Integration of symptomatic, demographical and diet-related comorbidities data with SARS-CoV-2 antibody rapid diagnostic tests during epidemiological surveillance: a cross-sectional study in Jakarta, Indonesia.

OBJECTIVES: Affordable options for COVID-19 epidemiological surveillance are needed. Virus detection by reverse transcription-PCR (RT-PCR) is sensitive but costly, and antigen-based rapid diagnostic tests (RDTs) are cheap but with reduced sensitivity; both detect current infection but not exposure. RDT-IgM/IgG antibodies to SARS-CoV-2 detect exposure but have poor sensitivity for current infection. We investigated if the integration of symptomatic, demographical and diet-related comorbidities data with antibody RDTs improves their potential to assess infection rates in addition to exposure, thereby broadening their utility for surveillance. DESIGN: We conducted a cross-sectional study using data from community surveillance for SARS-CoV-2. Health workers collected nasopharyngeal swabs for RT-PCR and RDT antigen assessments and venous blood for RDT-IgM/IgG from symptomatic and asymptomatic persons. Data on age, gender, contact history, symptoms (ie, fever, cough, runny nose, sore throat, headache, dyspnoea and diarrhoea), diet-related comorbidities (ie, diabetes and hypertension) and chest radiology were collected. SETTING: High-risk communities in Jakarta, Indonesia, in May 2020. PARTICIPANTS: 343 community members' data were included. OUTCOME MEASURES: RDT-IgM/IgG sensitivity, specificity and predictive values and area under receiver operating characteristic curve for RT-PCR positivity using RDT results alone and in combination with other predictors, including symptom components derived from principal component analysis. RESULTS: There were 24 PCR-confirmed infections. RDT-IgM/IgG-positive tests were associated with infection (OR 10.8, 95% CI 4.43 to 26.4, p<0.001) with an area under the curve (AUC) of 0.708% and 50% sensitivity, 91.5% specificity, 30.8% positive predictive value (PPV) and 96.1% negative predictive value (NPV). RDT results combined with age, gender, contact history, symptoms and comorbidities increased the AUC to 0.787 and yielded 62.5% sensitivity, 87.0% specificity, 26.6% PPV and 96.9% NPV. CONCLUSIONS: SARS-CoV-2 RDT-IgM/IgG results integrated with other predictors may be an affordable tool for epidemiological surveillance for population-based COVID-19 exposure and current infection, especially in groups with outbreaks or high transmission.

Pemeriksaan Laboratorium Pada Coronavirus Disease 2019 (COVID-19)

Coronavirus Disease 2019 (COVID-19) adalah penyakit yang disebabkan oleh virus SARS-CoV-2. Penyakit ini menyebar dengan cepat, menjadi pandemi, dan telah menginfeksi jutaan penduduk di lebih dari 200 negara dan wilayah serta berdampak pada sosioekonomi masyarakat. Pemeriksaan laboratorium berperan penting dalam manajemen pasien COVID-19 mulai dari penapisan sampai dengan surveilans. Oleh karena itu, studi literatur ini akan membahas tentang pemeriksaan laboratorium pada COVID-19. Kata kunci: COVID-19, SARS-CoV-2, pemeriksaan laboratorium

Did Noise Pollution Really Improve during COVID-19? Evidence from Taiwan

Background and objectives: The impacts of COVID-19 are like two sides of one coin. During 2020, there were many research papers that proved our environmental and climate conditions were improving due to lockdown or large-scale restriction regulations. In contrast, the economic conditions deteriorated due to disruption in industry business activities and most people stayed at home and worked from home, which probably reduced the noise pollution. Methods: To assess whether there were differences in noise pollution before and during COVID-19. In this paper, we use various statistical methods following odds ratios, Wilcoxon and Fisher’s tests and Bayesian Markov chain Monte Carlo (MCMC) with various comparisons of prior selection. The outcome of interest for a parameter in Bayesian inference is complete posterior distribution. Roughly, the mean of the posterior will be clear with point approximation. That being said, the median is an available choice. Findings: To make the Bayesian MCMC work, we ran the sampling from the conditional posterior distributions. It is straightforward to draw random samples from these distributions if they have regular shapes using MCMC. The case of over-standard noise per time frame, number of noise petition cases, number of industry petition cases, number of motorcycles, number of cars and density of vehicles are significant at α=5%. In line with this, we prove that there were differences of noise pollution before and during COVID-19 in Taiwan. Meanwhile, the decreased noise pollution in Taiwan can improve quality of life.

The value of anal swab RT-PCR for COVID-19 diagnosis in adult Indonesian patients.

OBJECTIVE: This study will test the performance of the anal swab PCR test when compared with the nasopharyngeal swab PCR test as a diagnostic tool for COVID-19. DESIGN: An observational descriptive study which included hospitalised suspected, or probable cases of hopitalised COVID-19 patients, conducted in Dr. Cipto Mangunkusumo National Hospital, Ciputra Hospital, Mitra Keluarga Depok Hospital and Mitra Keluarga Kelapa Gading Hospital, Indonesia. Epidemiological, clinical, laboratory and radiology data were obtained. Nasopharyngeal and anal swabs specimens were collected for SARS-CoV-2 RNA detection. RESULTS: We analysed 136 subjects as part of this study. The clinical spectrum of COVID-19 manifesation in this study was typical of hospitalised patients, with 25% classified as mild cases, 14.7% in severe condition and 12.5% of subjects classified as having acute respiratory distress syndrome. When compared with nasopharyngeal swab as the standard specimen for reverse transcription polymerase chain reaction (RT-PCR) detection of SARS-CoV-2 antigen, the sensitivity and specificity of the anal swab was 36.7% and 93.8%, respectively. The positive and negative predictive value were 97.8% and 16.5 %, respectively. The performance of the anal swab remained similar when only the subgroup of patients with gastrointestinal symptoms (n=92, 67.6%) was analysed (sensitivity 40% and specificity 91.7%). Out of all the subjects included in analysis, 67.6% had gastrointestinal symptoms. Similarly, 73.3% of patients in the anal swab-positive group had gastrointestinal symptoms. The two most common gastrointestinal symptoms in the subjects' population were nausea and anorexia. CONCLUSION: Anal swab specimen has low sensitivity (36.7%) but high specificity (93.8%) for detecting SARS-CoV-2 antigen by RT-PCR. Only one additional positive result was found by anal swab among the nasopharyngeal swab-negative group. Anal swab may not be needed as an additional test at the beginning of a patient's diagnostic investigation and nasopharyngeal swab RT-PCR remains as the standard diagnostic test for COVID-19.