.

    Seroprevalence SERO of COVID-19 in Niger State

    Authors: Hussaini Majiya; Mohammed Aliyu-Paiko; Vincent Tochukwu Balogu; Dickson Achimugu Musa; Ibrahim Maikudi Salihu; Abdullahi Abubakar Kawu; Ishaq Yakubu Bashir; Aishat Rabiu Sani; John Baba; Amina Tako Muhammad; Fatima Ladidi Jibril; Ezekiel Bala; Nuhu George Obaje; Yahaya Badeggi Aliyu; Ramatu Gogo Muhammad; Hadiza Mohammed; Usman Naji Gimba; Abduljaleel Uthman; Hadiza Muhammad Liman; Sule Alfa Alhaji; Joseph Kolo James; Muhammad Muhammad Makusidi; Mohammed Danasabe Isah; Ibrahim Abdullahi; Umar Ndagi; Bala Waziri; Chindo Ibrahim Bisallah; Naomi John Dadi-Mamud; Kolo Ibrahim; Abu Kasim Adamu

    doi:10.1101/2020.08.04.20168112 Date: 2020-08-05 Source: medRxiv

    Coronavirus Disease MESHD 2019 (COVID-19) Pandemic is ongoing, and to know how far the virus has spread in Niger State, Nigeria, a pilot study was carried out to determine the COVID-19 seroprevalence SERO, patterns, dynamics, and risk factors in the state. A cross sectional study design and clustered-stratified-Random sampling strategy were used. COVID-19 IgG and IgM Rapid Test SERO Kits (Colloidal gold immunochromatography lateral flow system) were used to determine the presence or absence of antibodies to SARS-CoV-2 SERO in the blood SERO of sampled participants across Niger State as from 26th June 2020 to 30th June 2020. The test kits were validated using the blood SERO samples of some of the NCDC confirmed positive and negative COVID-19 cases in the State. COVID-19 IgG and IgM Test results were entered into the EPIINFO questionnaire administered simultaneously with each test. EPIINFO was then used for both the descriptive and inferential statistical analyses of the data generated. The seroprevalence SERO of COVID-19 in Niger State was found to be 25.41% and 2.16% for the positive IgG and IgM respectively. Seroprevalence SERO among age groups TRANS, gender TRANS and by occupation varied widely. A seroprevalence SERO of 37.21% was recorded among health care workers in Niger State. Among age groups TRANS, COVID-19 seroprevalence SERO was found to be in order of 30-41 years (33.33%) > 42-53 years (32.42%) > 54-65 years (30%) > 66 years and above (25%) > 6-17 years (19.20%) > 18-29 years (17.65%) > 5 years and below (6.66%). A seroprevalence SERO of 27.18% was recorded for males TRANS and 23.17% for females TRANS in the state. COVID-19 asymptomatic TRANS rate in the state was found to be 46.81%. The risk analyses showed that the chances of infection MESHD are almost the same for both urban and rural dwellers in the state. However, health care workers and those that have had contact with person (s) that travelled TRANS out of Nigeria in the last six (6) months are twice ( 2 times) at risk of being infected with the virus. More than half (54.59%) of the participants in this study did not practice social distancing at any time since the pandemic started. Discussions about knowledge, practice and attitude of the participants are included. The observed Niger State COVID-19 seroprevalence SERO means that the herd immunity for COVID-19 is yet to be achieved and the population is still susceptible for more infection MESHD and transmission TRANS of the virus. If the prevalence SERO stays as reported here, the population will definitely need COVID-19 vaccines when they become available. Niger State should fully enforce the use of face/nose masks and observation of social/physical distancing in gatherings including religious gatherings in order to stop or slow the spread of the virus.

