scholarly journals Saliva is superior over nasopharyngeal swab for detecting SARS-CoV2 in COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Getachew Tesfaye Beyene ◽  
Fekadu Alemu ◽  
Eyerusalem Solomon Kebede ◽  
Dawit Hailu Alemayehu ◽  
Tamirayehu Seyoum ◽  
...  
Keyword(s):  
Viral Load ◽  
Low Cost ◽  
Good Alternative ◽  
Nasopharyngeal Swab ◽  
Sample Collection ◽  
Viral Shedding ◽  
Non Invasive ◽  
Global Pandemic ◽  
Diagnostic Capacity ◽  
Different Populations

AbstractScaling up of diagnostic capacity is needed to mitigate the global pandemic of SARS-CoV2. However, there are challenges including shortage of sample collection swabs and transport medium. Saliva has been recommended as a simple, low-cost, non-invasive option. However, data from different populations and settings are limited. Here, we showed that saliva could be a good alternative sample to diagnose COVID-19 patients. Pair of NPS-saliva samples was collected from 152 symptomatic; confirmed COVID-19 patients, and compared their positivity rate, viral load, and duration of viral shedding. From 152 patients, 80 (52.63%) tested positive and 72 (47.37%) were negative for SARSA-CoV2 in NPS sample. In saliva, 129 (92.14%) were tested positive and 11 (7.86%) were negative on the day of admission to hospital. The overall percent agreement of RT-PCR result of Saliva to NPS was 70% (196/280). A comparison of viral load from 72 NPS-saliva pair samples on day of admission shows saliva contains significantly higher viral load (P < 0.001). In conclusion, saliva has higher yield in detecting SARS-CoV2, and COVID-19 patients show higher viral load and prolonged period of viral shedding in saliva. Therefore, we recommend saliva as a better alternative sample to NPS to diagnose COVID-19 patients.

scholarly journals Spectrum and Clinical Characteristics of Symptomatic and Asymptomatic Coronavirus Disease 2019 (COVID-19) With and Without Pneumonia

2021 ◽  
Vol 8 ◽  
Author(s):  
Huihui Zeng ◽  
Yiming Ma ◽  
Zhiguo Zhou ◽  
Wenlong Liu ◽  
Peng Huang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Viral Load ◽  
Clinical Characteristics ◽  
Invasive Mechanical Ventilation ◽  
The Other ◽  
Limited Information ◽  
Viral Shedding ◽  
Non Invasive ◽  
Radiologic Findings ◽  
Global Pandemic

Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has become a global pandemic. Based on symptoms, COVID-19 cases can be classified as symptomatic or asymptomatic. However, there is limited information about the differences between COVID-19 patients with and without pneumonia. Our study aimed to further discuss the spectrum and clinical characteristics of symptomatic and asymptomatic COVID-19 patients with and without pneumonia.Methods: In China, all COVID-19 cases are hospitalized in designated hospitals until two continuous negative oropharyngeal swabs obtained, which allows the professional monitoring of symptoms and clinical characteristics. We stratified all COVID-19 cases in our database and evaluated clinical characteristics in different COVID-19 subgroups (symptomatic with pneumonia, symptomatic without pneumonia, asymptomatic with pneumonia, and asymptomatic without pneumonia).Results: According to symptoms and laboratory and radiologic findings, COVID-19 cases were defined as symptomatic with pneumonia, symptomatic without pneumonia, asymptomatic with pneumonia, or asymptomatic without pneumonia. There were differences in the clinical characteristics and prognosis among the four groups. Both non-invasive mechanical ventilation (18, 4.2%) and invasive mechanical ventilation (11, 2.6%) were applied in only the symptomatic with pneumonia group. Likewise, extracorporeal membrane oxygenation and continuous renal replacement therapy were applied in only the symptomatic with pneumonia group. There were no differences in viral load, the durations of viral shedding, and hospitalization among the four groups.Conclusion: We have defined a comprehensive spectrum of COVID-19 with and without pneumonia. The symptomatic with pneumonia group consumed more medical resources than the other groups, and extra caution and monitoring should be applied in this group. The asymptomatic COVID-19 group had a similar viral load and viral shedding duration as the symptomatic COVID-19 group.

scholarly journals Viral Load Dynamics in Sputum and Nasopharyngeal Swab in Patients with COVID-19

