ABSTRACT
Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic has affected the entire world. The need of timely detection of the virus has been of prime importance and the efforts to develop sensitive, specific, rapid, portable and cost effective diagnostic methods promoted the indigenous development of TrueNat testing for viral load in COVID-19 detection which had been previously designed for detection of Tuberculosis and other infectious organisms. Aim: To see the importance of TrueNat testing among symptomatic and asymptomatic cases in different age groups and gender. Materials and Methods: In this retrospective study conducted in the Department of Microbiology, Autonomous State Medical College and SNM Hospital, Firozabad, Uttar Pradesh, India, from June 2020 - May 2021, a total of 4,659 samples were collected from patients (Influenza Like Illness (ILI), Severe Acute Respiratory Illness (SARI), symptomatic, asymptomatic, those seeking hospitalisation, emergency), contacts and travellers and were subjected to testing by TrueNat (Molbio Quattro). The cases were divided into group A of patients who presented with symptoms ≤7 days;group B of patients who presented with signs and symptoms >7 days and group C comprised of asymptomatic patients. The symptoms of patients were associated with the Cycle threshold (Ct) values of the Envelope (E) gene and the RNA-dependent RNA polymerase gene (RdRp) gene. The Chi-square test was done to test the statistical significance of association of symptomatic patients with the outcome of the test. Results: The maximum number of positive cases were found in the people 20-39 years (p-value <0.05). The least positivity was found in the higher (80 years) and lower (below 9 years) age groups. The positivity rates had no significant impact on the gender. The percentage positivity as detected by TrueNat testing was 3.3% and maximum positive patients were found in the group having symptoms <7 days (p<0.05). On association of the Ct values of E gene and RdRp gene with the symptoms it was found that 28.1% and 27.2% of the patients were in the high Ct value group. Conclusion: TrueNat was found to be a portable and easy to perform test which did not require special laboratory set up. The use of Viral Lysis Medium (VLM) reduced the time of RNA extraction which not only rendered it safer to perform but expedited the results.
ABSTRACT
Introduction: Ever since the Coronavirus Disease 2019 (COVID-19) pandemic hit, there have been constant efforts to develop rapid, sensitive and specific diagnostic methods to detect the virus in order to curb the further spread of the disease. There is an array of tests available for the detection of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Time being a very crucial factor, Rapid Antigen Testing (RAT) is very helpful in detecting the virus. Aim: To discuss the importance of rapid testing among symptomatic and asymptomatic cases in different age groups and gender with association to infection. Materials and Methods: This retrospective study was conducted in Department of Microbiology, Autonomous State Medical College and SNM Hospital, Firozabad, Uttar Pradesh, India, from April 2020-August 2021. A total of 16,258 samples were collected from symptomatic patients having Influenza Like Illness (ILI), Severe Acute Respiratory Illness (SARI), those seeking hospitalisation, contacts (symptomatic and asymptomatic) and travellers were subjected to antigen detection by the Standard Q COVID-19 antigen kit following proper precautions. The cases were divided into Group A of patients who presented with symptoms ≤7 days, Group B of patients who presented with signs and symptoms >7 days and group C comprised of asymptomatic patients. The Chi-square test was done to test the statistical significance of association of symptomatic patients with outcome of the antigen test. Results: Of the total 16,258 samples tested, the maximum number of positive cases were found in the age group 30-39 years (p-value <0.05) followed by 20-29 years. The least number of positive cases (six) was found in the higher (90 years) and lower (below 9 years) age groups. No significant impact was found on the positivity rates on the basis of gender. The percentage positivity as detected by rapid antigen was 2% and maximum patients were found in the group having symptoms <7 days (p<0.05). Conclusion: Rapid Antigen Detection Test (RADT) for SARS-CoV-2 is a simple, portable, fast and easy to perform test. It could be easily used in rural areas as it does not require special laboratory set up. It could be used for mass testing and helped as a good epidemiological tool. However, few symptomatic cases which could not be detected by rapid testing had to be cross checked with Real Time-Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). Thus, when used in conjunction with molecular methods, the sensitivity of the test increased.
ABSTRACT
Introduction: World Health Organisation (WHO) declared the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) outbreak a pandemic on 11 March 2020, due to the constantly increasing number of cases outside China. Previously, India had global record of highest single day spike of Corona Virus Disease-19 (COVID-19) cases, with 97,894 cases on 17th September 2020. Aim: To find out the demographic and clinical characteristics of critically ill patients of SARS-CoV-2 and comparing the outcomes of patients admitted in COVID dedicated Intensive Care Unit (ICU) with and without co-morbidities and also in different age groups and sex.Material and Methods: This retrospective study from July 2020 to December 2020 was a single centre observational experience of management of COVID-19 patients at COVID dedicated ICU in Firozabad, India. The following data were recorded: Age, sex, comorbidities and mode of oxygen delivery (invasive mechanical ventilation, non-invasive mechanical ventilation, high flow nasal canula). Chi-square test was used to compare the outcomes of patients admitted in COVID dedicated ICU with and without co-morbidities and also in different age groups and sex.Results: In this study, the data of 120 severely ill COVID-19 patients were reviewed. The mean age of patients were (58±15.29) years and male to female ratio was 3:1. At least one comorbid condition was reported in 53.3% of patients-most common being Hypertension (36.6%) followed by Diabetes mellitus 2 (20%), COPD (15%). Then Cardiovascular Diseases, Renal, Liver diseases and ailments followed. All patients admitted to COVID ICU had moderate to severe Acute Respiratory Distress Syndrome (ARDS). Older age (61 years and above, mortality 17%), male sex (16.7% deaths among 90 critically ill male COVID patients) and presence of comorbid conditions appear to have higher mortality in this study. However apart from comorbid conditions (p=0.001) none was statistically significant. The overall mortality in this study of 120 critically ill COVID patients was 14.16%.Conclusion: From this study, it can be suggested that survival of critically ill COVID patients can further be improved by better management of their comorbid conditions and avoiding complications of invasive ventilation. However, further multicentric studies with large sample size are needed to confirm these findings.