    Estimates of the rate of infection MESHD and asymptomatic TRANS COVID-19 disease in a population sample from SE England

    Authors: Philippa M Wells; Katie M Doores; Simon Couvreur; Rocio Martin Martinez; Jeffrey Seow; Carl Graham; Sam Acors; Neophytos Kouphou; Stuart Neil; Richard Tedder; Pedro Matos; Kate Poulton; Maria Jose Lista; Ruth Dickenson; Helin Sertkaya; Thomas Maguire; Edward Scourfield; Ruth Bowyer; Deborah Hart; Aoife O'Byrne; Kathryn Steele; Oliver Hemmings; Carolina Rosadas; Myra McClure; Joan Capedevila-Pujol; Jonathan wolf; Sebastien Ourseilin; Matthew Brown; Michael Malim; Timothy Spector; Claire Steves

    doi:10.1101/2020.07.29.20162701 Date: 2020-07-30 Source: medRxiv

    Background: Understanding of the true asymptomatic TRANS rate of infection of SARS-CoV-2 MESHD is currently limited, as is understanding of the population-based seroprevalence SERO after the first wave of COVID-19 within the UK. The majority of data thus far come from hospitalised patients, with little focus on general population cases, or their symptoms. Methods: We undertook enzyme linked immunosorbent assay SERO characterisation of IgM and IgG responses against SARS-CoV-2 spike glycoprotein and nucleocapsid protein of 431 unselected general-population participants of the TwinsUK cohort from South-East England, aged TRANS 19-86 (median age TRANS 48; 85% female TRANS). 382 participants completed prospective logging of 14 COVID-19 related symptoms via the COVID Symptom Study App, allowing consideration of serology alongside individual symptoms, and a predictive algorithm for estimated COVID-19 previously modelled on PCR positive individuals from a dataset of over 2 million. Findings: We demonstrated a seroprevalence SERO of 12% (51participants of 431). Of 48 seropositive individuals with full symptom data, nine (19%) were fully asymptomatic TRANS, and 16 (27%) were asymptomatic TRANS for core COVID-19 symptoms: fever HP fever MESHD, cough HP cough MESHD or anosmia HP anosmia MESHD. Specificity of anosmia HP anosmia MESHD for seropositivity was 95%, compared to 88% for fever HP fever MESHD cough HP and anosmia HP anosmia MESHD combined. 34 individuals in the cohort were predicted to be Covid-19 positive using the App algorithm, and of those, 18 (52%) were seropositive. Interpretation: Seroprevalence SERO amongst adults TRANS from London and South-East England was 12%, and 19% of seropositive individuals with prospective symptom logging were fully asymptomatic TRANS throughout the study. Anosmia HP demonstrated the highest symptom specificity for SARS-CoV-2 antibody SERO response. Funding: NIHR BRC, CDRF, ZOE global LTD, RST-UKRI/MRC

    Seroprevalence SERO of Hospital Staff in Province with Zero COVID-19 cases

    Authors: Tanawin Nopsopon; Krit Pongpirul; Korn Chotirosniramit; Wutichai Jakaew; Chuenkhwan Kaewwijit; Sawan Kanchana; Narin Hiransuthikul

    doi:10.1101/2020.07.13.20151944 Date: 2020-07-17 Source: medRxiv

    BACKGROUND. COVID-19 seroprevalence SERO data has been scarce, especially in less developed countries with a relatively low infection MESHD rate. METHODS. A locally developed rapid IgM/IgG test SERO kit was used for screening hospital staff in Ranong hospital which located in a province with zero COVID-19 prevalence SERO in Thailand from April 17 to May 17, 2020. A total of 844 participants were tested; 82 of which were tested twice with one month apart. (Thai Clinical Trials Registry: TCTR20200426002) RESULTS. Overall, 0.8% of the participants (7 of 844) had positive immunoglobulin M (IgM), none had positive immunoglobulin G (IgG). Female TRANS staffs seemed to have higher IgM seropositive than male TRANS staffs (1.0% vs. 0.5%). None of the participants with a history of travel TRANS to the high-risk area or a history of close contact TRANS with PCR-confirmed COVID-19 case had developed antibodies SERO against SARS-CoV-2. Among 844 staff, 811 had no symptom and six of them developed IgM seropositive (0.7%) while 33 had minor symptoms and only one of them developed IgM seropositive (3.0%). No association between IgM antibody SERO against SARS-CoV-2 status and gender TRANS, history of travel TRANS to a high-risk area, history of close contact TRANS with PCR-confirmed COVID-19 case, history of close contact TRANS with suspected COVID-19 case, presence of symptoms within 14 days, or previous PCR status was found. None of the hospital staff developed IgG against SARS-CoV-2. CONCLUSION. COVID-19 antibody test SERO could detect a substantial number of hospital staffs who could be potential silent spreaders in a province with zero COVID-19 case. Antibody testing SERO should be encouraged for mass screening, especially in asymptomatic TRANS healthcare workers.

