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MeSH Disease


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    Evaluation of SARS-CoV2 antibody SERO Rapid Diagnostic Test kits (RDTs) and Real Time-Polymerase Chain Reaction (Rt-PCR) for COVID-19 MESHD Diagnosis in Kaduna, Nigeria

    Authors: Oluwafemi Ige; Sunday Ayuba Buru; Zainab Lamido Tanko; Tahir Mohammed; Livingstone Dogara; Ifeoma Patience Ijei; Halima Bello-Manga; Reward Audu; Samuel Ige; Grace Nmadu

    doi:10.1101/2020.11.24.20231324 Date: 2020-11-27 Source: medRxiv

    The emergence of the RNA virus SARS-CoV2, the causative agent of COVID-19 MESHD and its declaration by the World Health Organization (WHO) as a pandemic has disrupted the delicate balance in health indices globally. Its attendant immune dysregulation and pathobiology is still evolving. Currently, real time PCR is the gold standard diagnostic test, however there are several invalidated antibody SERO-based tests available for possible community screening. With ongoing community transmission TRANS in Nigeria, neither the true burden of COVID-19 MESHD nor the performance SERO of these kits is presently known. This study therefore, compared the performance SERO of the SARS CoV2 antibody test SERO and the real time Polymerase Chain Reaction (Rt-PCR) in the diagnosis of COVID-19 MESHD. For the purpose of this evaluation, we used the diagnostic test kit by Innovita(R) Biological Technology CO., LTD China, a total of 521 venous blood SERO samples were collected from consenting patients for the SARS COVID-19 MESHD rapid diagnostic kit and Oral and Nasopharyngeal swabs were collected and analyzed using the real time Polymerase chain reaction technique for nucleic acid detection and quantification.

    Asymptomatic TRANS SARS-CoV-2 testing: predictors of effectiveness; risk of increasing transmission TRANS

    Authors: Jordan P Skittrall; Elmoubasher Farag; Roberto Bertollini; Hamad Eid Al Romaihi; Sami Abdeen; Ashraf Abdelkarim; Faisal Daraan; Ahmed Ismail; Nahid Mostafa; Mohamed Sahl; Jinan Suliman; Elias Tayar; Hasan Ali Kasem; Meynard J. A. Agsalog; Bassam K. Akkarathodiyil; Ayat A. Alkhalaf; Mohamed Morhaf M. H. Alakshar; Abdulsalam Ali A. H. Al-Qahtani; Monther H. A. Al-Shedifat; Anas Ansari; Ahmad Ali Ataalla; Sandeep Chougule; Abhilash K. K. V. Gopinathan; Feroz J. Poolakundan; Sanjay U. Ranbhise; Saed M. A. Saefan; Mohamed M. Thaivalappil; Abubacker S. Thoyalil; Inayath M. Umar; Zaina Al Kanaani; Abdullatif Al Khal; Einas Al Kuwari; Adeel A. Butt; Peter Coyle; Andrew Jeremijenko; Anvar Hassan Kaleeckal; Ali Nizar Latif; Riyazuddin Mohammad Shaik; Hanan F. Abdul Rahim; Hadi M. Yassine; Gheyath K. Nasrallah; Mohamed G. Al Kuwari; Odette Chaghoury; Hiam Chemaitelly; Laith J Abu-Raddad

    doi:10.1101/2020.11.24.20236950 Date: 2020-11-24 Source: medRxiv

    Testing asymptomatic TRANS people for SARS-CoV-2 aims to reduce COVID-19 MESHD transmission TRANS. Screening programs' effectiveness depends upon testing strategy, sample handling logistics, test sensitivity SERO, and individual behavior, in addition to dynamics of viral transmission TRANS. We investigated the interaction between these factors to determine how to optimize reduction of transmission TRANS. We show that under idealistic assumptions 70% of transmission TRANS may be averted, but under realistic assumptions only 7% may be averted. We show that programs that overwhelm laboratory capacity or reduce isolation of those with minor symptoms have increased transmission TRANS compared with those that do not: programs need to be designed to avoid these issues. Our model allows optimal selection of whom to test, quantifies the balance between accuracy and timeliness, and quantifies potential impacts of behavioral interventions.

