scholarly journals SARS-CoV-2 transmission in intercollegiate athletics not fully mitigated with daily antigen testing

2021 ◽  
Author(s):  
Gage K. Moreno ◽  
Katarina M. Braun ◽  
Ian W. Pray ◽  
Hannah E. Segaloff ◽  
Ailam Lim ◽  
...  
Keyword(s):  
Intercollegiate Athletics ◽  
High Frequency ◽  
Index Patient ◽  
Mitigation Strategies ◽  
Athletic Programs ◽  
Test Results ◽  
Antigen Test ◽  
Rt Pcr ◽  
Polymerase Chain ◽  
Antigen Testing

AbstractBackgroundHigh frequency, rapid turnaround SARS-CoV-2 testing continues to be proposed as a way of efficiently identifying and mitigating transmission in congregate settings. However, two SARS-CoV-2 outbreaks occurred among intercollegiate university athletic programs during the fall 2020 semester despite mandatory directly observed daily antigen testing.MethodsDuring the fall 2020 semester, athletes and staff in both programs were tested daily using Quidel’s Sofia SARS Antigen Fluorescent Immunoassay (FIA), with positive antigen results requiring confirmatory testing with real-time reverse transcription polymerase chain reaction (RT-PCR). We used genomic sequencing to investigate transmission dynamics in these two outbreaks.ResultsIn Outbreak 1, 32 confirmed cases occurred within a university athletics program after the index patient attended a meeting while infectious despite a negative antigen test on the day of the meeting. Among isolates sequenced from Outbreak 1, 24 (92%) of 26 were closely related, suggesting sustained transmission following an initial introduction event. In Outbreak 2, 12 confirmed cases occurred among athletes from two university programs that faced each other in an athletic competition despite receiving negative antigen test results on the day of the competition. Sequences from both teams were closely related and unique from strains circulating in the community, suggesting transmission during intercollegiate competition.ConclusionsThese findings suggest that antigen testing alone, even when mandated and directly observed, may not be sufficient as an intervention to prevent SARS-CoV-2 outbreaks in congregate settings, and highlights the importance of supplementing serial antigen testing with appropriate mitigation strategies to prevent SARS-CoV-2 outbreak in congregate settings.SummaryHigh frequency, rapid turnaround SARS-CoV-2 testing continues to be proposed as a way of efficiently identifying and mitigating transmission in congregate settings. However, here we describe two SARS-CoV-2 outbreaks occurred among intercollegiate university athletic programs during the fall 2020 semester.

scholarly journals Application of a Serial Antigen Based Testing Strategy for SARS-CoV-2 and Student Adherence in a University Setting, Wisconsin — October–November 2020

2021 ◽  
Author(s):  
John Paul Bigouette ◽  
Laura Ford ◽  
Ian Pray ◽  
Kimberly Langolf ◽  
Juliana Kahrs ◽  
...  
Keyword(s):  
Male Students ◽  
Test Results ◽  
Antigen Test ◽  
Testing Strategy ◽  
Rt Pcr ◽  
Testing Strategies ◽  
Serial Testing ◽  
Polymerase Chain ◽  
Antigen Tests ◽  
University Setting

Abstract Background Serial SARS-CoV-2 testing has been implemented at institutions of higher education (IHEs) and other settings. Testing strategies can include algorithms specifying confirmatory reverse transcription polymerase chain reaction (RT-PCR) testing after an antigen test. It is unknown how testing strategies perform detecting SARS-CoV-2, including individual adherence to serial testing requirements. Methods Student serial testing adherence was defined as completing ≥80% of weekly tests from October 5–November 14, 2020 and evaluated using logistic regression. Medical records were reviewed for all positive antigen test encounters and 10% of daily negative antigen test encounters during October 19–November 30, 2020. Results were used to estimate the proportion of individuals requiring only antigen tests, requiring and completing RT-PCR testing, and associated costs of tests. Results Two-thirds (66.5%; 1,166/1,754) of eligible on-campus students adhered to weekly testing; female students were more adherent (adjusted odds ratio [aOR]:2.07, 95% CI:1.66–2.59) than male students. Of all antigen test encounters, 11.5% (1,409/12,305) reported >1 COVID-19 symptoms. Of non-COVID-19 exposed antigen test encounters, 88% (10,386/11,769) did not require confirmatory RT-PCR testing. Only 28% (390/1,387) of testing encounters had an associated recommended confirmatory RT-PCR test performed. We estimated the testing strategy captured 61% (235/389) of predicted RT-PCR positive specimens. Conclusions At this IHE, most students voluntarily adhered to serial testing. The majority of antigen test results did not require confirmatory RT-PCR testing, but when required, most students did not obtain it. Including strategies to increase the proportion of individuals obtaining indicated confirmatory testing might improve the testing program’s performance.