2020 ◽  
Vol 99 (11) ◽  
pp. 1239-1244 ◽  
Author(s):  
R. Liu ◽  
S. Yi ◽  
J. Zhang ◽  
Z. Lv ◽  
C. Zhu ◽  
...  
Keyword(s):  
Viral Load ◽  
Quantitative Polymerase Chain Reaction ◽  
Nasopharyngeal Swab ◽  
Chain Reaction ◽  
Global Pandemic ◽  
Observational Cohort ◽  
Polymerase Chain ◽  
Underlying Diseases ◽  
Temporal Profiles ◽  
Substantial Morbidity

Coronavirus disease 2019 (COVID-19) has caused a global pandemic associated with substantial morbidity and mortality. Nasopharyngeal swabs and sputum samples are generally collected for serial viral load screening of respiratory contagions, but temporal profiles of these samples are not completely clear in patients with COVID-19. We performed an observational cohort study at Renmin Hospital of Wuhan University, which involved 31 patients with confirmed COVID-19 with or without underlying diseases. We obtained samples from each patient, and serial viral load was measured by real-time quantitative polymerase chain reaction. We found that the viral load in the sputum was inclined to be higher than samples obtained from the nasopharyngeal swab at disease presentation. Moreover, the viral load in the sputum decreased more slowly over time than in the nasopharyngeal group as the disease progressed. Interestingly, even when samples in the nasopharyngeal swab turned negative, it was commonly observed that patients with underlying diseases, especially hypertension and diabetes, remained positive for COVID-19 and required a longer period for the sputum samples to turn negative. These combined findings emphasize the importance of tracking sputum samples even in patients with negative tests from nasopharyngeal swabs, especially for those with underlying conditions. In conclusion, this work reinforces the importance of sputum samples for SARS-CoV-2 detection to minimize transmission of COVID-19 within the community.

scholarly journals Favorable outcome on viral load and culture viability using Ivermectin in early treatment of non-hospitalized patients with mild COVID-19, A double-blind, randomized placebo-controlled trial.

2021 ◽  
Author(s):  
Asaf Biber ◽  
Michal Mandelboim ◽  
Geva Harmelin ◽  
Dana Lev ◽  
Li Ram ◽  
...  
Keyword(s):  
Viral Load ◽  
Early Stage ◽  
Controlled Trial ◽  
Nasopharyngeal Swab ◽  
Multivariable Logistic Regression Model ◽  
Double Blind ◽  
Viral Shedding ◽  
Viral Culture ◽  
Culture Viability ◽  
Double Blinded

Background: Ivermectin, an antiparasitic agent, also has antiviral properties. Our aim was to assess whether ivermectin can shorten the viral shedding in patients at an early stage of COVID19 infection. Methods: The double blinded trial compared patients receiving ivermectin 0.2 mg/kg for 3 days vs. placebo in non-hospitalized COVID19 patients. RT-PCR from a nasopharyngeal swab was obtained at recruitment and then every two days. Primary endpoint was reduction of viral-load on the 6th day (third day after termination of treatment) as reflected by Ct level>30 (non-infectious level). The primary outcome was supported by determination of viral culture viability. Results: Eighty nine patients were eligible (47 in ivermectin and 42 in placebo arm). Their median age was 35 years. Females accounted for 21.6%, and 16.8% were asymptomatic at recruitment. Median time from symptom onset was 4 days. There were no statistical differences in these parameters between the two groups. On day 6, 34 out of 47 (72%) patients in the ivermectin arm reached the endpoint, compared to 21/ 42 (50%) in the placebo arm (OR 2.62; 95% CI: 1.09 to 6.31). In a multivariable logistic regression model, the odds of a negative test at day 6 was 2.62 time higher in the ivermectin group (95% CI: 1.06 to 6.45). Cultures at days 2 to 6 were positive in 3/23 (13.0%) of ivermectin samples vs. 14/29 (48.2%) in the placebo group (p=0.008). Conclusions: There were significantly lower viral loads and viable cultures in the ivermectin group, which could lead to shortening isolation time in these patients.

scholarly journals Tomography for electrical impedance

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Juan David Muñoz Sánchez ◽  
Víctor Hugo Mosquera Leyton
Keyword(s):  
Electrical Impedance Tomography ◽  
Electrical Impedance ◽  
Wrist Joint ◽  
Low Cost ◽  
Good Alternative ◽  
Medical Applications ◽  
Joint Diseases ◽  
Impedance Tomography ◽  
Non Invasive ◽  
Joint Injuries