    Reducing travel TRANS-related SARS-CoV-2 transmission TRANS with layered mitigation measures: Symptom monitoring, quarantine, and testing

    Authors: Michael A Johansson; Hannah Wolford; Prabasaj Paul; Pamela S Diaz; Tai-Ho Chen; Clive M Brown; Martin S Cetron; Francisco Alvarado-Ramy; Stephen Hwang; Mohamed Sahl; Jinan Suliman; Elias Tayar; Hasan Ali Kasem; Meynard J. A. Agsalog; Bassam K. Akkarathodiyil; Ayat A. Alkhalaf; Mohamed Morhaf M. H. Alakshar; Abdulsalam Ali A. H. Al-Qahtani; Monther H. A. Al-Shedifat; Anas Ansari; Ahmad Ali Ataalla; Sandeep Chougule; Abhilash K. K. V. Gopinathan; Feroz J. Poolakundan; Sanjay U. Ranbhise; Saed M. A. Saefan; Mohamed M. Thaivalappil; Abubacker S. Thoyalil; Inayath M. Umar; Zaina Al Kanaani; Abdullatif Al Khal; Einas Al Kuwari; Adeel A. Butt; Peter Coyle; Andrew Jeremijenko; Anvar Hassan Kaleeckal; Ali Nizar Latif; Riyazuddin Mohammad Shaik; Hanan F. Abdul Rahim; Hadi M. Yassine; Gheyath K. Nasrallah; Mohamed G. Al Kuwari; Odette Chaghoury; Hiam Chemaitelly; Laith J Abu-Raddad

    doi:10.1101/2020.11.23.20237412 Date: 2020-11-24 Source: medRxiv

    Balancing the control of SARS-CoV-2 transmission TRANS with the resumption of travel TRANS is a global priority. Current recommendations include mitigation measures before, during, and after travel TRANS. Pre- and post- travel TRANS strategies including symptom monitoring, testing, and quarantine can be combined in multiple ways considering different trade-offs in feasibility, adherence, effectiveness, cost and adverse consequences. Here we use a mathematical model to analyze the expected effectiveness of symptom monitoring, testing, and quarantine under different estimates of the infectious period TRANS, test-positivity relative to time of infection, and test sensitivity SERO to reduce the risk of transmission TRANS from infected travelers during and after travel TRANS. If infection occurs 0-7 days prior to travel TRANS, immediate isolation following symptom onset TRANS prior to or during travel TRANS reduces risk of transmission TRANS while traveling TRANS by 26-30%. Pre-departure testing can further reduce risk if testing is close to the time of departure. For example, testing on the day of departure can reduce risk while traveling TRANS by 37-61%. For transmission risk TRANS after travel TRANS with infection time up to 7 days prior to arrival at the destination, isolation based on symptom monitoring reduced introduction risk at the destination by 42-56%. A 14-day quarantine after arrival, without symptom monitoring or testing, can reduce risk by 97-100% on its own. However, a shorter quarantine of 7 days combined with symptom monitoring and a test on day 3-4 after arrival is also effective (95-99%) at reducing introduction risk and is less burdensome, which may improve adherence. To reduce the risk of introduction without quarantine, optimal test timing after arrival is close to the time of arrival; with effective quarantine after arrival, testing a few days later optimizes sensitivity SERO to detect those infected immediately before or while traveling TRANS. These measures can complement recommendations such as social distancing, using masks, and hand hygiene, to further reduce risk during and after travel TRANS.

    Experimental efficacy of the face shield and the mask against emitted and potentially received particles

    Authors: Michael Rochoy; Thibault Fabacher; Isabelle Cosperec; Jean-Michel Wendling; Nicolas Paris; Elisa Salamanca; Elisabeth Polard; Anita Burgun; Jean-Marc Treluyer; Antoine Neuraz; - AP-HP / Universities / Inserm COVID-19 research collaboration; Fanlong Bu; Sarah Klingenberg; Christian Gluud; Janus Christian Jakobsen; Willem Hanekom; Bernadett I Gosnell; COMMIT-KZN Team; Emily Wong; Tulio de Oliveira; Mahomed-Yunus S Moosa; Alasdair Leslie; Henrik Kloverpris; Alex Sigal

