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Objective: By the time coronavirus disease-2019 (COVID-19) had been announced as pandemic, the disease was shown to have a great risk among pregnant woman if lower respiratory system is involved. We aimed to describe clinical characteristics of deliveries with asymptomatic COVID-19 infection, investigate transplacental transmission, and compare first-line histopathological findings with healthy controls. Material and Methods: We conducted a prospective cohort study of consecutive term deliveries at our tertiary hospital's obstetric unit between March and November 2021. Forty-five patients with asymptomatic reverse transcription-polymerase chain reaction (RT-PCR) positivity were matched with 45 controls with negative RT-PCR testing. All newborns of mothers with positive RT-PCR results for COVID-19 underwent a nasopharyngeal swab following delivery, and Apgar scores of the newborns were extracted from pediatric charts. Placentas were transported and fixated in 10% formaldehyde solution before pathological evaluation. Results: There were no significant differences in Apgar scores, birth weights, head circumferences, birth height, and genders between the 2 groups. RT-PCR results were negative in all of the newborns, indicating no vertical transmission. Placental focal and global calcification, and choriamnionitis frequencies were similar between the groups, whereas placental fibrin deposits were significantly more frequent in the placentas of infected pregnancies. Conclusion: There was no evidence of vertical transmission and any characteristic feature in the placentas of pregnancies with asymptomatic COVID-19 infection. Although no significant clinical implication was found, increased perivillous fibrin deposition in the study group could be a baseline step for the progression of perinatal infection.
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With the advent of the e-commerce markets, the small businesses in India are experiencing a major hit and a loss of customers. Since the medieval times, India is known for its street markets. It is so prominent that it is a cultural representation, and this prompts a considerable number of people to opt for establishment of business on the streets. During the pandemic, the street vendors are experiencing losses to an extent that they are unable to support their families. Our solution to the problem is a web application called 'Street Vendor Mart'. This aims at helping the hard-working street vendors by marketing their business. Say a citizen is walking on the road and finds a street vendor who is toiling under the sun, seeking to earn even the minimum wage. This citizen can help this street vendor through our application, 'Street vendor mart'. The advertisement posted by the citizen will now be recorded on the site and visible to any person who wishes to do some street shopping. If a user wants to shop for some item for cheaper prices, the user can log in to our site and find a list of street vendors around his location to buy the products. The users can visit the vendors near them, shop from them. Thus our 'Street Vendor Mart' is essentially a virtual mall filled with stores by street vendors If two or more vendors are selling the same category of products in the same location, then the gains will not be up to the mark because of the reduction in demands. As a solution to this, our web application runs Data Analytics to find the optimal location for the vendor to sell his/her category of goods which will maximize their profit. © 2022 IEEE.
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Background: Health sectors can be listed under the high-risk work areas. As we all know, in this COVID 19 pandemic, doctors, nurses, health workers are the front line warriors. If we consider only the nursing personnel here, their tasks alone are prone to occupational hazards. Musculoskeletal disorders (MSDs) are most common among the self-reported occupational diseases. In previous studies, a significantly large number of participants reported musculoskeletal symptoms faced at least once. Insufficiency of ergonomic expertise is one of the most important recognizable risk factors as well as the shortage of staff in hospitals. MSDs are caused due to stressful physical work, static work postures, frequent bending, and twisting, lifting, pushing, and pulling of heavy objects, vibrations, localized mechanical pressure, etc. Various studies have shown that the daily chores of nursing personnel put them at high risk of MSDs. Methods : The study areas were different hospitals and nursing homes in West Bengal. Only the female, registered nurses working in different wards are chosen for this study. The study's inclusion criteria were only the female, registered nurses and the absence of any chronic disease in them. The exclusion criteria were the nursing students, nurses having histories of recent or previous major accidents/injuries or chronic diseases. The study population was interviewed on a one-to-one basis by means of a questionnaire based on Modified Nordic Musculoskeletal Questionnaire. Result(s): Among the total study population, 67.5% of subjects reported low back pain (LBP). 22.5% reported upper back, knee, and ankle discomfort. 27.5%, 15%, and 12.5% reported neck, shoulder, and wrist/hand discomfort, respectively. Conclusion(s): The results of this study have revealed that MSDs are a common phenomenon among nursing personnel. LBP is the most familiar among them, 67.5% of subjects have reported the presence of discomfort. Not only LBP, subjects reported neck, shoulder, knee, and upper back discomfort along with ankle and wrist symptoms. In this COVID-19 scenario, their jobs have become more strenuous than usual. It is found that tasks requiring continuous long hours to perform are causing symptoms to appear. Shift rotations, splitting of shifts, using more ergonomically designed tools, knowledge of ergonomic skills are required in this situation to avoid the aggravation of symptoms.