Introduction:This review article shows the state of the art of different techniques for monitoring joint injuries. This work is the product of the research project "Viability of electrical impedance tomography for the monitoring of joint injuries", which took place at the University of Cauca during the period 2018-2019. Aim:Identify non-invasive bio-image methods that are used in the evaluation of joint diseases. Methodology: Selection and review of papers related to the evaluation of joint injuries using non-invasive bio-image technologies using systematic mapping.  Results: Magnetic resonance and computed tomography systems make up the non-invasive methods of greater reliability and application in the evaluation of joint injuries. Similarly, some studies show good results from other methods such as systems based on bio-impedance when monitoring the deterioration of joint cartilage. However, electrical impedance tomography (EIT) devices have not yet been widely studied in the joint injuries evaluation. Conclusion: Electronic prototypes of low-cost electrical impedance tomography have been developed that have allowed for the detection and recognition of gestures made by hand from the analysis of the distribution of conductivity in the wrist joint, which allows us to infer that EIT could be a good alternative for the monitoring of joint injuries. Originality: The literature does not show studies focused on the development and implementation of EIT systems in medical applications related to joint injuries. Limitations: This review paper only mentions those studies that describe the non-invasive bio-image methods used to evaluate joint diseases, including the medical applications of EIT systems.

scholarly journals Low-Cost Polyester-Tipped Three-Dimensionally Printed Nasopharyngeal Swab for the Detection of Severe Acute Respiratory Syndrome-Related Coronavirus 2 (SARS-CoV-2)

2020 ◽  
Vol 58 (11) ◽  
Author(s):  
Mohammad Alghounaim ◽  
Sulaiman Almazeedi ◽  
Sarah Al Youha ◽  
Jesse Papenburg ◽  
Osama Alowaish ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Polylactic Acid ◽  
Low Income ◽  
Low Cost ◽  
Positive Control ◽  
Low Income Countries ◽  
Contact Tracing ◽  
Nasopharyngeal Swab ◽  
Sample Collection ◽  
3D Printed

ABSTRACT Case identification, isolation, and contact tracing are fundamental strategies used to control the spread of coronavirus disease 2019 (COVID-19). This has led to widespread testing that interrupted the supply chain for testing materials around the world. A prospective study was conducted to compare inexpensive and easily sourced 3-dimensionally (3D)-printed polylactic acid and polyester nasopharyngeal swabs to commercially manufactured swabs for the detection of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2). During the study period, 287 laboratory-confirmed hospitalized COVID-19 patients, at multiple stages of their illness, were enrolled. The median age for the study population was 47.6 years (interquartile range [IQR], 34.4 to 56.6 years), and two-thirds (67.6%) of the subjects were male. The median duration of hospitalization, at the time of sampling, was 13 days (IQR, 10 to 16 days). Overall concordance between the prototype and control swabs was 80.8% (Cohen’s kappa coefficient, 0.61). Most discrepant results were due to prototype-positive control-negative results. When considering all positive results to be true positives, the prototype swab had a higher sensitivity (90.6% versus 80.8%; 95% confidence interval [CI], 85.7% to 94.0% and 74.7% to 85.7%, respectively; P < 0.015). The cost to produce the prototype swab was estimated to be $0.05 per swab. Polylactic acid 3D-printed polyester-tipped swabs were shown to be effective for nasopharyngeal sample collection. We believe that this design can easily be adopted in countries where commercial swabs are not readily available and can play a vital role in public health efforts for disease control in low-income countries.

scholarly journals The benefits of meditation and mindfulness practices during times of crisis such as COVID-19

2020 ◽  
Vol 37 (4) ◽  
pp. 256-258 ◽  
Author(s):  
C. Behan
Keyword(s):  
Stress Reduction ◽  
Healthcare Professionals ◽  
Low Cost ◽  
Evidence Base ◽  
Meditation Practice ◽  
Pain Scores ◽  
Global Pandemic ◽  
Mindfulness Practices ◽  
Different Populations ◽  
Anxiety Depression

