scholarly journals Novel Approaches to Diagnose COVID-19

2020 ◽  
pp. 66-71
Author(s):  
Solaf Jawhar Ali
Keyword(s):  
Clinical Symptoms ◽  
Low Cost ◽  
Case Definition ◽  
Diagnostic Tools ◽  
Rt Pcr ◽  
Public Health Agencies ◽  
Health Agencies ◽  
Acute Respiratory Diseases ◽  
Diagnostic Approaches ◽  
Laboratory Examinations

An widespread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019 has occurred worldwide.  Public health agencies are in need of developing diagnostic tools which will have a major impact in tracking the virus and suppressing the transmission. Diagnosis of the disease is based on clinical symptoms, epidemiological history and laboratory examinations. Severe acute respiratory diseases with fever and ,cough and dyspnea, are used as the case definition to select people for testing. Different samples taken from the human body such as oropharyngeal (OP) and nasopharyngeal (NP) swabs are used to detect the virus. SARS-CoV-2 can be detected with different methods in the laboratory including real time RT-PCR, chest CT scan and immunoassays. Viral nucleic acid testing has played important role in control COVIDI-19 outbreak.  More recently, a new CRISPR-based DETECTR assay has been developed to detect COVID-19. This test is rapid (~30 min), low-cost, and precise for identification of SARS-CoV-2. In addition, immunoassays and medical imaging can use as supplementary tests, combined with RT-PCR. This review is conducted to summarizes the current information on the present diagnostic approaches for SARS-CoV-2.

scholarly journals Point-of-Care Diagnostic Tools for Surveillance of SARS-CoV-2 Infections

2021 ◽  
Vol 9 ◽  
Author(s):  
Dhanasekaran Sakthivel ◽  
David Delgado-Diaz ◽  
Laura McArthur ◽  
William Hopper ◽  
Jack S. Richards ◽  
...  
Keyword(s):  
Large Scale ◽  
Clinical Symptoms ◽  
Point Of Care ◽  
Cost Effective ◽  
Nucleic Acid Amplification ◽  
Diagnostic Tools ◽  
Rt Pcr ◽  
Serological Tests ◽  
Polymerase Chain ◽  
Effective Public Health

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a recently emerged and highly contagious virus that causes coronavirus disease 2019 (COVID-19). As of August 24, 2021, there were more than 212 million confirmed COVID-19 cases and nearly 4.4 million deaths reported globally. Early diagnosis and isolation of infected individuals remains one of the most effective public health interventions to control SARS-CoV-2 spread and for effective clinical management of COVID-19 cases. Currently, SARS-CoV-2 infection is diagnosed presumptively based on clinical symptoms and confirmed by detecting the viral RNA in respiratory samples using reverse transcription polymerase chain reaction (RT-PCR). Standard RT-PCR protocols are time consuming, expensive, and technically demanding, which makes them a poor choice for large scale and point-of-care screening in resource-poor settings. Recently developed isothermal nucleic acid amplification tests (iNAAT), antigen and/or serological tests are cost-effective to scale COVID-19 testing at the point-of-care (PoC) and for surveillance activities. This review discusses the development of rapid PoC molecular tools for the detection and surveillance of SARS-CoV-2 infections.

scholarly journals Network Analysis of Outpatients to Identify Predictive Symptoms and Combinations of Symptoms Associated With Positive/Negative SARS-CoV-2 Nasopharyngeal Swabs

2021 ◽  
Vol 8 ◽  
Author(s):  
Hervé Spechbach ◽  
Frédérique Jacquerioz ◽  
Virginie Prendki ◽  
Laurent Kaiser ◽  
Mikaela Smit ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Outpatient Setting ◽  
Case Definition ◽  
Rt Pcr ◽  
Thoracic Pain ◽  
Runny Nose ◽  
Abdominal Symptoms ◽  
Targeted Testing ◽  
Dedicated Networks ◽  
Systemic Symptoms