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The new corona virus illness (COVID-19) swept around the world, quickly creating a serious international disaster. For the treatment and prevention of COVID-19, apitherapy appears to be a viable source of pharmacological and nutraceutical medicines. Honey, pollen, propolis, royal jelly, beeswax, and bee venom, for example, have been demonstrated to have significant antiviral action against infections that cause severe respiratory syndromes, including those produced by human corona viruses. Furthermore, many of these natural products are involved in the induction of antibody production, maturation of immune cells, and stimulation of innate and adaptive immunological responses and many of them are involved in the induction of antibody production, maturation of immune cells, and stimulation of innate and adaptive immunological responses.
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The aim of this paper is to discuss the paradigm shift in residential choices induced by the COVID-19 pandemic in Europe. Firstly, the resilience of the rural regions belonging to the Northern Periphery and Arctic Program will be explored-the challenges brought about by COVID-19 within their tourism sectors, and the opportunities for rural revival generated by the current shifts in workplace mobility. The paper will then delve deeper into the case study of Ireland. The pre-existing issue of Ireland's one-off housing and suburban sprawl will be explored, and the extent to which the regional plan "Our Rural Future" will tackle these issues by optimizing building density and dwelling typology in the post-COVID-19 era.
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Scalable alternate end-game strategies for the synthesis of the anti-COVID drug molecule Nirmatrelvir (1, PF-07321332) have been described. The first involves a direct synthesis of 1 via amidation of the carboxylic acid 7 (suitably activated as a mixed anhydride with either pivaloyl chloride or T3P) with the amino-nitrile 10·HCl. T3P was found to be a more practical choice since the reagent promoted efficient and concomitant dehydration of the amide impurity 9 (derived from the amino-amide contaminant 8·HCl invariably present in 10·HCl) to 1. This observation allowed for the development of the second strategy, namely a continuous flow synthesis of 1 from 9 mediated by T3P. Under optimized conditions, this conversion could be achieved within 30 min in flow as opposed to 12–16 h in a traditional batch process. The final API had quality attributes comparable to those obtained in conventional flask processes.
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Introduction: World Health Organization (WHO) received reports of above 149 million occurrences reported of COVID-19 as of April 29, 2022, including more than 3.1 million fatalities. Patients who have severe COVID-19 have significantly higher levels of interleukin (IL-6) and other proinflammatory cytokines. In COVID-19 individuals, elevated serum levels of cytokines such as interleukin-6 (IL-6), IL-10, tumor necrosis factor (TNF), and interferon may result in deadly ARDS and coagulation issues. Tocilizumab is a humanized recombinant monoclonal antibody being used in treating autoimmune and inflammation-related conditions. It was given FDA approval on January 8, 2010, primarily to treat several immune and inflammatory responses, including multiple types of arthritis, particularly cytokine release disorder. Aims and Objectives: To evaluate the maximal benefit of tocilizumab over the standard treatment in COVID-19 and to determine the effect of tocilizumab on the outcome predictors. Method(s): This is a Retrospective and Observational Study which was conducted on 52 COVID-19 patients who were admitted to DCH of SCBMCH, Cuttack from June 2021 to November 2021. The patients were grouped into two, namely, the tocilizumab group and the control group. All the patients received standard treatment consisting of antibiotics and while, the tocilizumab group received a single intravenous dose of 400mg of tocilizumab. After the tocilizumab therapy, several outcome factors were determined for effective statistical analysis. Result(s): The study showed that 38.46% of the Tocilizumab group died while 53.85% of the control group had died (p<0.05). It also showed that 46.15% % of the patients in the control group had died and their SpO2 was less than 90% and CRP>200 mg/L. Most of the outcome predictors were significantly different (p<0.05) in the Tocilizumab group as compared to the control group, except clinical status after 1 week and IL-6>100 pg/ml. Conclusion(s): The study concluded that tocilizumab can be beneficial in symptomatic improvement in outcome predictors and decrease death rates among patients with COVID-19. Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.
