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Respiratory Diseases
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Aref T. Senno, Ryan K. Brannon
There have been numerous diagnostic tests developed by private companies and government agencies worldwide with varying degrees of accuracy. There currently is no gold standard diagnostic test for COVID-19, although NAAT to detect viral RNA has become the most common means of rapid diagnosis. Sample sites include the sputum, nasopharynx, throat, saliva, urine, stool, and blood. Nasopharyngeal swab displays high levels of sensitivity when compared to other sample sites, although anterior nares, oropharyngeal, saliva, and mid-turbinate swabs are acceptable depending on type of test used [144, 145]. NAAT usually results in 15 minutes to 8 hours, although turnaround time is dependent upon laboratory capacity and volume. Accuracy of testing varies across different NAAT used globally, but sensitivity and specificity are high (>95% and >99%, respectively) [146, 147]. Viral RNA—and thus a positive NAAT—may persist for up to 6 weeks following symptom onset, although infectiousness does not necessarily persist over this time period [148].
Specific Infections in Children
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Neal Russell, Sarah May Johnson, Andrew Chapman, Christian Harkensee, Sylvia Garry, Bhanu Williams
Diagnosis may be clinical, and treatment and isolation should be started once the diagnosis is suspected. If available, a full blood count may reveal leucocytosis; higher white cell counts are associated with more severe outcomes (including seizures). Laboratory confirmation is possible with per-nasal or nasopharyngeal swab polymerase chain reaction (PCR) or culture (particularly if <2 weeks since onset) or with serology.
Clinical Basis of COVID-19
Published in Wenguang Xia, Xiaolin Huang, Rehabilitation from COVID-19, 2021
Using RT-PCR and/or Next-Generation Sequencing (NGS) methods, 2019-nCoV nucleic acid can be detected in nasopharyngeal swabs, sputum, and other lower respiratory secretions, blood, feces, and other specimens. It is more accurate to detect lower respiratory tract specimens (sputum or airway extracts). Specimens should be sent for examination as soon as possible after collection. When collecting samples from the oral, nasopharyngeal swabs, and other parts of the upper respiratory tract, it is recommended to collect nasopharyngeal swabs for virus nucleic acid testing. In order to improve the detection accuracy, it is recommended to collect multiple samples (oropharyngeal swabs, nasopharyngeal swabs, nasal swabs, etc.) from the same patient for combined detection. For suspected patients with digestive tract symptoms, stool or anal swabs can be collected at the same time of testing.
Sensitivity and specificity of 14 SARS-CoV-2 serological assays and their diagnostic potential in RT-PCR negative COVID-19 infections
Published in Acta Clinica Belgica, 2022
Eveline Van Honacker, Liselotte Coorevits, Jerina Boelens, Bruno Verhasselt, Eva Van Braeckel, Fré Bauters, Liesbet De Bus, Petra Schelstraete, Jef Willems, Stien Vandendriessche, Elizaveta Padalko
All patients consulting at the emergency department of our hospital from the 1st of March till the 14th of May, with symptoms suggestive of COVID-19 disease that required hospital admission and for which laboratory diagnosis was performed in our institution were retrospectively included in a database. In all patients a RT-PCR test on nasopharyngeal/throat swab was performed at the time of admission. If the initial nasopharyngeal swab was found to be negative, a second nasopharyngeal and additional anal swab were analyzed. If still negative, a bronchoalveolar lavage (BAL) was performed. Patients with repetitive negative molecular testing for SARS-CoV-2 but high clinical, epidemiological and/or radiological suspicion of COVID-19 disease were subjected to serological testing using COVID-19 IgG/IgM rapid test (Prima Professional®). Among this retrospective cohort of hospitalized patients clinically treated for COVID-19 disease, we calculated the number of patients that ultimately had a RT-PCR confirmed diagnosis. As such, an estimation of the added diagnostic value of SARS-CoV-2 serology in this cohort could be calculated.
Results of preoperative screening for COVID-19 correlate with the incidence of infection in the general population -a tertiary care experience
Published in Hospital Practice, 2021
Jesus Villa, Tejbir Pannu, Carla McWilliams, Chandra Kizer, Raul Rosenthal, Carlos Higuera, Preetesh Patel
Since 13 April 2020, all patients with planned or unplanned procedures at our institution had a mandatory preoperative screening for COVID-19. After Institutional Review Approval, we retrospectively reviewed the results of the preoperative screening tests (all specialties) performed between 13 April 2020 and 27 August 2020. Test results were provided by our Department of Clinical Quality. We reviewed the medical records to determine whether patients with a positive COVID-19 result were asymptomatic or not. All patients underwent nasopharyngeal swab RT-PCR testing within 3 days prior to their procedure. Because many patients underwent multiple testing, it is important to make clear that, in the current investigation, the unit of analysis is the number of patients tested for COVID-19 instead of the number of tests performed.
Identifying asymptomatic healthcare workers with COVID-19 in a community hospital: an institution’s experience
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
Neal Mehta, Krishna Vedala, Stephanie Swaim, Stephanie Welch, Amber Calendar, Krishna Kakkera, Khaled Khasawneh, Roy Kamoga
White River Medical Center (WRMC) is the largest acute care facility for White River Health System and serves 10 counties in North Central Arkansas. After a cluster of healthcare workers tested positive for COVID-19, our organization was in a unique position. Due to having plentiful supplies and resources in an area with relatively low incidence, the organization elected to test all employees involved in direct inpatient care who cleared point-of-entry screening via daily temperature checks and did not self-report any symptoms of COVID-19. A total of 647 employees were tested with nearly 81% of the testing being completed within three days. A National Reference Laboratory processed all nasopharyngeal swabs. Of all tested employees, three (0.4%) were positive and asymptomatic. Contact tracing was completed by the organization and the Arkansas Department of Health to identify, monitor, and actively/passively follow potential persons of interest. All positive individuals were quarantined for 10 to 14 business days and were only allowed to return to work after two negative tests in accordance with local recommendations.