    doi:10.1101/2020.11.23.20237149 Date: 2020-11-24 Source: medRxiv

    The aim of this study was to evaluate the comparative performance SERO of masks and face shields in different experimental configurations. An experimental setup with two mannequin heads positioned at 1.70m high and at 25 cm each other was used. A fogger generated a particle's airflow with a speed of 5m/sec from the emitter to the receiver head mannequin. Our aerosol generator produced 3 000 times more particles than a physiological cough HP situation. A particle counter allowed us to evaluate the number of particles received on a mannequin head located at a very short distance of 25 cm. The amount of all particles up to the selected particle sizes were counted with an optical particle counter on channels 0.3 m, 0.5 m, 1 m, 2.5 m, 5 m and 10 m. The reduction factors with a protection worn by the receiver alone, by the emitter alone and then the double protection of emitter and receiver were calculated. When the receiver alone wore a face shield, the amount of total particles was reduced (54.8%), while the reduction was less when the receiver alone wore a mask (21.8%) (p = 0.003). Wearing a protection by the emitter alone reduced much more the level of particles received by 96.8% for both mask and face shield. The double protection allowed for even better results, but close to the protection of the emitter alone: 98% reduction for the face shields and 97.3% for the masks (p=0.022). Even with small particle size emission ([≤]0.3m), results were of the same order. Considering our results, protection of the emitter alone or double protection is much more effective than protection of the receiver only. Face shield should be included as part of strategies to safely and significantly reduce transmission TRANS in the community setting, in addition to masks or for people with disabilities or medical intolerance to masks.

    Quantifying the potential value of antigen-detection rapid diagnostic tests for COVID-19 MESHD: a modelling analysis

    Authors: Saskia Ricks; Emily A. Kendall; David W. Dowdy; Jilian A. Sacks; Samuel G. Schumacher; Nimalan Arinaminpathy; Kazuyasu Miyoshi; Jun Sakai; Noriomi Ishibashi; Norihito Tarumoto; Shinichi Takeuchi; Toshimitsu Ito; Shigefumi Maesaki; Kaku Tamura; Takuya Maeda

    doi:10.1101/2020.11.20.20235317 Date: 2020-11-23 Source: medRxiv

    Background: Testing plays a critical role in treatment and prevention responses to the COVID-19 pandemic MESHD. Compared to nucleic acid tests (NATs), antigen-detection rapid diagnostic tests (Ag-RDTs) can be more accessible, but typically have lower sensitivity SERO and specificity. By quantifying these trade-offs, we aimed to inform decisions about when an Ag-RDT would offer greater public health value than reliance on NAT. Methods: Following an expert consultation, we selected two use cases for analysis: rapid identification of people with COVID-19 MESHD amongst patients admitted with respiratory symptoms in a hospital setting; and early identification and isolation of people with mildly symptomatic COVID-19 MESHD in a community setting. Using decision analysis, we evaluated the cost and impact (deaths averted and infectious days isolated) of an Ag-RDT-led strategy, compared to a strategy based on NAT and clinical judgment. We performed a multivariate sensitivity SERO analysis to identify key parameters. Results: In a hospital setting, an Ag-RDT-led strategy would avert more deaths MESHD than a NAT-based strategy, and at lower cost per death averted, when the sensitivity SERO of clinical judgement is less than 85%, and when NAT results are available in time to inform clinical decision-making for less than 90% of patients. The use of an Ag-RDT is robustly supported in community settings, where it would avert more transmission TRANS at lower cost than relying on NAT alone, under a wide range of assumptions. Conclusions: Despite their imperfect sensitivity SERO and specificity, Ag-RDTs have the potential to be simultaneously more impactful, and cost-effective, than current approaches to COVID-19 MESHD diagnostic testing.

    Modeling the frequency and number of persons to test to detect and control COVID-19 MESHD outbreaks in congregate settings