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Introduction: In the general population, maternal SARS-CoV-2 infection during pregnancy is associated with an increased risk of several adverse maternal and fetal outcomes. In patients with Multiple Sclerosis (PwMS) an increased risk of severe COVID- 19 was reported after treatment with antiCD20 or corticosteroid close to COVID-19 onset. However, no data are currently available about maternal and fetal outcomes in pregnant women with MS who contracted COVID-19 during gestation. Objective(s): To evaluate maternal and fetal outcomes and their predictors in a population of pregnant women with MS with COVID-19 diagnosis selected from two large national registries and compared with matched control pregnancies extracted from a historical Italian MS cohort. Method(s): We recruited pregnant pwMS who contracted SARSCoV- 2 infection after conception and were prospectively followed- up in Italian and Turkish MS Centres, in the period 2020-2022. All the patients were administered a structured interview which gathered detailed information on pregnancy course and outcomes, as well as on possible confounders, including disease modifying treatments. A historical matched control group was extracted from a previous Italian multicenter cohort. Data on pregnancy outcomes were compared using logistic and linear multivariable regression analyses, when appropriate. Result(s): So far clinical characteristics and data on COVID-19 outcomes are available for 85 pregnant MS women (mean age 35.2+/-6.4 years, 83 relapsing remitting (RR), mean disease duration 8.3+/-6.86 years, median Expanded Disability Status Scale (EDSS) 1.0 (IQR 1.0-2.5), body mass index 24.5+5.8, current smokers 10.6%, occasional or regular alcohol consumption 28.3%). As for COVID-19 course, 8 women (9.4%) were hospitalized;no one required transfer to intensive care. The historical control group consists of 232 women with RRMS (mean age 34.6+/-3.1 years, mean disease duration 8.8+/-4.8 years, median EDSS 1.5 (IQR 1.0-2.0). The collection of information on maternal and fetal outcomes is ongoing: eclampsia, maternal mortality and admission to intensive care unit, spontaneous abortion, stillbirths, congenital abnormalities, preterm delivery, child weight and length at birth, admission to neonatal intensive care unit. Conclusion(s): Our preliminary data show no increased risk of severe COVID-19 in MS patients who contracted the infection during pregnancy. The analysis on pregnancy-related maternal and fetal outcomes is ongoing.
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Introduction: As a high-efficacy multiple sclerosis (MS) treatment, cladribine necessitates empirical data from diverse populations. Objective(s): To study the efficacy and safety data of cladribine treatment in a real-world setting. Method(s): Patients from eight MS clinics in Turkey were involved in the study. We retrieved the demographic, clinical, MRI, safety, laboratory, COVID-19, and pregnancy records of patients with at least six months of follow-up on cladribine treatment. Result(s): Our study included 210 MS patients (52 males, 158 females;193 relapsing and 17 relapsing-progressive MS). The mean age at MS disease onset was 27.6 years (+/-8.5). Before cladribine treatment, 56.7% of patients used first-line, and 41.9% used both first and second-line therapies. During a mean follow-up period of 13.0 months (+/-4.7) following cladribine treatment, 5.7% of patients experienced a relapse. The shortest duration of relapse following cladribine administration was one week, and the longest duration was 15.3 months. Interestingly, 50% of the relapses occurred within the first three months. Among relapsing patients, five switched from fingolimod, two from dimethylfumarate, and one from ocrelizumab and interferon-beta. The mean annualized relapse rate was 0.41 (+/-0.41) in the two years preceding cladribine and 0.11 (+/-0.55) one year following treatment. At baseline, the mean EDSS score was 2.47 (+/-1.63), and 51.9% of patients ranked below EDSS 3. EDSS progression was observed in 7.6% of patients following cladribine treatment. On cladribine, eight patients (9.4%) exhibited radiological progression. There was no difference in NEDA status between patients switching from first or second-line therapy (p=0.43). COVID was observed in 73 patients, 54 of them had a mild disease course, six had a moderate disease course, and one had a severe disease course. There have been no COVID-related fatalities. There were five pregnancies documented, three of which are currently ongoing. One of the pregnancies ended with healthy childbirth, while the other was terminated in the first trimester with a miscarriage. Conclusion(s): Despite the relatively short duration of follow-up, our study demonstrates that cladribine is effective in providing NEDA. Moreover, switching from fingolimod to cladribine may increase the likelihood of early relapse.