scholarly journals Is it enough for COVID-19 screening test? Limitation of swab test and general characteristics of mild symptom patients

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042110261
Author(s):  
Sungwoo Choi ◽  
Hyo Jeong Choi ◽  
Ho Jung Kim
Keyword(s):  
Screening Test ◽  
Community Treatment ◽  
Upper Respiratory Tract ◽  
Test Results ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Positive Rate ◽  
Upper Respiratory ◽  
Polymerase Chain ◽  
Discharge Criteria

The most common method for SARS-CoV-2 testing is throat or nasal swabbing by real-time reverse transcription polymerase chain reaction (RT-PCR) assay. In South Korea, drive-through swab test is used for screening system and community treatment centers (CTCs), which admit and treat confirmed COVID-19 patients with mild symptoms, are being used. This retrospective study was conducted on patients admitted to a CTC on March 6, 2020. A total of 313 patients were admitted. The nasal and throat swabs were collected from the upper respiratory tract, and a sputum test was performed to obtain lower respiratory samples. The positive rate of the first set of test, sputum test was higher than that of the swab test ( p = 0.011). In the second set of test, 1 week after the first ones, the rate of positive swab tests was relatively high ( p = 0.026). In the first set of test, 66 of 152 (43.4%) patients showed 24-h consecutive negative swab test results, when the sputum test results were considered together, that number fell to 29 patients (19.1%) ( p < 0.001). Also, in the second set of test, 63 of 164 (38.4%) patients met the discharge criteria only when the swab test was considered; that number fell to 30 (18.3%) when the sputum test results were also considered ( p < 0.001). Using the swab test alone is insufficient for screening test and discharge decision. Patients who may have positive result in the sputum test can be missed.

scholarly journals Screening, Diagnostic and Prognostic Tests for COVID-19: A Comprehensive Review

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 561
Author(s):  
Mariana Ulinici ◽  
Serghei Covantev ◽  
James Wingfield-Digby ◽  
Apostolos Beloukas ◽  
Alexander G. Mathioudakis ◽  
...  
Keyword(s):  
Point Of Care ◽  
Standard Test ◽  
Current Evidence ◽  
Molecular Testing ◽  
Rt Pcr ◽  
Diagnostic Screening ◽  
Comprehensive Review ◽  
Prognostic Tests ◽  
Polymerase Chain ◽  
Antigen Testing

While molecular testing with real-time polymerase chain reaction (RT-PCR) remains the gold-standard test for COVID-19 diagnosis and screening, more rapid or affordable molecular and antigen testing options have been developed. More affordable, point-of-care antigen testing, despite being less sensitive compared to molecular assays, might be preferable for wider screening initiatives. Simple laboratory, imaging and clinical parameters could facilitate prognostication and triage. This comprehensive review summarises current evidence on the diagnostic, screening and prognostic tests for COVID-19.

scholarly journals COVID-19 and pregnancy – where are we now? A review

2020 ◽  
Vol 48 (5) ◽  
pp. 428-434 ◽  
Author(s):  
Aleksandra Rajewska ◽  
Wioletta Mikołajek-Bedner ◽  
Joanna Lebdowicz-Knul ◽  
Małgorzata Sokołowska ◽  
Sebastian Kwiatkowski ◽  
...  
Keyword(s):  
Case Fatality ◽  
Fetal Distress ◽  
Delivery Mode ◽  
Test Results ◽  
Rt Pcr ◽  
Third Trimester ◽  
The Third ◽  
Laboratory Test Results ◽  
Protective Antibodies ◽  
Polymerase Chain