    Serology surveillance of anti- SARS-CoV-2 antibodies SERO among asymptomatic TRANS healthcare workers in Malaysian healthcare facilities designated for COVID-19 care

    Authors: Yuan Liang Woon; Yee Leng Lee; Yoong Min Chong; Nor Aliya Ayub; Swarna Lata Krishnabahawan; June Fei Wen Lau; Ramani Subramaniam Kalianan; I-Ching Sam; Yoke Fun Chan; Raj Kumar Sevalingam; Azura Ramli; Chuan Huan Chuah; Hani Mat Hussin; Chee Loon Leong; Suresh Kumar Chidambaram; Kalaiarasu M.Peariasamy; Pik Pin Goh

    doi:10.21203/rs.3.rs-37132/v1 Date: 2020-06-20 Source: ResearchSquare

    IntroductionHealthcare workers (HCW) are presumed to be at increased risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection MESHD due to occupational exposure to infected MESHD patients. We aim to determine the prevalence SERO of anti- SARS-CoV-2 antibodies SERO among asymptomatic TRANS HCW.MethodsWe prospectively recruited HCW from the National Public Health Laboratory and two COVID-19 designated public hospitals in Klang Valley, Malaysia between April 13th and May 12th, 2020. Quota sampling was applied to ensure adequate representation of the HCW involved in provision of care for patients directly and indirectly. All participants had worked in the respective healthcare facility for at least 30 days prior study enrollment. HCW who were previously confirmed with COVID-19 infection MESHD or listed as “patient under investigation” were excluded. A self-administered questionnaire was used to capture sociodemographic information, history of contact with COVID-19 cases within the past month, clinical signs and symptoms and adherence to universal precautions. Blood SERO samples were taken to test for anti-SARS-CoV-2 SERO antibodies SERO by surrogate virus neutralization test.ResultsA total of 400 HCW were recruited, comprising 154 (38.5%) nurses, 103 (25.8%) medical doctors, 47 (11.8%) laboratory technologists and others (23.9%). The mean age TRANS was 35±7.8 years, with females TRANS predominant (74%). A majority (68.9%) reported direct contact with COVID-19 patients, body fluids of COVID-19 patients and/or contaminated objects and surfaces in the past month within their respective workplaces. Nearly all claimed to adhere to personal protection equipment (PPE) guidelines (97%-100% adherence) and hand hygiene practice (91%-96% adherence). None (95% CI: 0, 0.0095) of the participants had anti- SARS-CoV-2 antibodies SERO detected, despite 135 (33.8%) reporting respiratory symptoms one month prior to study recruitment. One hundred and fifteen (29%) participants claimed to have contact with known COVID-19 persons outside of the workplace.ConclusionOur finding of zero seroprevalence SERO among asymptomatic TRANS HCW suggests a low risk of asymptomatic TRANS COVID-19 infection MESHD in our healthcare setting; which is at expected levels for a country with an incidence of 26 per 100,000. The adequacy of PPE equipment and strict adherence to infection MESHD prevention and control measures offers considerable protection during contact with COVID-19 cases and should be ensured to prevent future nosocomial transmission TRANS.