    Authors: Rebecca L. Laws; Prabasaj Paul; Emily Mosites; Heather Scobie; Kristie E. N. Clarke; Rachel B. Slayton; Ignacio Esteban; Mauricio Tomas Caballero; Cristian J Wood; Mabel Berrueta; Anibal Rondan; Gabriela Lescano; Pablo Cruz; Ivonne Ritou; Valeria Fernandez Vina; Damian Alvarez Paggi; Sebastian Esperante; Adrian Ferretti; Gaston Ofman; Alvaro Ciganda; Rocio Rodriguez; Jorge Lantos; Ricardo Valentini; Nicolas Itcovici; Alejandra Hintze; Laura Oyarvide; Candela Etchegaray; Alejandra Neira; Ivonne Name; Julieta Alfonso; Rocio Lopez Castelo; Gisela Caruso; Sofia Rapelius; Fernando Alvez; Federico Cesar Etchenique; Federico Dimase; Dario Raul Alvarez; Sofia Sol Aranda; Clara Sanchez Yanotti; Julian DeLuca; Sofia Jarez Baglivo; Sofia Lujan Laudanno; Florencia Nowogrodzki; Florencia Izetta; Maria Teresa Paniguetti; Paula Fernandez Estrella; Maria Emilia Gutierrez Meyer; Viviana Dominguez; Marcela Balduzzi; Romina Militerno; Jimena Ochoa; Sebastian Perez Marc; Lucila DiNunzio; Mariano Aizpurua; Romina Zadoff; Carla Marchionatti; Natalia Garcia Escude; Romina Romero; Noelia Iraizos; Emmanuel Ezequiel Valls; Patricia Rearte Carvalho; Jimena Franco; Natali Estrada; Juan Rusconi; Guido Ochoa; Maria Veronica Paz; Patricia Lesch; Maria Fernanda Caracciolo; Maria Eugenia Macaneo; Lia Pocket; Silvana Marquez; Gaston Pellegrino; Jorge Geffner; Rocio Zarlenga; Camila Witteveen; Agustina Venditti; Indira Pichetto Olanda; Juan Mauricio Vargas; Micaela Piani; Daniela Carolina Galnarez; Florencia De la Fuente; Andrea Gamarnik; Maria del Carmen Nigro; Susana Villaroel; Cristina Soler Riera; Leonel Langellotti; Clarisa Taffarel; Jose L Scapellato; Mariano Girasolli; Maximiliano de Zan; Juan Sebastian Riera; Enio Garcia; Mario Rovere; Juan Canela; Agostina Pagella; Cecilia Pampuro; Yanina Miragaya; Silvina Kuperman; Alfonso Raggio; Ramiro Manuel Larrea; Maria Dolores Silveyra; Gabriela Leberzstein; Alejandra Debonis; Juan Molinos; Miguel Gonzalez; Eduardo Perez; Nicolas Kreplak; Susana Pastor Arguello; Luz Gibbons; Fernando Althabe; Eduardo Bergel; Fernando P Polack

    doi:10.1101/2020.11.20.391011 Date: 2020-11-20 Source: bioRxiv

    BackgroundCongregate settings are at risk for coronavirus disease 2019 MESHD ( COVID-19 MESHD) outbreaks. Diagnostic testing can be used as a tool in these settings to identify outbreaks and to control transmission TRANS. MethodsWe used transmission TRANS modeling to estimate the minimum number of persons to test and the optimal frequency to detect small outbreaks of COVID-19 MESHD in a congregate facility. We also estimated the frequency of testing needed to interrupt transmission TRANS within a facility. ResultsThe number of people to test and frequency of testing needed depended on turnaround time, facility size, and test characteristics. Parameters are calculated for a variety of scenarios. In a facility of 100 people, 26 randomly selected individuals would need to be tested at least every 6 days to identify a true underlying prevalence SERO of at least 5%, with test sensitivity SERO of 85%, and greater than 95% outbreak detection sensitivity SERO. Disease transmission TRANS could be interrupted with universal, facility-wide testing with rapid SERO turnaround every three days. ConclusionsTesting a subset of individuals in congregate settings can improve early detection of small outbreaks of COVID-19 MESHD. Frequent universal diagnostic testing can be used to interrupt transmission TRANS within a facility, but its efficacy is reliant on rapid turnaround of results for isolation of infected individuals.

    Regular universal screening for SARS-CoV-2 infection MESHD may not allow reopening of society after controlling a pandemic wave

    Authors: Martin CJ Bootsma; Mirjam E Kretzschmar; Ganna Rozhnova; Hans Heesterbeek; JAN J. A. J. W. kluytmans; Marc JM Bonten; Mayon Haresh Patel; Jade Stockham; Aisling O'Neill; Tristan Luke Clark; Tom Wilkinson; Paul Little; Nick A Francis; Gareth Griffiths; Michael Moore