Meditation and mindfulness are practices that can support healthcare professionals, patients, carers and the general public during times of crisis such as the current global pandemic caused by COVID-19. While there are many forms of meditation and mindfulness, of particular interest to healthcare professionals are those with an evidence base such as mindfulness-based stress reduction (MBSR). Systematic reviews of such practices have shown improvements in measures of anxiety, depression and pain scores. Structural and functional brain changes have been demonstrated in the brains of people with a long-term traditional meditation practice, and in people who have completed a MBSR programme. Mindfulness and meditation practices translate well to different populations across the lifespan and range of ability. Introducing a mindfulness and meditation practice during this pandemic has the potential to complement treatment and is a low-cost beneficial method of providing support with anxiety for all.

scholarly journals A rapid, low cost, and highly sensitive SARS-CoV-2 diagnostic based on whole genome sequencing

2020 ◽  
Author(s):  
Brian Glenn St Hilaire ◽  
Neva C. Durand ◽  
Namita Mitra ◽  
Saul Godinez Pulido ◽  
Ragini Mahajan ◽  
...  
Keyword(s):  
Drug Targets ◽  
De Novo ◽  
Low Cost ◽  
Diagnostic Methods ◽  
Nasopharyngeal Swab ◽  
De Novo Genome Assembly ◽  
Global Pandemic ◽  
Single Person ◽  
Novel Coronavirus ◽  
Almost All

AbstractEarly detection of infection with SARS-CoV-2 is key to managing the current global pandemic, as evidence shows the virus is most contagious on or before symptom onset. Here, we introduce a low-cost, high-throughput method for diagnosis of SARS-CoV-2 infection, dubbed Pathogen-Oriented Low-Cost Assembly & Re-Sequencing (POLAR), that enhances sensitivity by aiming to amplify the entire SARS-CoV-2 genome rather than targeting particular viral loci, as in typical RT-PCR assays. To achieve this goal, we combine a SARS-CoV-2 enrichment method developed by the ARTIC Network (https://artic.network/) with short-read DNA sequencing and de novo genome assembly. We are able to reliably (>95% accuracy) detect SARS-CoV-2 at concentrations of 84 genome equivalents per milliliter, better than the reported limits of detection of almost all diagnostic methods currently approved by the US Food and Drug Administration. At higher concentrations, we are able to reliably assemble the SARS-CoV-2 genome in the sample, often with no gaps and perfect accuracy. Such genome assemblies enable the spread of the disease to be analyzed much more effectively than would be possible with an ordinary yes/no diagnostic, and can help identify vaccine and drug targets. Finally, we show that POLAR diagnoses on 10 of 10 clinical nasopharyngeal swab samples (half positive, half negative) match those obtained in a CLIA-certified lab using the Center for Disease Control’s 2019-Novel Coronavirus test. Using POLAR, a single person can process 192 samples over the course of an 8-hour experiment, at a cost of ∼$30/patient, enabling a 24-hour turnaround with sequencing and data analysis time included. Further testing and refinement will likely enable greater enhancements in the sensitivity of the above approach.

scholarly journals Incidence rate, clinical course and risk factor for recurrent PCR positivity in discharged COVID-19 patients in Guangzhou, China: a prospective cohort study

2020 ◽  
Author(s):  
Jia-Zhen Zheng ◽  
Rui Zhou ◽  
Feng-Juan Chen ◽  
Guo-Fang Tang ◽  
Ke-Yi Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Viral Load ◽  
Incidence Rate ◽  
Clinical Symptoms ◽  
N Gene ◽  
Nasopharyngeal Swab ◽  
Post Discharge ◽  
Viral Shedding ◽  
Low Efficiency