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This study aimed to adapt the COVID-19 Stress Scales (CSS) into Turkish and provide evidence for construct validity. For this purpose, firstly, Confirmatory factor analysis (CFA) was applied for the 5-factor model obtained during the development of CSS and the theoretically expected 6-factor model with total of 546 respondents. The findings revealed that the 6-factor model of CSS had a better fit in the Turkish sample. Factor loadings varied between .62 -.95 and correlations between subscales were between .44 -.76. Cronbach's Alpha and McDonald's omega coefficients for each subscale indicated good-to-excellent internal consistency. To evaluate the criterion-related validity, the Turkish version of The Fear of COVID-19 Scale (FCV-19S) was administered to the participants and the correlation coefficients between this scale and the six subscale of CSS were calculated. We also conducted the Rasch analysis with related items to provide psychometric evidence for their unidimensional structure of each of the six subscales. Lastly, Differential item functioning (DIF) analysis was performed across subgroups by gender, having COVID-19, and being a student. Overall, the results of both CFA and Rasch analyses provided evidence to support the substantive aspect of validity and the appropriateness of the CSS as a measure of COVID-19 stress level in a Turkish sample.
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This chapter seeks to examine the impact of COVID-19 on the Turkish tourism economy. Towards this end, first of all, tourist arrivals and tourism income of Turkey were compared between pre-pandemic and within the pandemic period. Afterwards, to investigate whether COVID-19 leads to a decrease in stock prices of tourism firms, the return data of 11 firms listed in the Borsa Istanbul restaurants and hotels subsector for 10 months were examined by panel data methods. According to comparison of tourist arrivals and tourism income to the previous year, there was a vital decrease as 69% and 65% respectively in 2020. Moreover, coverage rate of foreign trade deficit of tourism income in Turkey decreased almost 80% in 2020. Overall, results of pooled OLS regression analysis revealed that COVID-19 cases and COVID-19-related deaths were decreasing monthly stock price returns. Based on these findings, it is recommended to policymakers to find better policies for a better tourism economy. © 2021, IGI Global.
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The number of people infected with COVID-19 is skyrocketing all over the world. It causes symptoms such as fever, shortness of breath, and other breathing difficulties and it affects people differently. Elevated heart rate (above 90 beats per minute), increase in body temperature (above 37 degree Celsius), lower oxygen saturation (less than 94 percent) are serious symptoms. To detect the virus early and restrict its spread, Cov-Verhindern is a versatile device that can be used anywhere such as shops, malls and educational institutions. 'Verhindern' is a German term that means 'Try to avoid'. We're attempting to stop the spread of COVID-19 here, hence the term 'Cov-Verhindern'. This system includes sanitizing session, temperature sensing, oxygen saturation and heart beat monitoring through an IoT-based program along with a gate mechanism and interaction process. © 2022 Author(s).