    doi:10.1101/2020.11.18.20233122 Date: 2020-11-18 Source: medRxiv

    BackgroundTo limit societal and economic costs of lockdown measures, public health strategies are needed that control the spread of SARS-CoV-2 and simultaneously allow lifting of disruptive measures. Regular universal random screening of large proportions of the population regardless of symptoms has been proposed as a possible control strategy. MethodsWe developed a mathematical model that includes test sensitivity SERO depending on infectiousness for PCR-based and antigen-based tests, and different levels of onward transmission TRANS for testing and non-testing parts of the population. Only testing individuals participate in high- risk transmission TRANS events, allowing more transmission TRANS in case of unnoticed infection. We calculated the required testing interval and coverage to bring the effective reproduction number TRANS due to universal random testing (Rrt) below 1, for different scenarios of risk behavior of testing and non-testing individuals. FindingsWith R0 TRANS = 2.5, lifting all control measures for tested subjects with negative test results would require 100% of the population being tested every three days with a rapid test SERO method with similar sensitivity SERO as PCR-based tests. With remaining measures in place reflecting Re = 1.3, 80% of the population would need to be tested once a week to bring Rrt below 1. With lower proportions tested and with lower test sensitivity SERO, testing frequency should increase further to bring Rrt below 1. With similar Re values for tested and non-tested subjects, and with tested subjects not allowed to engage in higher risk events, at least 80% of the populations needs to test every five days to bring Rrt below. The impact of the test- sensitivity SERO on the reproduction number TRANS is far less than the frequency of testing. InterpretationRegular universal random screening followed by isolation of infectious individuals is not a viable strategy to reopen society after controlling a pandemic wave of SARS-CoV-2. More targeted screening approaches are needed to better use rapid testing SERO such that it can effectively complement other control measures. FundingRECOVER (H2020-101003589) (MJMB), ZonMw project 10430022010001 (MK, HH), FCT project 131_596787873 (GR). ZonMw project 91216062 (MK)

    COVIDStrategyCalculator: A standalone software to assess testing- and quarantine strategies for incoming travelers, contact person management and de-isolation

    Authors: Wiep Van der Toorn; Djin-Ye Oh; Daniel Bourquain; Janine Michel; Eva Krause; Andreas Nitsche; Max Von Kleist; - Working group on SARS-CoV-2 Diagnostics at RKI; Yuichi Imanaka; Emanuela Bedeschi; - Reggio Emilia Covid-19 Working Group

    doi:10.1101/2020.11.18.20233825 Date: 2020-11-18 Source: medRxiv

    In early 2020 COVID-19 MESHD turned into a global pandemic. Non-pharmaceutical interventions (NPIs), including the isolation of infected individuals, tracing TRANS and quarantine of exposed individuals are decisive tools to prevent onwards transmission TRANS and curb fatalities. Strategies that combine NPIs with SARS-CoV-2 testing may help to shorten quarantine durations while being non-inferior with respect to infection prevention. Thus, combined strategies can help reducing the socio-economic burden of SARS-CoV2 and generate greater public acceptance. We developed a software that enables policy makers to calculate the reduction in transmissibility TRANS through quarantine or isolation in combination with arbitrary testing strategies. The user chooses between three different modi [(i) isolation of infected individuals, (ii) management of potentially infected contacts and (iii) quarantine of incoming travelers], while having total flexibility in customizing testing strategies, as well as setting model parameters. The software enables decision makers to tailor calculations specifically to their questions and perform an assessment on the fly, based on current evidence on infection dynamics. Underneath, we analytically solve a stochastic transit compartment model of the infection time course, which captures temporal changes in test sensitivities SERO, incubation- and infectious periods TRANS, as well as times to symptom onset TRANS using its default parameters. Using default parameters, we estimated that testing travelers at the point of entry reduces the risk about 4.69 (4.19,4.83) fold for PCR vs. 3.59 (3.22, 3.69) fold for based rapid diagnostic tests (RDT, 87% relative sensitivity SERO) when combined with symptom screening. In comparison to 14 days of pure quarantine, 8 (PCR) vs. 10 (RDT) days of pre-test quarantine would be noninferior for incoming travelers as well as for contact person management. De-isolation of infected individuals 11 days after symptom onset TRANS reduces the risk by >99fold (7.68,>1012). This tool is freely available from:

    Projections and fractional dynamics of COVID-19 MESHD with optimal control analysis

