ABSTRACT
The diagnosis of SARS-CoV-2 is based on the use of nucleic acid amplification tests (NAAT), especially rRT-PCR. The latter also allows us to quickly identify variants of concern. However, its use in follow-up of patients and the correlation between Ct value and the viability of the virus is controversial.
Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19 Testing , Humans , Pathology, MolecularABSTRACT
Background: Information regarding the incidence and characteristics of COVID-19 pneumonia amongst pregnant women is scarce. Methods: Single-centre experience with 32 pregnant women diagnosed with COVID-19 between March 5 to April 5, 2020 at Madrid, Spain. Findings: COVID-19 pneumonia was diagnosed in 61.5% (32/52) women. Only 18.7% (6/32) had some underlying condition (mostly asthma). Supplemental oxygen therapy was required in 18 patients (56.3%), with high-flow requirements in six (18.7%). Eight patients (25.0%) fulfilled the criteria for acute distress respiratory syndrome. Invasive mechanical ventilation was required in two patients (6.2%). Tocilizumab was administered in five patients (15.6%). Delivery was precipitated due to COVID-19 in three women (9.4%). All the newborns had a favourable outcome, with no cases of neonatal SARS-CoV-2 transmission. Severe cases of pneumonia requiring supplemental oxygen were more likely to exhibit bilateral alveolar or interstitial infiltrates on chest X-ray (55.6% vs. 0.0%;P-value = 0.003) and serum C-reactive protein (CRP) levels >10 mg/dL (33.0% vs. 0.0%;P-value = 0.05) at admission than those with no oxygen requirements. Interpretation: Pregnant women with COVID-19 have a high risk of developing pneumonia, with a severe course in more than half of cases. The presence of bilateral kung infiltrates and elevated serum CRP at admission may identify women at-risk of severe COVID-19 pneumonia. (C) 2020 The Author(s). Published by Elsevier Ltd.
ABSTRACT
OBJECTIVES: The standard RT-PCR assay for coronavirus disease 2019 (COVID-19) is laborious and time-consuming, limiting testing availability. Rapid antigen-detection tests are faster and less expensive;however, the reliability of these tests must be validated before they can be used widely. The objective of this study was to determine the performance of the Panbio TM COVID-19 Ag Rapid Test Device (PanbioRT) (Abbott) in detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in nasopharyngeal swab specimens. METHODS: This prospective multicentre study was carried out in ten Spanish university hospitals and included individuals with clinical symptoms or epidemiological criteria of COVID-19. Only individuals with <=7 days from the onset of symptoms or from exposure to a confirmed case of COVID-19 were included. Two nasopharyngeal samples were taken to perform the PanbioRT as a point-of-care test and a diagnostic RT-PCR test. RESULTS: Among the 958 patients studied, 325 (90.5%) had true-positive results. The overall sensitivity and specificity for the PanbioRT were 90.5% (95%CI 87.5-93.6) and 98.8% (95%CI 98-99.7), respectively. Sensitivity in participants who had a threshold cycle (C<sub>T</sub>) < 25 for the RT-PCR test was 99.5% (95%CI 98.4-100), and in participants with <=5 days of the clinical course it was 91.8% (95%CI 88.8-94.8). Agreement between techniques was 95.7% (kappa score 0.90;95%CI 0.88-0.93). CONCLUSIONS: The PanbioRT performs well clinically, with even more reliable results for patients with a shorter clinical course of the disease or a higher viral load. The results must be interpreted based on the local epidemiological context.