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SARS-CoV-2 has created huge changes in the entire world. Trend of the outbreak of COVID-19 was constantly up during the initial days of the infection spread and gradually reduced at times. There were many trials on different varieties of vaccines manufactured by different companies. Presently precautions are taken to reduce the pandemic and significant results have been obtained for it and vaccines are also released for the security and welfare of mankind. The aim of the proposed work is to find the possible vaccine reactions, prediction of Covid-19 outbreak after the administration of vaccines using multiple machine learning algorithms, and visualization of few statistics regarding to the same. In this paper, we experimented with machine learning algorithms like support vectors, linear regression, and polynomial regression to predict vaccination. Classification algorithms like Support vectors with linear and RBF kernels, logistic regression, K-Neighbors Classifiers, Gaussian Naïve Bayes classifier, Decision Trees, and Random Forest algorithms for determining the vaccine reactions are implemented. We have achieved the highest accuracy of 0.56 for classifying the major symptoms after administering the vaccine using random forest classifier combined with optuna method of hyperparameter tuning and RMSE score of 0.091859 for number of people vaccinated using polynomial regression of degree four. To achieve this purpose, we have made use of Covid-19 disease data, World vaccination and Vaccine reactions dataset that were available on Kaggle. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Objective: Major challenge for health care service became a situation of a pandemic caused by COVID-19 infection, when doctors continued to provide care switching to remote consultations when possible. This provided better accessibility to receive consultation form doctor, and those consultations where sometimes the only way to be consulted for the patient. Aims of the study: To explore and analyze Latvia's doctors experience on providing remote consultations during COVID-19 pandemics. Objective: 1) To detect the volume and type of work physicians are able to manage remotely. 2) To find out what technical, GDPR-associated and other difficulties face doctors during the process. 3) To define the general attractiveness of remote consulting. Design and method: Two groups of doctors filled in the questionnaires in year 2021. Results: In one group, which consisted of 200 general practitioners, most respondents consider they could provide remote medical consultation about healthy lifestyle - 89,0% (n = 178);regarding check-ups, screening results - 86,5% (n = 173);to manage recommendations of other healthcare specialists - 66% (n = 132). Difficulties faced: 54,0% (n = 108) were not satisfied with payment, 22,5% (n = 45) admitted lack of specific skills, 45,5% (n = 91) found it problematic to make e-referrals. 61,0% (n = 122) like the idea of implementing services in practice on a regular basis. Another group, which consisted of 62 doctors of different specialties working in Clinical University Hospital. All doctors (62) were consulting by phone, 18 doctors only by phone, however 44 were consulting via e-mails, social network on video-conference platforms as well. Research revealed that the process of patient identification, search of patient's data and sensitive data transfer is complicated, time consuming and requires different approaches to manage. Conclusions: Latvian doctors have experience in remote consulting. When consulting remotely Latvian doctors were facing technical, legal, social and other difficulties. Some Latvian doctors are interested in introducing remote consulting services in their practice, if the restrictive moments for their provision would be eliminated. As well as there is need for amendments in normative regulation for providing remote consultations, and challenges relates to payment system implementations especially for state paid services.
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Objective: Remote consultations are quickly emerging to give more access to real-time, high-quality, efficient, and cost-effective healthcare in the current COVID- 19 pandemic. Objective is to investigate the changing experiences of remote consulting for patients in Latvia and plan effective health policies, to provide a full analysis of the policy for telemedicine applications and solutions based on the current conditions. Design and method: Materials and approaches include an examination of normative documents as well as a variety of informational sources. The information offered is mostly based on national strategy papers, official reports, and scientefic publications on Tele-medicine implementation. Results: Telemedicine's range will continue to expand, connecting patients and providers internationally as providers look to expand globally. This will not only help improve the long-term policies about health but may also provide patients with rare diseases alternative avenues to seek highly specialized care. Telemedicine strategy must react faster than ever during the COVID-19 epidemic. Latvia has reacted to Covid pandemics and have noticable implemented new possibilities to provide new approaches provided by telemedicine: providing remote consutlations to patients in different sectors, using E-referrals that were implemented but not sufficiently used before, providing more possibilites to provide remote services also for consiliums, physician-physiscan online consultations. New ICT tools were used for patient remote monitoring. The normative regulation, stategical decisions and changes in long-term policy documents haven't been changed, so there are limitations to provide the telemedice expansion or stable use after the emengency situation ends. Health policies about telemedicine have another key role with to pursuing that. Conclusions: Telemedicine is fast expanding, demand for this service is rising. Although not a replacement for face-to-face consultations, this study illustrates that remote consulting can be an acceptable adjunct to traditional face-to-face consultations. More research is required to identify overall safety and applicability. Digital Health Strategy in Latvia is still on developing stage. Changes or legislation to clarify Telemedicine are still in the process. It is important to provide a good environment for Telemedicine to expand, setting strategies and visions on how those new approaches will be regulating normatively and administratively.