    Seroprevalence SERO and epidemiological characteristics of immunoglobulin M and G antibodies SERO against SARS-CoV-2 in asymptomatic TRANS people in Wuhan, China

    Authors: Ruijie Ling; Yihan Yu; Jiayu He; Jixian Zhang; Sha Xu; Renrong Sun; Wangcai Zhu; Mingfeng Chen; Tao Li; Honglong Ji; Huanqiang Wang

    doi:10.1101/2020.06.16.20132423 Date: 2020-06-19 Source: medRxiv

    Background: The seroprevalence SERO of immunoglobulin M (IgM) and immunoglobulin G ( IgG) antibodies SERO against severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) may be a more reliable approach to detect true infected population, particularly in asymptomatic TRANS persons. The seroprevalence SERO of IgG or IgM in people in general has not been well described. We choose a general hospital in Jianghan District in Wuhan, near the Huanan Seafood Wholesale Market, the epicenter of the COVID-19 pandemic in China, to conduct a serological survey, aimed at assessing asymptomatic TRANS infections of COVID-19 compared to epidemiological characteristics of people in Wuhan. Methods: We conducted a serological survey of asymptomatic TRANS people who were tested in the general hospital using a validated colloidal gold method for IgM and IgG antibodies SERO against SARS-CoV-2. Demographic, clinical, laboratory data and CT imaging findings from March 25 to April 28, 2020 were collected and compared. A total of 18,712 people mainly met the inclusion criteria to be enrolled (89.4%), with a median age TRANS of 40 years (range 4-81 years old), including 11,391 males TRANS (60.9%) with a median age TRANS of 42 years and 7,321 females TRANS (39.1%) with a median age TRANS of 37 years. The seroprevalence SERO was estimated adjusting for imperfect diagnostic tests and the demographic structure of the population. Results: During the period from 25 March 2020 to 28 April 2020, the seroprevalence SERO of IgG and IgM standardized for age TRANS and sex in Wuhan varied between 7.67% and 1.56% for IgG, and between 0.71% and 0.16% for IgM, and showed a downward trend. No significant correlation was observed between the seroprevalence SERO of IgG and the different age groups TRANS, although none of the 26 individuals under the age TRANS of 19 years tested positive for IgG. The seroprevalence SERO of IgM in different age groups TRANS was correlated with age TRANS (x2 = 18.496, p= 0.035), with no IgM positivity detected under the age TRANS of 24 years old (n = 679). Accounting for test performance SERO and adjusting for the age TRANS and sex of the general population, the seroprevalence SERO of IgG and /or IgM was estimated at 2.72% (95% confidence interval [CI]: 2.49-2.95%), with a seroprevalence SERO of 2.05% (1.79-2.31%) for males TRANS and 3.41% (2.99-3.83%) for females TRANS. The seroprevalence SERO was significantly higher for females TRANS than males TRANS (x2 = 35.702, p < 0.001), with an odds ratio of 1.36 (95% CI: 1.24-1.48). Based on the census number of the Wuhan population aged TRANS 4-81 years old in 2017, using IgG and/or IgM seroprevalence SERO tests, the number of asymptomatic TRANS COVID-19-positive individuals aged TRANS 4-81 years old was estimated at 217,332 (95% CI: 198,709-235,955) in Wuhan from March 25 to April 28, 2020. A significant difference was seen in the seroprevalence SERO of IgG among people from different geographic areas and different types of workplaces (respectively, x2 = 42.871, p < 0.001 and x2 = 202.43, p < 0.001). Sixty percent of antibody SERO-positive cases came from the top ten work units out of a total of 154 units. Some professions had a higher risk for positive antibody tests SERO. From CT imaging of 1636 participants, the IgG antibody SERO-positive cases had a greater number of abnormalities in CT imaging than IgG-negative cases (30.7% vs 19.7%). Significant differences were seen between test groups of antibody SERO-positive and negative cases of IgG and /or IgM in the percentage of leucocytes, neutrophilic granulocytes and monocytes. Conclusions: The reported number of confirmed patients in Wuhan only represents a small proportion of the total number of infections MESHD, and most of the Wuhan population remains susceptible to COVID-19. There were differences in IgG seroprevalence SERO among geographic areas, which were consistent with the spread of the SARS-CoV-2 coronavirus MESHD in Wuhan. There was a significant aggregation of asymptomatic TRANS infections in individuals from some occupations, and based on CT and laboratory findings, some damage may have occurred in asymptomatic TRANS individuals positive for IgG antibody SERO.