Background: Limited data exist on early predictive clinical symptoms or combinations of symptoms that could be included in the case definition of coronavirus disease 2019 (COVID-19), particularly for mild-to-moderate disease in an outpatient setting.Methods: A cohort study of individuals presenting with clinical symptoms to one of the largest dedicated networks of COVID-19 test centers in Geneva, Switzerland, between March 2 and April 23, 2020. Individuals completed a symptom questionnaire, received a nurse-led check-up, and nasopharyngeal swabs were obtained. An analysis of clinical features predicting the positivity and negativity of the SARS-CoV-2 RT-PCR test was performed to determine the relationship between symptoms and their combinations.Results: Of 3,248 patients included (mean age, 42.2 years; 1,504 [46.3%] male), 713 (22%) had a positive RT-PCR; 1,351 (41.6%) consulted within 3 days of symptom onset. The strongest predictor of a positive SARS-CoV-2 RT-PCR was anosmia, particularly in early disease, followed by fever, myalgia, and cough. Symptoms predictive of a negative test were breathing difficulties, abdominal symptoms, thoracic pain and runny nose. Three distinct networks of symptoms were identified, but did not occur together: respiratory symptoms; systemic symptoms related to fever; and other systemic symptoms related to anosmia.Conclusions: Symptoms and networks of symptoms associated with a positive/negative SARS-CoV-2 RT-PCR are emerging and may help to guide targeted testing. Identification of early COVID-19-related symptoms alone or in combination can contribute to establish a clinical case definition and provide a basis for clinicians and public health authorities to distinguish it from other respiratory viruses early in the course of the disease, particularly in the outpatient setting.

scholarly journals The sensitivity and specificity of chest CT in the diagnosis of COVID-19

2020 ◽  
Author(s):  
Anita Kovács ◽  
Péter Palásti ◽  
Dániel Veréb ◽  
Bence Bozsik ◽  
András Palkó ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Gold Standard ◽  
Clinical Symptoms ◽  
Close Contact ◽  
Chest Ct ◽  
Added Value ◽  
Ct Scans ◽  
Diagnostic Tools ◽  
Diagnostic Process ◽  
Rt Pcr

Abstract Purpose The identification of patients infected by SARS-CoV-2 is highly important to control the disease; however, the clinical presentation is often unspecific and a large portion of the patients develop mild or no symptoms at all. For this reason, there is an emphasis on evaluating diagnostic tools for screening. Chest CT scans are emerging as a useful tool in the diagnostic process of viral pneumonia cases associated with COVID-19. This review examines the sensitivity, specificity, and feasibility of chest CT in detecting COVID-19 compared with real-time polymerase chain reaction (RT-PCR). Methods Sensitivity and specificity of chest CT in detecting COVID-19 in its various phases was compared using RT-PCR as a gold standard. A “reverse calculation approach” was applied and treated chest CT as a hypothetical gold standard and compared RT-PCR to it point out the flaw of the standard approach. Results High sensitivity (67–100%) and relatively low specificity (25–80%) was reported for the CT scans. However, the sensitivity of RT-PCR was reported to be modest (53–88%), hence cannot serve as an appropriate ground truth. The “reverse calculation approach” showed that CT could have a higher specificity (83–100%) if we consider the modest sensitivity of the RT-PCR. Conclusions The sensitivity and specificity of the chest CT in diagnosing COVID-19 and the radiation exposure have to be judged together. Arguments are presented that chest CT scans have added value in diagnosing COVID-19 especially in patients, who exhibit typical clinical symptoms and have negative RT-PCR results in highly infected regions. Key Points • CT scans have higher specificity if we take into account the low sensitivity of the RT-PCR. • Avoid chest CT as a sole diagnostic approach for COVID-19 infection. • Patients who had negative RT-PCR result with typical clinical symptoms in highly infected regions or with close contact of COVID-19-infected patients; the use of chest CT is warranted.

scholarly journals A two-pronged approach for rapid and high-throughput SARS-CoV-2 nucleic acid testing

2020 ◽  
Author(s):  
Neeru Gandotra ◽  
Irina Tikhonova ◽  
Nagarjuna R. Cheemarla ◽  
James Knight ◽  
Ellen Foxman ◽  
...  
Keyword(s):  
High Throughput ◽  
High Throughput Sequencing ◽  
Low Cost ◽  
Rna Extraction ◽  
Clinical Specimen ◽  
Rna Isolation ◽  
Turnaround Time ◽  
Ease Of Use ◽  
Diagnostic Tools ◽  
Rt Pcr