AbstractThe new acute respiratory disease severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is highly contagious. It has caused many deaths, despite a relatively low general case fatality rate (CFR). The most common early manifestations of infection are fever, cough, fatigue and myalgia. The diagnosis is based on the exposure history, clinical manifestation, laboratory test results, chest computed tomography (CT) findings and a positive reverse transcription-polymerase chain reaction (RT-PCR) result for coronavirus disease 2019 (COVID-19). The effect of SARS-CoV-2 on pregnancy is not already clear. There is no evidence that pregnant women are more susceptible than the general population. In the third trimester, COVID-19 can cause premature rupture of membranes, premature labour and fetal distress. There are no data on complications of SARS-CoV-2 infection before the third trimester. COVID-19 infection is an indication for delivery if necessary to improve maternal oxygenation. Decision on delivery mode should be individualised. Vertical transmission of coronavirus from the pregnant woman to the fetus has not been proven. As the virus is absent in breast milk, the experts encourage breastfeeding for neonatal acquisition of protective antibodies.

Death and COVID-19 Anxiety in Home-Quarantined Individuals Aged 65 and Over During the Pandemic

2021 ◽  
pp. 003022282110598
Author(s):  
Hümeyra Aslaner ◽  
Betül Özen ◽  
Zeliha K. Erten ◽  
Mebrure Beyza Gökçek
Keyword(s):  
Polymerase Chain Reaction ◽  
Death Anxiety ◽  
Short Form ◽  
Anxiety Score ◽  
Test Results ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Test Result ◽  
Pcr Test

Urgent measures were taken for those at the age of 65 and over who were at the risk group all over the world due to the COVID-19 pandemic. It is known that many individuals at the age of 65 and over have experienced anxiety due to the uncertainties. This study aimed to determine the anxiety and death anxiety in individuals aged 65 and over who were isolation at home due to being diagnosed with COVID-19 or being in contact during the pandemic process. The study is descriptive and cross-sectional. It was performed with 656 home-quarantined individuals aged between 65–80 years with positive or negative real-time polymerase chain reaction (RT-PCR) test result. A form including questions about the death anxiety and the Coronavirus Anxiety Scale Short Form prepared by the researchers were administered to the individuals by phone call. Of the participants, 49.5% were male. Median COVID-19 anxiety score was 4 (0–18). Anxiety scores of the male and female participants were similar. Participants with negative polymerase chain reaction (PCR) results and those with death anxiety had higher COVID anxiety scores. Death anxiety has increased by 1.661 times in male gender, 1.983 times in RT-PCR positivity and 0.146 times in the presence of symptoms. Individuals with positive COVID-19 test results or those aged 65 and over who had death anxiety and negative COVID-19 test result but who were in home-isolation due to being a contact had higher anxiety score. For this reason, those with death anxiety can be supported in line with their religious beliefs to reduce anxiety. Those with negative PCR test results in quarantine can be adequately informed about the COVID-19.

scholarly journals Comparison of SARS-CoV-2 antigen electrochemiluminescence immunoassay to RT-PCR assay for laboratory diagnosis of COVID-19 in Peshawar

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Bilal Iqbal ◽  
Maria Khan ◽  
Noman Shah ◽  
Mirza Muhammad Dawood ◽  
Valeed Jehanzeb ◽  
...  
Keyword(s):  
Laboratory Diagnosis ◽  
Cross Sectional Study ◽  
Antigen Test ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Cross Sectional ◽  
Viral Loads ◽  
Testing Algorithms ◽  
Frequent Testing ◽  
Antigen Testing