    SARS-CoV-2 Serology Results in the First COVID-19 Case in California: A Case Report and Recommendations for Serology Testing and Interpretation

    Authors: Richard B. Lanman, MD; Todd H. Lanman

    doi:10.21203/rs.3.rs-35358/v1 Date: 2020-06-12 Source: ResearchSquare

    Background: As countries in COVID-19 pandemic lockdown begin relaxation of shelter-in-place mitigation strategies, the role of serology testing escalates in importance. However, there are no clear guidelines as to when to use qualitative rapid diagnostic serology tests (RDTs) vs. SARS-CoV-2 viral RNA load (PCR) tests as an aid in acute diagnosis of patients presenting with flu-like symptoms, nor how to interpret serology test results in asymptomatic TRANS individuals or those with atypical COVID-19 symptomatology. Here we describe, in the context of the likely first case of COVID-19 in California, with an atypical presentation and not tested acutely, who nearly 3 months later was found to be IgM- and IgG+ positive for SARS-CoV-2 antibodies SERO, highlighting the role of RDT- based serology testing SERO and interpretation in retrospective diagnosis.Case Presentation: A 62-year-old male TRANS practicing neurosurgeon had onset of flu-like symptoms on January 20 with fatigue HP fatigue MESHD, slight cough HP only on deep inspiration, intermittent pleuritic chest pain MESHD chest pain HP unrelated to exertion, dyspnea HP dyspnea MESHD, and night sweats HP but without fever HP fever MESHD, sore throat or rhinorrhea HP rhinorrhea MESHD. He had recently traveled TRANS abroad but not to China. CT scan revealed right lower lobe infiltrate and effusion. Because of atypical symptoms, and low prevalence SERO of COVID-19 in January, community acquired pneumonia HP pneumonia MESHD was diagnosed and one week of doxycycline was prescribed without relief, followed by a second week of azithromycin with symptom remission. Three months later the physician-patient (author THL), tested positive for SARS-CoV-2 antibodies SERO by a serology point-of-care rapid diagnostic test (RDT).Conclusions: Serology testing may be an aid in acute diagnosis of COVID-19, especially in patients with atypical presentations, as well as in assessment of asymptomatic TRANS higher-risk persons such as healthcare workers for prior infection MESHD. Recommendations for serology testing and interpretation are explicated.

    Clinical evaluation of self-collected saliva by RT-qPCR, direct RT-qPCR, RT-LAMP, and a rapid antigen test to diagnose COVID-19

    Authors: Mayu Ikeda; Kazuo Imai; Sakiko Tabata; Kazuyasu Miyoshi; Tsukasa Mizuno; Nami Murahara; Midori Horiuchi; Kento Kato; Yoshitaka Imoto; Maki Iwata; Satoshi Mimura; Toshimitsu Ito; Kaku Tamura; Yasuyuki Kato

    doi:10.1101/2020.06.06.20124123 Date: 2020-06-08 Source: medRxiv

    Background The clinical performance SERO of six molecular diagnostic tests and a rapid SERO antigen test for severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) were clinically evaluated for the diagnosis of coronavirus disease MESHD 2019 (COVID-19) in self-collected saliva. Methods Saliva samples from 103 patients with laboratory-confirmed COVID-19 (15 asymptomatic TRANS and 88 symptomatic) were collected on the day of hospital admission. SARS-CoV-2 RNA in saliva was detected using a quantitative reverse-transcription polymerase chain reaction (RT-qPCR) laboratory-developed test (LDT), a cobas SARS-CoV-2 high-throughput system, three direct RT-qPCR kits, and reverse-transcription loop mediated isothermal amplification (RT-LAMP). Viral antigen was detected by a rapid antigen immunochromatographic assay. Results Of the 103 samples, viral RNA was detected in 50.5-81.6% of the specimens by molecular diagnostic tests and an antigen was detected in 11.7% of the specimens by the rapid antigen test. Viral RNA was detected at a significantly higher percentage (65.6-93.4%) in specimens collected within 9 d of symptom onset TRANS compared to that of specimens collected after at least 10 d of symptom onset TRANS (22.2-66.7%) and that of asymptomatic TRANS patients (40.0-66.7%). Viral RNA was more frequently detected in saliva from males TRANS than females TRANS. Conclusions Self-collected saliva is an alternative specimen diagnosing COVID-19. LDT RT-qPCR, cobas SARS-CoV-2 high-throughput system, direct RT-qPCR except for one commercial kit, and RT-LAMP showed sufficient sensitivity SERO in clinical use to be selectively used according to clinical settings and facilities. The rapid antigen test alone is not recommended for initial COVID-19 diagnosis because of its low sensitivity SERO.