AbstractImproved molecular screening and diagnostic tools are needed to substantially increase SARS-CoV-2 testing capacity and throughput while reducing the time to receive test results. Here we developed multiplex reverse transcriptase polymerase chain reaction (m-RT-PCR) for detection of SARS-CoV-2 using rapid DNA electrophoresis and alternatively using multiplex viral sequencing (mVseq). For RNA specimens extracted from nasopharyngeal (NP) swabs in viral transport media (VTM), our assays achieved a sensitivity for SARS-CoV-2 detection corresponding to cycle threshold (Ct) of 37.2 based on testing of these specimens using quantitative reverse transcription PCR (RT-qPCR). For NP swab-VTM specimens without prior RNA extraction, sensitivity was reduced to Ct of 31.6, which was due to lower concentration of SARS-CoV-2 genome copies in VTM compared to RNA-extracted samples. Assay turnaround time was 60 minutes using rapid gel electrophoresis, 90 minutes using Agilent Bioanalyzer, and 24-48 hours using Illumina sequencing, the latter of which required a second PCR to produce a sequence-ready library using m-RT-PCR products as the template. Our assays can be employed for high-throughput sequencing-based detection of SARS-CoV-2 directly from a clinical specimen without RNA isolation, while ease-of-use and low cost of the electrophoresis-based readout enables screening, particularly in resource-constrained settings.

scholarly journals Dispositivos de tecnologia assistiva para crianças e adolescentes com deficiência física confeccionados em projetos de extensão para comunidade / Assistive technology devices for children and adolescents with physical disabilities made in a community extension project

2021 ◽  
Vol 5 (1) ◽  
pp. 45-60
Author(s):  
Bruna Araújo Morais Xavier ◽  
Gilma Correa Coutinho ◽  
Mariana Midori Sime ◽  
Fabiana Drumond Marinho
Keyword(s):  
Occupational Therapy ◽  
Assistive Technology ◽  
Children And Adolescents ◽  
Clinical Performance ◽  
Physical Disabilities ◽  
Low Cost ◽  
Free Access ◽  
Public Health Agencies ◽  
Health Agencies ◽  
Made In

Os dispositivos de Tecnologia Assistiva (TA) proporcionam autonomia às pessoas com deficiência. O objetivo do estudo foi investigar que tipos de dispositivos de TA de baixo custo têm sido confeccionados pela terapia ocupacional para crianças e adolescentes com deficiência física em um projeto de extensão universitário, caracterizando o material, o perfil epidemiológico e demográfico, e as atividades da vida diária auxiliadas com o uso dos dispositivos. Método: Estudo de análise documental realizado nas fichas de atendimento de pacientes na faixa etária de 0-18 anos, no período de 2013 a 2018. Os dados analisados foram sexo, idade, diagnóstico, município de moradia, tipo de dispositivo, material utilizado e as atividades da vida diária para o uso dos dispositivos. Resultados e Discussão: Foram analisadas 91 fichas de pacientes residentes em 26 municípios. Dentre os 27 diagnósticos encontrados, 7 casos considerados raros foram atendidos, e os de paralisia cerebral foram os mais frequentes. Dos dispositivos, as órteses estáticas e as adaptações para escrita foram as que mais atenderam aos pacientes, sendo utilizado o termoplástico e outros materiais de baixo custo, como o EVA e a madeira para a confecção. As órteses e as adaptações foram utilizadas nas atividades da vida diária de alimentação, escrita, vestuário e higiene. Considerações: Através do projeto de extensão, crianças e adolescentes com deficiência física tiveram acesso gratuito à dispositivos de TA, que deveriam ser ofertados pelos órgãos públicos de saúde em seus municípios de moradia. A vivência também favoreceu a potencialização do aprendizado dos discentes na atuação clínica da terapia ocupacional com a comunidade. Abstract Assistive Technology (AT) devices provide autonomy to people with disabilities. The aim of the study was to investigate what types of low-cost AT devices have been made by occupational therapy for children and adolescents with physical disabilities in a university extension project, featuring the material, the epidemiological and demographic profile, and the activities of life daily assistance with the use of the devices. Method: Document analysis study carried out on patient care records in the age group 0-18 years, from 2013 to 2018. The data analyzed were sex, age, diagnosis, municipality of residence, type of device, material used and activities of daily living for the use of devices. Results and Discussion: 91 records of patients residing in 26 municipalities were analyzed. Among the 27 diagnoses found, 7 cases considered rare were attended to, and cerebral palsy cases were the most frequent. Of the devices, static orthoses and adaptations for writing were the ones that most attended patients, using thermoplastic and other low-cost materials, such as EVA and wood for making. Orthoses and adaptations were used in daily activities of food, writing, clothing and hygiene. Considerations: Through the extension project, children and adolescents with physical disabilities had free access to AT devices, which should be offered by public health agencies in their municipalities. The experience also favored the enhancement of students' learning in the clinical performance of occupational therapy with the community.Keywords: Education, Assistive technology, Child, Adolescent, Physical disability, Occupational Therapy Resumen Los dispositivos de tecnología de asistencia (AT) brindan autonomía a las personas con discapacidad. El objetivo del estudio fue investigar qué tipos de dispositivos de TA de bajo costo han sido fabricados por terapia ocupacional para niños y adolescentes con discapacidad física en un proyecto de extensión universitaria, destacando el material, el perfil epidemiológico y demográfico y las actividades de la vida. Asistencia diaria con el uso de los dispositivos. Método: Estudio de análisis documental realizado sobre historias clínicas de pacientes en el grupo de edad 0-18 años, de 2013 a 2018. Los datos analizados fueron sexo, edad, diagnóstico, municipio de residencia, tipo de dispositivo, material utilizado y actividades de la vida diaria para el uso de dispositivos. Resultados y Discusión: Se analizaron 91 registros de pacientes residentes en 26 municipios. De los 27 diagnósticos encontrados, se atendieron 7 casos considerados raros y los casos de parálisis cerebral fueron los más frecuentes. De los dispositivos, las ortesis estáticas y las adaptaciones para la escritura fueron las que más atendieron a los pacientes, utilizando termoplásticos y otros materiales de bajo costo, como EVA y madera para su confección. Se utilizaron órtesis y adaptaciones en las actividades diarias de alimentación, escritura, vestimenta e higiene. Consideraciones: A través del proyecto de extensión, los niños, niñas y adolescentes con discapacidad física tuvieron acceso gratuito a los dispositivos de TA, los cuales deben ser ofrecidos por las agencias de salud pública en sus municipios. La experiencia también favoreció la mejora del aprendizaje de los estudiantes en el desempeño clínico de la terapia ocupacional con la comunidad.Palabras clave: Educación, Tecnología de asistencia, Niños, Adolescentes, Discapacidad física, Terapia ocupacional

