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The Evolution of COVID-19 Diagnostics
Published in Debmalya Barh, Kenneth Lundstrom, COVID-19, 2022
Praveen Rai, Ballamoole Krishna Kumar, Deekshit Vijaya Kumar, Prashant Kumar, Anoop Kumar, Shashi Kumar Shetty, Biswajit Maiti
RT-qPCR is considered to be the best method for detection of SARS-CoV-2. In addition to the sensitivity and specificity, the assay can be used for quantitative estimation of viral load. However, the method has several limitations, which include:It cannot be deployed as a PoC or for bedside testing in resource-limited settings.Technical complexity and high costs place a high demand on experimental instruments, testing reagents, and the skill of research personnel.Tests typically take 4–6 hours to complete, but the logistical requirement to ship clinical samples leads to a turnaround time of more than 24 hours that delays the reporting.
And Now, as Promised
Published in Rae-Ellen W. Kavey, Allison B. Kavey, Viral Pandemics, 2020
Rae-Ellen W. Kavey, Allison B. Kavey
Information on viral dynamics in infected patients is emerging from serial findings in SARS-CoV-2-infected individuals. Viral loads in throat swab and sputum samples peaked at ~5–6 days after infection; this pattern is distinct from SARS, where viral load typically peaked at around 10 days after infection. Sputum samples generally showed higher viral loads than throat swab samples. Viral load was highest early after symptom onset, but in a single patient who died, viral load was persistently very high. Stool samples from a small subset of patients were weakly positive.37
Norovirus
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Various commercial EIA assays exist with sensitivities for each assay ranging from 30% to 90% and specificity 60% to 100%. Factors influencing this are the viral load and genotype. To increase the sensitivity of the EIAs, it is recommended to take multiple samples. Because of the modest performance of these commercial kits, particularly their poor sensitivity, they are not recommended for clinical diagnosis of norovirus infection in sporadic cases of gastroenteritis. Besides EIAs, there now also exist lateral-flow immunochromatographic assays with sensitivities also showing a wide range between 19% and 90%. Real-time RT-PCR is the gold standard for diagnosis.
Remdesivir for the treatment of COVID 19: review of the pharmacological properties, safety and clinical effectiveness
Published in Expert Opinion on Drug Safety, 2021
Ashesha Mechineni, Hagar Kassab, Rajapriya Manickam
In the United States, the first reported case of COVID-19 was treated with remdesivir [16]. Subsequently, a study of remdesivir use in a cohort of hospitalized patients with severe COVID-19 was published by Grein et al. Of the 53 patients receiving remdesivir, 36 (68%) had improvement in oxygen support status, and mortality occurred in 7 (13%) patients. In patients receiving mechanical ventilation, 17 out of 30 (57%) were extubated [17]. Antinori et al. also published their experience with remdesivir use in 35 patients with COVID-19. Of those, 18 patients were admitted to the intensive care unit (ICU) and 17 patients to the infectious disease (ID) ward [18]. The primary outcome was a change in the patient’s hospitalization status on the 10th and 28th day of treatment, which was measured using a 7-category ordinal scale. On day 28, 82.3% of patients from the ID ward and 33.3% of ICU patients were discharged. Baseline and post-treatment viral load was measured in 21 of the 35 patients. All 21 patients had reverse transcriptase-polymerase chain reaction (RT-PCR) negative viral load at a median duration of 12 days after treatment initiation [18]. Further details regarding the trial design and final outcomes can be found in Table 1.
Clinical Features of Ocular Syphilis: a Retrospective Clinical Study in an Italian Referral Centre
Published in Seminars in Ophthalmology, 2020
Antonietta Moramarco, Fabiana Mallone, Maria Pia Pirraglia, Alice Bruscolini, Rosalia Giustolisi, Maurizio La Cava, Alessandro Lambiase
Specifically, all recruited patients were subjected to screening non-treponemal tests: analysis for venereal disease research laboratory and Rapid Plasma Reagin (RPR), with confirmatory treponemal tests: Treponema pallidum hemagglutination assay (TPHA) and Fluorescent treponemal antibody absorption test. We performed Cerebrospinal fluid (CSF) analysis for all participants as per the protocol for ocular syphilis. Results of the HIV test with the enzyme-linked immunosorbent assay method with confirmation by Western blot analysis were collected for all patients. Patients with a positive HIV test also had their HIV-RNA status and CD4 counts assessed. The average CD4 count in HIV-positive patients was 275 (3–1300) at presentation. Among the patients for whom records of the viral load were available, the average baseline load was 100.000 (0–339.000).
Adherence among chaos: Exploring how control and relationships influence adherence to HIV medication
Published in Cogent Medicine, 2018
Megan Lefebvre, Maria Mayan, Christine Hughes, Stan Houston
Our study involved HIV-positive individuals attending the NAP. The NAP provides care by an interdisciplinary healthcare team (i.e. infectious disease physicians, nurses, pharmacists, social workers, psychologists, dietitians) to all HIV-positive individuals in northern Alberta. HIV-positive individuals are seen four weeks after initiating ART and then every three to four months; additional support may be provided by team members between physician visits. Antiretroviral prescribing is limited to infectious disease physicians and ART is dispensed from outpatient pharmacies. ART and associated testing (i.e. CD4 cell counts, VL measurements, genotypic ART sensitivity testing) is provided at no cost to the individual through a provincial government program. Viral load is typically monitored either prior to, or at each visit, as part of routine care.