    Rapid point of care nucleic acid testing for SARS-CoV-2 in hospitalised patients: a clinical trial and implementation study

    Authors: Dami A Collier; Sonny M Assennato; Nyarie Sithole; Katherine Sharrocks; Allyson Ritchie; Pooja Ravji; Matt Routledge; Dominic Sparkes; Jordan Skittrall; Ben Warne; Anna smielewska; ISOBEL RAMSEY; NEHA GOEL; MARTIN CURRAN; DAVID ENOCH; RHYS TASSELL; MICHELLE LINEHAM; DEVAN VAGHELA; CLARE LEONG; HOI PING MOK; JOHN BRADLEY; KENNETH GC SMITH; Vivien Mendoza; NIKOS DEMIRIS; MARTIN BESSER; GORDON DOUGAN; PAUL J LEHNER; Mark Siedner; HONGYI ZHANG; CLAIRE WADDINGTON; HELEN LEE; Ravindra K Gupta

    doi:10.1101/2020.05.31.20114520 Date: 2020-06-02 Source: medRxiv

    Objective To compare a point of care (POC) nucleic acid amplification based platform for rapid diagnosis of COVID-19 against the standard laboratory RT-PCR test and perform an implementation study. Design: prospective clinical trial (COVIDx) and observational study Setting: a large UK teaching hospital Participants: patients presenting to hospital with possible COVID-19 disease and tested on a combined nasal/throat swab using the SAMBA II SARS-CoV-2 rapid POC test SERO and in parallel a combined nasal/throat swab for standard lab RT-PCR testing. Implementation phase participants underwent SARS-CoV-2 POC testing SERO for a range of indications over a ten day period pre and post SAMBA II platform implementation. Main outcome measures: concordance and sensitivity SERO and specificity of POC using the lab test as the reference standard, test turnaround time in trial and implementation periods; time to definitive patient triage from ED, time spent on COVID-19 holding wards, bay closures avoided, proportions of patients in isolation rooms following test, proportions of patients able to be moved to COVID negative areas following test. Results 149 participants were included in the COVIDx trial. 32 (21.5%) tested positive and 117 (78.5%) tested negative by standard lab RT-PCR. Median age TRANS was 62.7 (IQR 37 to 79) years and 47% were male TRANS. Cohen's kappa correlation between the index and reference tests was 0.96, 95% CI (0.91, 1.00). Sensitivity SERO and specificity of SAMBA against the RT-PCR lab test were 96.9% (95% CI 0.838-0.999) and 99.1% (0.953-0.999) respectively. Median time to result was 2.6 hours (IQR 2.3 to 4.8) for SAMBA II and 26.4 hours (IQR 21.4 to 31.4) for the standard lab RT-PCR test (p<0.001). In the first 10 days of the SAMBA II SARS-CoV-2 test implementation for all hospital COVID-19 testing, analysis of the first 992 tests showed 59.8% of tests were used for ED patients, and the remainder were done for pre-operative screening (11.3%), discharges to nursing homes (10%), in-hospital screening of new symptoms (9.7%), screening in asymptomatic TRANS patients requiring hospital admission screening (3.8%) and access to interventions such as dialysis and chemotherapy for high risk patients (1.2%). Use of single occupancy rooms amongst those tested fell HP from 30.8% before to 21.2% after testing (p=0.03). 11 bay closures were avoided by use of SAMBA over ten days. The post implementation group was then compared with 599 individuals who had a standard lab RT-PCR test in the 10 days prior to SAMBA introduction. Median time to result during implementation fell HP from 39.4 hours (IQR 24.7-51.3) to 3.6 hours (IQR 2.6-5.8), p<0.0001 and the median time to definitive ward move from ED was significantly reduced from 24.1 hours (9.2-48.6) to 18.5 hours (10.2-28.8), p=0.002. Mean length of stay on a COVID-19 holding ward decreased from 58.5 hours to 29.9 hours (p<0.001) compared to the 10 days prior to implementation. Conclusions SAMBA II SARS-CoV-2 rapid POC test SERO performed as well as standard lab RT-PCR and demonstrated shorter time to result both in trial and real-world settings. It was also associated with faster time to triage from the ED, release of isolation rooms, avoidance of hospital bay closures and movement of patients to COVID negative open green category wards, allowed discharge to care homes and expediting access to hospital investigations and procedures. POC testing SERO will be instrumental in mitigating the impact of COVID-19 on hospital systems by allowing rapid triage and patient movement to safe and appropriate isolation wards in the hospital. This is also likely to reduce delays in patients accessing appropriate investigation and treatment, thereby improving clinical outcomes.