Abstract Background: The phenomenon of COVID-19 patients tested positive for SARS-CoV-2 after discharge (redetectable as positive, RP) emerged globally. The data of incidence rate and risk factors for RP event and the clinical features of RP patients may provide recommendations for virus containment and discharge assessment for COVID-19. Methods: The baseline included 285 adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Guangzhou Eighth People's Hospital. We started the Observation on Jan 20, 2020, and acquired all their definite clinical outcome (becoming RP or keeping normal during post-discharge surveillance) by Mar 10, 2020. The dynamic clinical data of patients during observation were prospectively collected and analyzed. Univariate and multivariate-adjusted logistic regression were used to explore the risk factors related to RP events in COVID-19 patients. Results: By March 10, 27 (9.5%) discharged patients had tested positive for SARS-CoV-2 in their nasopharyngeal swab after a median duration of 7·0 days (IQR 5·0-8·0). Age, sex, epidemiological history, clinical symptoms and underlying diseases were similar between RP and non-RP patients (p>0.05). Compared to first admission, RP patients generally had milder clinical symptoms, lower viral load, shorter length of stay and improved pulmonary conditions at readmission (p<0.05). Elder RP patients (≥ 60 years old) were more likely to be symptomatic compared to younger patients (7/8, 87.5% vs. 3/19, 18.8%, p=0.001) at readmission. A prolonged duration of viral shedding (>10 days) during the first hospitalization [adjusted odds ratio [aOR]: 5.82, 95% confidence interval [CI]: 2.50-13.57 for N gene; aOR: 9.64, 95% CI: 3.91-23.73 for ORF gene] and higher Ct value (ORF) in the third week of the first hospitalization (aOR: 0.69; 95% CI: 0.50-0.95) were associated with RP events. Conclusions: RP events occurred in nearly 10% of COVID-19 patients which deserves globally attention. During hospitalization, patients’ low efficiency of viral clearance was a risk factor for RP event. Elderly RP patients were more likely to develop clinical symptoms. To reduce the possibility of reinfection and readmission during the management of COVID-19, more rigorously monitoring on patients’ viral load should be carried out especially in elder patients and later stage of hospitalization.

Responses to External Emotions or their Transitions at Central to Peripheral Nervous System Levels: A Methodological Contribution to Mental Health

2020 ◽  
Vol 16 (2) ◽  
pp. 138-152
Author(s):  
Bingren Zhang ◽  
Chu Wang ◽  
Chanchan Shen ◽  
Wei Wang
Keyword(s):  
Healthy Volunteers ◽  
Psychiatric Patients ◽  
Event Related Potentials ◽  
Emotional Stimuli ◽  
Non Invasive ◽  
Related Potentials ◽  
Different Populations ◽  
Invasive Techniques ◽  
Psychiatric Problems ◽  
Different Levels

Background: Responses to external emotional-stimuli or their transitions might help to elucidate the scientific background and assist the clinical management of psychiatric problems, but pure emotional-materials and their utilization at different levels of neurophysiological processing are few. Objective: We aimed to describe the responses at central and peripheral levels in healthy volunteers and psychiatric patients when facing external emotions and their transitions. Methods: Using pictures and sounds with pure emotions of Disgust, Erotica, Fear, Happiness, Neutral, and Sadness or their transitions as stimuli, we have developed a series of non-invasive techniques, i.e., the event-related potentials, functional magnetic resonance imaging, excitatory and inhibitory brainstem reflexes, and polygraph, to assess different levels of neurophysiological responses in different populations. Results: Sample outcomes on various conditions were specific and distinguishable at cortical to peripheral levels in bipolar I and II disorder patients compared to healthy volunteers. Conclusions: Methodologically, designs with these pure emotions and their transitions are applicable, and results per se are specifically interpretable in patients with emotion-related problems.

Effective optimization of SARS-CoV-2 laboratory testing variables in an era of supply chain constraints

2020 ◽  
Vol 15 (15) ◽  
pp. 1483-1487
Author(s):  
Nikhil S Sahajpal ◽  
Ashis K Mondal ◽  
Allan Njau ◽  
Sudha Ananth ◽  
Kimya Jones ◽  
...  
Keyword(s):  
Supply Chain ◽  
Rna Extraction ◽  
Nasopharyngeal Swab ◽  
Sample Collection ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Short Supply ◽  
Viral Transport ◽  
3D Printed ◽  
Bridging Studies

RT-PCR-based assays for the detection of SARS-CoV-2 have played an essential role in the current COVID-19 pandemic. However, the sample collection and test reagents are in short supply, primarily due to supply chain issues. Thus, to eliminate testing constraints, we have optimized three key process variables: RNA extraction and RT-PCR reactions, different sample types and media to facilitate SARS-CoV-2 testing. By performing various validation and bridging studies, we have shown that various sample types such as nasopharyngeal swab, bronchioalveolar lavage and saliva, collected using conventional nasopharyngeal swabs, ESwab or 3D-printed swabs and, preserved in viral transport media, universal transport media, 0.9% sodium chloride or Amies media are compatible with RT-PCR assay for COVID-19. Besides, the reduction of PCR reagents by up to fourfold also produces reliable results.

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