Scoring System for the Diagnosis of COVID-19

2020 ◽  
Vol 13 (1) ◽  
pp. 413-414 ◽  
Author(s):  
Mohamed Farouk Allam
Keyword(s):  
Scoring System ◽  
Clinical Symptoms ◽  
False Negative ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Negative Results ◽  
False Negative Results ◽  
Symptoms And Signs

Due to the international spread of COVID-19, the difficulty of collecting nasopharyngeal swab specimen from all suspected patients, the costs of RT-PCR and CT, and the false negative results of RT-PCR assay in 41% of COVID-19 patients, a scoring system is needed to classify the suspected patients in order to determine the need for follow-up, home isolation, quarantine or the conduction of further investigations. A scoring system is proposed as a diagnostic tool for suspected patients. It includes Epidemiological Evidence of Exposure, Clinical Symptoms and Signs, and Investigations (if available). This scoring system is simple, could be calculated in a few minutes, and incorporates the main possible data/findings of any patient.

The Perils of Partnership

2019 ◽  
Author(s):  
Jonathan H. Marks
Keyword(s):  
Public Health ◽  
Multinational Corporations ◽  
Separation Of Powers ◽  
Public Health Research ◽  
Noncommunicable Diseases ◽  
New Paradigm ◽  
Public Health Agencies ◽  
Ethical Implications ◽  
Health Agencies ◽  
Public Bodies

Collaboration with industry has become the paradigm in public health. Governments commonly develop close relationships with companies that are creating or exacerbating the very problems public health agencies are trying to solve. Nowhere is this more evident than in partnerships with food and soda companies to address obesity and diet-related noncommunicable diseases. The author argues that public-private partnerships and multistakeholder initiatives create webs of influence that undermine the integrity of public health agencies; distort public health research and policy; and reinforce the framing of public health problems and their solutions in ways that are least threatening to the commercial interests of corporate “partners.” We should expect multinational corporations to develop strategies of influence. But public bodies need to develop counter-strategies to insulate themselves from corporate influence in all its forms. The author reviews the ways in which we regulate public-public interactions (separation of powers) and private-private interactions (antitrust and competition laws), and argues for an analogous set of norms to govern public-private interactions. The book also offers a novel framework that is designed to help public bodies identify the systemic ethical implications of their existing or proposed relationships with industry actors. The book makes a compelling case that, in public health, the paradigm public-private interaction should be at arm’s length: separation, not collaboration. The author calls for a new paradigm to protect and promote public health while avoiding the ethical perils of partnership with industry.