Abstract Objectives Antigen based rapid diagnostic tests possesses a potential to be utilized along with Gold standard methods to detect Covid-19 infection to cope with the demand of testing. The aim of this study was to determine diagnostic accuracy of electrochemiluminescence based automated antigen detection immunoassay comparing with molecular based test RT-PCR (Covid-19). Methods It was a cross-sectional study conducted in RMI Peshawar, from 1st April 2021 till 30th April 2021. The study comprised 170 individuals who were suspected of having Covid-19. Nasopharyngeal samples taken from suspected individuals were analyzed by RT-PCR and automated antigen test (Elecsys SARS-CoV-2 Antigen) simultaneously. The correlation of SARS-CoV-2 antigen with PCR positive and negative cases was analyzed for specificity, sensitivity respectively. Results The ECLIA based Elecsys antigen test (Roche) revealed overall sensitivity 72%, specificity 95% and accuracy of 94.9%. Sensitivity of antigen test progressively declined from 94.3% in Ct <25 to 70.8% in Ct 26–29 and then to 47.2% in Ct 30–35. Conclusions Based on the findings of our study we conclude that automated antigen testing (Elecsys SARS-CoV-2 Antigen) cannot replace molecular based testing like RT PCR. Elecsys SARS-CoV-2 Ag test should be used complementary to RT-PCR in testing algorithms. Frequent testing strategy should be adopted while using automated antigen testing to overcome its limitation in individuals with low viral loads.

scholarly journals Antigen Testing for COVID-19 Asymptomatic Screening: Why it Should be Preferred Over PCR Insights From Navy Region Japan’s Experience With a Comprehensive Antigen Testing Strategy

2021 ◽  
Author(s):  
Ross A Mullinax
Keyword(s):  
Public Health ◽  
Infectious Virus ◽  
Infectious Period ◽  
Test Results ◽  
Testing Strategy ◽  
Viral Loads ◽  
Viral Culture ◽  
Polymerase Chain ◽  
Antigen Testing

ABSTRACT Polymerase chain reaction (PCR) is commonly used in asymptomatic screening testing, but is suboptimal for this purpose as it will identify many old persistent positives that are no longer infectious. This can result in placement of individuals that are not infectious to others into isolation. This results in substantial adverse impact to military manning and operations, without any benefit to public health. Antigen testing does not have this same drawback. Antigen testing, while less sensitive than PCR, will identify the vast majority of infectious positives, especially those with higher viral loads that are more likely to transmit to others. Importantly, use of antigen testing will also greatly increase the certainty of benefit from isolation, reducing the risk of isolating those individuals who are beyond their infectious period and pose no threat to public health. The literature on this topic is reviewed, with particular focus on studies that perform viral culture in addition to PCR and antigen testing. This allows for determination of sensitivity for infectious virus. Also, Navy Region Japan’s experience with a comprehensive antigen testing strategy is described. The challenges presented by persistent positive PCR test results are examined, as well as the real-world benefits from implementing widespread use of antigen testing.

scholarly journals Risk Factors for SARS-CoV-2 Infection and Presence of Anti-SARS-CoV-2 Antibodies among University Student Dormitory Residents, September–November 2020

2021 ◽  
Author(s):  
Hannah E Segaloff ◽  
Devlin Cole ◽  
Hannah G Rosenblum ◽  
Christine C Lee ◽  
Clint N Morgan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Test Results ◽  
Rt Pcr ◽  
Adjusted Risk ◽  
Social Events ◽  
Adjusted Risk Ratio ◽  
Infection Risk Factors ◽  
Polymerase Chain ◽  
Survey Responses ◽  
The Relationship

Abstract Background Multiple SARS-CoV-2 outbreaks occurred at universities during Fall 2020, but little is known about risk factors for campus-associated infections immunity provided by anti-SARS-CoV-2 antibodies in young adults. Methods We conducted surveys and serology tests among students living in dormitories in September and November to examine infection risk factors and antibody presence. Using campus weekly reverse transcription polymerase chain reaction (RT-PCR) test results, the relationship between survey responses, SARS-CoV-2 antibodies and infections was assessed. Results Of 6136 students, 1197 completed the survey and 572 also completed serologic testing in September compared with 517 and 414 in November, respectively. Participation in fraternity or sorority events (adjusted Risk Ratio (aRR): 1·9 [95% CI: 1·4–2·5]) and frequent alcohol consumption (aRR: 1·6 [1·2–2·2]) were associated with SARS-CoV-2 infection. Mask wearing during social events (aRR: 0·6 [0·6–1·0]) was associated with decreased risk. None of the 20 students with antibodies in September tested postive for SARS-CoV-2 during the semester, while 27·8% of students who tested RT-PCR positive tested negative for antibodies in November. Conclusion Frequent drinking and attending social events were associated with SARS-CoV-2 infection. Antibody presence in September appeared to be protective from re-infection, but this finding was not statistically significant.

