ABSTRACT
BACKGROUND: real-time RT-PCR was recommended by WHO for COVID-19 diagnosis. The cycle threshold (Ct) values were expected to have an association with clinical manifestation. However, the diagnostic modalities such as quantitative molecular detection and virus isolation were not yet available for the routine test. This study has been conducted to analyze the relationship between the Ct values of qualitative rRT-PCR and the clinical manifestation and to describe the factors determining the result. METHODS: from March to April 2020, specimens were sent to our laboratory from different healthcare centers in Jakarta. The patient's characteristic and clinical manifestation were extracted from the specimen's epidemiology forms. The specimens extracted and tested using rRT-PCR, and the Ct value were collected. The data were analyzed using the appropriate statistic test. RESULTS: from 339 positive results, the mild to moderate case was 176 (52%) and the severe cases was 163 (48%). Female was dominant in the mild to moderate cases (58%), while the male was prevalent in the severe cases (60%). The median age for mild to moderate case was 35 years old and severe cases was 49 years old. Statistical analysis found relationship between both group with gender (p = 0.001) and age (p < 0.001), but not with the Ct value. CONCLUSION: many variables in specimen sampling and processing could affect the Ct value result. In addition, the disease's severity was depended with the host immune response, regardless the number of virus. There was suggested no significant difference between the Ct values of mild-moderate and severe COVID-19, and thus should not be loosely interpreted.
ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic has caused an international shortage of nasopharyngeal flocked swabs, which are one of the main supplies for diagnostic testing. In response to this issue, our institution developed locally made nasopharyngeal swabs. This report aims to provide a clinical evaluation by conducting a sterility test, reverse transcription polymerase chain reaction (RT-PCR) compatibility test, and a user-based survey test of two batches of locally made flocked swabs. Sterility and compatibility tests were conducted at our microbiology laboratory. Participants with clinical suspicion of COVID-19 were scheduled for swab tests using Flocked Swab HS-19 and samples obtained were tested using the RT-PCR method. The cycle threshold (Ct) value of the samples was recorded. A user-based survey was conducted to evaluate the swab stick and flocked-fiber tip performance. The sterility test showed no evidence of bacterial growth on both blood agar and thioglycolate medium. RT-PCR compatibility test from Ct value of 33 samples of the first batch and 30 samples of the second batch was recorded with a mean Ct of 27.17±2.96 and 23.99±2.18, respectively. Six parameters of the swab stick (comfortability, smoothness, flexibility, durability, applicability, and breakpoint performance) showed satisfactory scores with an average of 4.14 out of 5.0 for the first batch and 4.16 for the second batch, while 4 parameters of the flocked-fiber tip (fiber adherence, thickness, symmetricity, and sample collection sufficiency) revealed acceptable scores with an average of 3.6 out of 5.0 for the first batch and 3.75 for the second batch. This study indicates that locally made flocked swabs are satisfactory and clinically applicable for testing and diagnosing COVID-19. Furthermore, mass production and distribution across the country are expected. The development of these swabs, which involved multidisciplinary teamwork and various industrial partners, portrayed a valuable lesson on how to cope with the pandemic through innovation. © 2020. All Rights Reserved.
ABSTRACT
Indonesia first reported SARS-CoV-2 in March 2020. From March to April, clinical microbiology laboratory Universitas Indonesia in Jakarta received 4617 specimens with 12.6% positivity rate and 22% asymptomatic case. The result of this study could give an early picture of Indonesia's COVID 19 outbreak situation.