Asymptomatic low-density Plasmodium infection during non-transmission season: a community-based cross-sectional study in two districts of North Eastern Region, India

2021 ◽  
Author(s):  
Hari Shankar ◽  
Sobhan Phookan ◽  
Mrigendra Pal Singh ◽  
Ram Suresh Bharti ◽  
Naseem Ahmed ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Diagnostic Tools ◽  
Eastern Region ◽  
Low Density ◽  
Plasmodium Infection ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health Agencies ◽  
North Eastern ◽  
Asymptomatic Infections

Abstract Background Malaria elimination requires targeting asymptomatic and low-density Plasmodium infections that largely remain undetected. Therefore we conducted a cross-sectional study to estimate the burden of asymptomatic and low-density Plasmodium infection using conventional and molecular diagnostics. Methods A total of 9118 participants, irrespective of age and sex, were screened for malaria using rapid diagnostic tests (RDTs), microscopy and polymerase chain reaction. Results Among the participants, 707 presented with symptoms and 8411 without symptoms, of which Plasmodium was present in 15.6% (110/707) and 8.1% (681/8411), respectively. Low-density infection was found in 5.1% (145/2818) of participants and 8327 of 9118 were Plasmodium negative. Endemicity was propotional to asymptomatic infections (high endemicity 11.1% [404/3633] vs low endemicity 5.8% [277/4778]; odds ratio [OR] 2.0 [95% confidence interval {CI} 1.7 to 2.4]) but inversely related to low-density infection (high endemicity 3.7% [57/1545] vs low endemicity 6.9% [88/1273]; OR 1.9 [95% CI 1.4 to 2.7]). The spleen rate in children 2–9 y of age was 17.9% (602/3368) and the enlarged spleen index was 1.6. Children between 8 and 14 y showed higher odds for asymptomatic (adjusted OR [aOR] 1.75 [95% CI 1.4 to 2.2]) and low-density infections (aOR 0.63 [95% CI 0.4 to 1.0)] than adults. Conclusions The prevalence of asymptomatic and low-density Plasmodium infection undermines the usefulness of standard diagnostic tools used by health agencies. This necessitates deploying molecular tools in areas where malaria microscopy/RDTs indicate a dearth of infection.

scholarly journals Prolonged SARS-CoV-2-RNA Detection from Nasopharyngeal Swabs in an Oncologic Patient: What Impact on Cancer Treatment?

2021 ◽  
Vol 28 (1) ◽  
pp. 847-852
Author(s):  
Anna Ferrari ◽  
Marco Trevenzoli ◽  
Lolita Sasset ◽  
Elisabetta Di Liso ◽  
Toni Tavian ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Clinical Symptoms ◽  
Palliative Radiotherapy ◽  
Rt Pcr ◽  
Cancer Treatments ◽  
Global Challenge ◽  
Viral Culture ◽  
Pcr Assays

The pandemic of SARS-CoV-2 is a serious global challenge affecting millions of people worldwide. Cancer patients are at risk for infection exposure and serious complications. A prompt diagnosis of SARS-CoV-2 infection is crucial for the timely adoption of isolation measures and the appropriate management of cancer treatments. In lung cancer patients the symptoms of infection 19 may resemble those exhibited by the underlying oncologic condition, possibly leading to diagnostic overlap and delays. Moreover, cancer patients might display a prolonged positivity of nasopharyngeal RT-PCR assays for SARS-CoV-2, causing long interruptions or delay of cancer treatments. However, the association between the positivity of RT-PCR assays and the patient’s infectivity remains uncertain. We describe the case of a patient with non-small cell lung cancer, and a severe ab extrinseco compression of the trachea, whose palliative radiotherapy was delayed because of the prolonged positivity of nasopharyngeal swabs for SARS-CoV-2. The patient did not show clinical symptoms suggestive of active infection, but the persistent positivity of RT-PCR assays imposed the continuation of isolation measures and the delay of radiotherapy for over two months. Finally, the negative result of SARS-CoV-2 viral culture allowed us to verify the absence of viral activity and to rule out the infectivity of the patient, who could finally continue her cancer treatment.

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