scholarly journals Direct Comparison of SARS Co-V-2 Nasal RT- PCR and Rapid Antigen Test (BinaxNOWTM) at a Community Testing Site During an Omicron Surge

2022 ◽  
Author(s):  
John Schrom ◽  
Carina Marquez ◽  
Genay Pilarowski ◽  
Grace Wang ◽  
Anthea Mitchell ◽  
...  
Keyword(s):  
San Francisco ◽  
High Viral Load ◽  
Antigen Test ◽  
Rt Pcr ◽  
Repeat Testing ◽  
Single Antigen ◽  
Testing Site ◽  
Antigen Testing ◽  
Test Result ◽  
Community Site

In 731 persons seeking COVID-19 testing at a walk-up San Francisco community site in January 2022, simultaneous nasal rapid antigen testing (BinaxNOWTM) and RT-PCR testing was performed. There were 296 (40.5%) positive tests by RT-PCR; 97% of a random sample were the omicron variant. Sensitivity of a single antigen test was 95.2% (95% CI 92-98%); 82.1% (95% CI 77-87%) and 65.2% (95% CI 60-70%) for Ct threshold of < 30, < 35 and no threshold, respectively. A single BinaxNowTM rapid antigen test detected 95% of high viral load omicron cases from nasal specimens. As currently recommended, repeat testing should be done for high- risk persons with an initial negative antigen test result.

scholarly journals Diagnostic performance of a novel digital immunoassay (RapidTesta SARS-CoV-2): a prospective observational study with 1,127 nasopharyngeal samples

2021 ◽  
Author(s):  
Hiromichi Suzuki ◽  
Yusaku Akashi ◽  
Atsuo Ueda ◽  
Yoshihiko Kiyasu ◽  
Yuto Takeuchi ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Prospective Observational Study ◽  
Test Results ◽  
Antigen Test ◽  
Rt Pcr ◽  
Asymptomatic Patients ◽  
Pcr Method ◽  
Antigen Tests ◽  
Positive Line ◽  
Test Cassette

Introduction: Digital immunoassays are generally regarded as superior tests for the detection of infectious disease pathogens, but there have been insufficient data concerning SARS-CoV-2 immunoassays. Methods: We prospectively evaluated a novel digital immunoassay (RapidTesta SARS-CoV-2). Two nasopharyngeal samples were simultaneously collected for antigen tests and RT-PCR. Real-time RT-PCR for SARS-CoV-2, using a method developed by the National Institute of Infectious Diseases, Japan, served as the reference RT-PCR method. Results: During the study period, 1,127 nasopharyngeal samples (symptomatic patients: 802, asymptomatic patients: 325) were evaluated. For digital immunoassay antigen tests, the sensitivity was 78.3% (95% CI: 67.3%-87.1%) and the specificity was 97.6% (95% CI: 96.5%-98.5%). When technicians visually analyzed the antigen test results, the sensitivity was 71.6% (95% CI: 59.9%-81.5%) and the specificity was 99.2% (95% CI: 98.5%-99.7%). Among symptomatic patients, the sensitivity was 89.4% (95% CI; 76.9%-96.5%) with digital immunoassay antigen tests, and 85.1% (95% CI; 71.7%-93.8%) with visually analyzed the antigen test, respectively. Conclusions: The findings indicated that RapidTesta SARS-CoV-2 analysis with the DIA device had sufficient analytical performance for the detection of SARS-CoV-2 in nasopharyngeal samples. When positive DIA results are recorded without a visually recognizable red line at the positive line location on the test cassette, additional RT-PCR evaluation should be performed.

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