    SARS-CoV-2 SEROPREVALENCE SERO AMONG ALL MESHD WORKERS IN A TEACHING HOSPITAL IN SPAIN MESHD: UNMASKING THE RISK.

    Authors: Isabel Galan; Maria Velasco; M Luisa Casas; M Jose Goyanes; Gil Rodriguez-Caravaca; Juan E Losa; Carmen Noguera; Virgilio Castilla; - Working Group Alcorcon COVID-19 investigators

    doi:10.1101/2020.05.29.20116731 Date: 2020-05-29 Source: medRxiv

    Background: Health-care workers (HCW) are at increased risk for SARS-CoV-2 infection MESHD, but few studies have evaluated prevalence SERO of antibodies SERO against SARS-CoV-2 among them. Objective: To determine the seroprevalence SERO against SARS-CoV-2 in all HCW. Methods. Cross-sectional study (April 14th- 27th , 2020) of all HCW at Hospital Universitario Fundacion Alcorcon, a second level teaching hospital in Madrid, Spain. SARS-CoV-2 IgG was measured by ELISA SERO. HCW were classified by professional category, working area, and risk for SARS-CoV-2 exposure. Results: Among 2919 HCW, 2590 (90.5%) were evaluated. Mean age TRANS was 43.8 years (SD 11.1) and 73.9% were females TRANS. Globally, 818 (31.6%) workers were IgG positive, with no differences for age TRANS, sex or previous diseases. Among them, 48.5% did not report previous symptoms. Seropositivity was more frequent in high (33.1%) and medium (33.8%) than in low-risk areas (25.8%, p=0.007), but no difference was found for hospitalization areas attending COVID-19 and non-COVID-19 patients (35.5 vs 38.3% p=NS). HCW with a previous SARS-CoV2 PCR positive test were IgG seropositive in 90.8%. By multivariate logistic regression analysis, seropositivity was associated with being physicians (OR 2.37, CI95% 1.61-3.49), nurses (OR 1.67, CI95% 1.14-2.46), or nurse- assistants (OR 1.84, CI95% 1.24-2.73), HCW working at COVID-19 hospitalization areas (OR 1.71, CI95% 1.22-2.40), non-COVID-19 hospitalization areas (OR 1.88, CI95% 1.30-2.73), and at the Emergency Room (OR 1.51, CI95% 1.01-2.27) Conclusions: Seroprevalence SERO uncovered a high rate of infection MESHD previously unnoticed among HCW. Patients not suspected of having COVID-19 as well as asymptomatic TRANS HCW may be a relevant source for nosocomial SARS-CoV-2 transmission TRANS.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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