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This article collated various findings on consumers' impulse buying, specifically during the COVID-19 pandemic. A detailed literature review revealed interesting facts about the pre-studied antecedents of impulse buying. It is found that perceived risk, which is known to hinder consumers' impulse buying earlier, surprisingly appeared to facilitate consumer impulse buying during the infamous global pandemic. The shift happened due to the various psychological changes that consumers experienced during the pandemic. This research monograph is interested in documenting the findings on impulse buying during the pandemic because it is essential to understand consumer changes. The post-pandemic world of consumers' buying behavior and the pattern is likely to change. Researchers correctly pointed out to this concern that whether the changes that the pandemic has caused will sustain or not. Moreover, scholars have also estimated what changes are probable to appear in the consumers' buying process. This study extensively puts forward the detailed findings, facilitating researchers and practitioners to devise their course of action post the COVID-19 pandemic. © 2022, Associated Management Consultants Pvt. Ltd.. All rights reserved.
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Background: Covid-19 affected our population in multiple waves. We have looked for the differences in frequency and the weight/impact of symptoms between the first and the second waves. Method: The post-covid-19 subjects attending our out-patient department for post-covid-19 problems after the 1st and he 2nd waves were enquired retrospectively about the demography with the frequency and severity of different symptoms cough, breathlessness, throat pain, nasal discharge, fever, body-ache, weakness, diarrhoea, constipation, pedal/finger swelling, headache, expectoration. anosmia, and loss of taste) that they suffered from. The weight/impact of a symptom was derived by multiplying the duration of symptoms (in days) with the severity (in Likert scale;0 to 5;0=none and 5=maximum possible symptoms). The data was analysed statistically using unpaired 't-test' and 'chi-square test' to compare between the two covid-19 waves. Result: 185 and 222 subjects' data were included for the 1st and the 2nd waves of covid-19 respectively. The gender ratio was similar but the mean age was significantly lower in the victims of the second wave (56.17±13.64, 51.32±15.59;p=0.0017). As regards the symptom-frequency, fever (p=0.0154), constipation (p=0.0243), headache (p=0.0014), anosmia (p=<0.0001) and loss of taste (p=0.0009) were significantly worse in the 2nd wave. The symptom severity of cough (p=0.0184), throat pain (p=0.039), mild weakness (p=0.0063), anosmia (p=0.0004) and loss of taste (p=0.0026) were also higher in the 2nd wave of Covid-19. Conclusion: It appears that each wave of the pandemic was distinct as regards the symptomatology. Such peculiarity in the clinical dynamics of Covid-19 needs to be noticed and followed in future.