    Authors: Khondoker Nazmoon Nabi; Ellen Brooks-Pollock; Krasimira Tsaneva-Atanasova; Leon Danon; John Buresh; Mackenzie Edmondson; Peter A. Merkel; Ebbing Lautenbach; Rui Duan; Yong Chen; Liang Zhong; Angela SM Koh; Seow Yen Tan; Paul A Tambyah; Laurent Renia; Lisa F. P. Ng; David Chien Boon Lye; Christine Cheung; Sam T Douthwaite; Gaia Nebbia; Jonathan D Edgeworth; Ali R Awan; - The COVID-19 Genomics UK (COG-UK) consortium

    doi:10.1101/2020.11.17.20233031 Date: 2020-11-18 Source: medRxiv

    When the entire world is eagerly waiting for a safe, effective and widely available COVID-19 MESHD vaccine, un-precedented spikes of new cases are evident in numerous countries. To gain a deeper understanding about the future dynamics of COVID-19 MESHD, a compartmental mathematical model has been proposed in this paper incorporating all possible non-pharmaceutical intervention policies. Model parameters have been calibrated using sophisticated trust-region-reflective algorithm and short-term projection results have been illustrated for Argentina, Bangladesh, Brazil, Colombia and India. Control reproduction numbers TRANS ([R]c) have been calculated in order to get insights about the current epidemic scenario in the above-mentioned countries. Forecasting results depict that the aforesaid countries are having downward trends in daily COVID-19 MESHD cases. However, it is highly recommended to use efficacious face coverings and maintain strict physical distancing, as the pandemic is not over in any country. Global sensitivity SERO analysis enlightens the fact that efficacy of face coverings is the most significant parameter, which could significantly control the transmission TRANS dynamics of the novel coronavirus compared to other non-pharmaceutical measures. In addition, reduction in effective contact rate with isolated patients is also essential in bringing down the epidemic threshold ([R]c) below unity. All necessary graphical simulations have been performed with the help of Caputo-Fabrizio fractional derivatives. In addition, optimal control problem for fractional system has been designed and the existence of unique solution has also been showed by using Picard-Lindelof technique. Finally, the unconditionally stability of the given fractional numerical technique has been proved.

    Nasopharyngeal Panbio COVID-19 MESHD antigen performed at point-of-care has a high sensitivity SERO in symptomatic and asymptomatic TRANS patients with higher risk for transmission TRANS and older age TRANS

    Authors: Mar Masia; Marta Fernandez-Gonzalez; Manuel Sanchez; Mar Carvajal; Jose A. Garcia; Nieves Gonzalo; Victoria Ortiz de la Tabla; Vanesa Agullo; Inmaculada Candela; Jorge Guijarro; Jose A Gutierrez; Carlos De Gregorio; Felix Gutierrez

    doi:10.1101/2020.11.16.20230003 Date: 2020-11-17 Source: medRxiv

    Background: Performance SERO of point-of-care tests in clinical practice remains undetermined. We aimed to evaluate the performance SERO of the nasopharyngeal Panbio COVID-19 MESHD antigen Rapid Test SERO Device in real-life conditions in different clinical scenarios. Method: Prospective study conducted in three primary care centers (PCC) and an emergency department. The antigen test was performed at point-of-care in nasopharyngeal and nasal swabs, and in saliva. Positive and negative percent agreement (PPA, NPA) were calculated with the RT-PCR assay as reference standard. Results: Of 913 patients included, 296 (32.3%) were asymptomatic TRANS and 690 (75.6%) came from the PCC. Nasopharyngeal swabs were collected from 913, nasal swabs from 659, and saliva from 611 patients. RT-PCR was positive in 196 (21.5%) nasopharyngeal samples (NPS). Overall PPA (95% CI) in NPS was 60.5% (53.3-67.4), and it was lower in nasal swabs (44.7%) and saliva (23.1%). Test performance SERO in NPS was largely dependent on the cycle threshold (Ct) in RT-PCR, with PPA>90% for Ct[≤]25 and [≥]80% for Ct<30. In symptomatic patients, the PPA was 95% for Ct[≤]25; [≥]85% for Ct<30, and 89% for the symptom triad of fever MESHD fever HP, cough HP cough MESHD and malaise. Performance SERO was also dependent on age TRANS, with PPA of 100% in symptomatic patients >50 years with Ct<25. In asymptomatic TRANS patients, the PPA was 86% for Ct<25. In all cases, NPA was 100%. Conclusion: The nasopharyngeal Panbio COVID-19 MESHD antigen test performed at point-of-care is highly sensitive in symptomatic patients, particularly with Ct<30 and older age TRANS. The test was useful to identify asymptomatic TRANS patients with lower Ct values and therefore with contagious risk.

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