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Background:The gold standard for diagnosis of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection is reverse transcriptase real time polymerase chain reaction (RT-PCR) using respiratory samples. Collection of oro- nasopharyngeal swab (OP/NP) requires a trained health care worker (HCW) and appropriate biosafety conditions. There is need for a simpler strategy for sample collection without compromising the sensitivity. Saliva sample can be collected without any intervention of HCW. Therefore, the primary objective of the study was to evaluate efficacy of SARS -CoV-2 RT-PCR using self-collected saliva specimen. Methods:This pilot study was carried out at an ICMR approved molecular laboratory. The study population consisted of adults reporting to Flu OPD and hospitalized suspected COVID-19 cases. After obtaining consent, 3-5 ml of saliva was submitted in a universal sterile container by participants. Parallel (OP/NP) swab in viral transport medium (VTM) was also collected as per national guidelines. Both specimens were subjected to RNA extraction and SARS-CoV-2 RT PCR us- ing ICMR approved kit. Cycle threshold value of Envelope_Sarbeco gene (“E”), HKU Orf 1b gene (“HKU”) and Actin (Internal control) obtained for saliva and OP/NP swab were tabulated. Results:Saliva and OP/NP swab in parallel were collected from 85 individuals. The mean age of study population was 35.2 yr and 81% were male. The overall sensitivity and specificity of RT PCR on saliva sample was 95.6% and 92.5%. The concordance between ‘E” and “HKU” Ct value obtained by OP/NP and Saliva RT-PCR was 97.64% and 95.29%. The posi- tive and negative predictive value of the novel method was 93.5% and 94.9% respectively. Conclusions:Saliva collection requires lesser logistic requirement and saves VTM. Self-collected saliva is a reliable bio- logical sample and promising tool for SARS-CoV-2 testing in resource limited setting. Saliva RT-PCR could be cost- effective measure for laboratory capacity building.
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Background: The gold standard for the diagnosis of coronavirus (CoV) disease 2019 in the hospital and community setting is by the real-time reverse transcription-based polymerase chain reaction (RT-PCR) using the respiratory samples. The collection of nasopharyngeal or oropharyngeal swab (NP/OP) needs experienced medical personal and appropriate biosafety conditions. There is need for a simpler strategy for the sample collection without compromising the sensitivity. Saliva sample collection is noninvasive. Therefore, the primary objective of the study was to evaluate the efficacy of severe acute respiratory syndrome CoV-2 (SARS-CoV-2) RT-PCR using self-collected saliva specimen. Materials and Methods: This pilot study was carried out at an Indian Council of Medical Research (ICMR) approved molecular laboratory. Self-collected saliva and OP/NP swab in the viral-transported medium (VTM) were collected in parallel from the study participants and processed for SARS-CoV-2 RT-PCR. Cycle threshold (Ct) value of envelope gene ("E"), HKU Orf 1b gene ("HKU"), and Actin (internal control) obtained for saliva and NP/OP swab were tabulated. Results: Saliva and OP/NP swab in parallel were collected from 85 individuals. The mean age of the study population was 35.2 years, and 81% were male. The overall sensitivity and specificity of RT PCR on the saliva sample were 95.6% and 92.5%. The concordance between 'E" and "HKU" Ct value obtained by NP/OP and saliva RT-PCR was 97.64% and 95.29%. The positive and negative predictive value of the novel method was 93.5% and 94.9%, respectively. Conclusion: Self-collected saliva is a reliable biological sample and promising tool for SARS-CoV-2 testing in the resource-limited setting.
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Background: As the world battles the coronavirus disease 2019 (COVID-19) pandemic, rapid detection is the key to contain the spread of the disease. Although real-time polymerase chain reaction (RT-PCR) remains the gold standard for the diagnosis of severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) infection, it demands specialized equipment and technical expertise. SARS-CoV-2 rapid antigen detection test (RAT) is the user-friendly alternative, which needs evaluation in the hospital setting. Materials and Methods: This cross-sectional study was carried out at the Indian Council of Medical Research approved COVID-19 diagnostic molecular laboratory between November and December 2020. Nasopharyngeal swabs in viral transport medium (VTM) were received from suspected SARS-CoV-2 infected individuals were processed for SARS-CoV-2 RT-PCR and a rapid antigen detection test, COVID-19 Ag Respi-Strip. Results: A total of 342 samples were assessed for this study by RT-PCR and Rapid Antigen Test. The sensitivity of RAT was found to be 41% at an RT-PCR cycle threshold of 35 or below. Sensitivity of RAT improved to 81.2% when a RT-PCR cycle threshold of 25 or below was considered as positive. Specificity of RAT was 99% to 100%. Conclusion: Rapid antigen test is a cost-effective alternative for screening of symptomatic individuals in the hospital setting. However, due to low sensitivity, the negative results need to be interpreted with caution.