Graphene-Based Electrochemical Nano-Biosensors for Detection of SARS-CoV-2

COVID-19, a viral respiratory illness, is caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), which was first identified in Wuhan, China, in 2019 and rapidly spread worldwide. Testing and isolation were essential to control the virus's transmission due to the severity of the disease. In this context, there is a global interest in the feasibility of employing nano-biosensors, especially those using graphene as a key material, for the real-time detection of the virus. The exceptional properties of graphene and the outstanding performance of nano-biosensors in identifying various viruses prompted a feasibility check on this technology. This paper focuses on the recent advances in using graphene-based electrochemical biosensors for sensing the SARS-CoV-2 virus. Specifically, it reviews various types of electrochemical biosensors, including amperometric, potentiometric, and impedimetric biosensors, and discusses the current challenges associated with biosensors for SARS-CoV-2 detection. The conclusion of this review discusses future directions in the field of electrochemical biosensors for SARS-CoV-2 detection, underscoring the importance of continued research and development in this domain.

Evaluation of Lung Ultrasound in Assessment of Critically Ill patients in Respiratory Intensive Care Unit

Reaching a proper diagnosis for critically ill patients is like collecting pieces of puzzle and bed side lung ultrasound (LUS) becomes a crucial piece complementary to clinical and laboratory pieces. It is a bed side, real time tool for diagnosis of patients in ICU who are critical to be transferred to radiology unit especially in Covid-19 pandemic with risk of infection transmission. The aim was to evaluate the accuracy of lung ultrasound in assessment of critically ill patients admitted to Respiratory Intensive Care Unit (RICU), moreover to assess its diagnostic performance in different pulmonary diseases as compared to the gold standard approach accordingly. This observational prospective (cross sectional) study with a total 183 patients who met the inclusion criteria,were selected from patients admitted at the RICU;Chest Department, Zagazig University Hospitals, during the period from September 2019 to September 2021. LUS examination was performed to diagnose the different pulmonary diseases causing RF. All cases were examined by LUS on admission. From a total 183 patients, 111 patients 60.7% were males and 72 patients 39.3% were females, with a mean age of 56+/-12.77 years, 130 patients were breathing spontaneously received conservative management with O2 therapy, 32 patients needed NIV while 21 patients needed IMV with ETT. Exacerbated COPD was the most common disease finally diagnosed followed by bacterial pneumonia, exacerbated ILD, post Covid-19 fibrosis and pulmonary embolism in32, 29,27, 19 and 11 patients respectively with corresponding diagnostic accuracy of LUS 97.3%, AUC=0.943, 93.9% (AUC=0.922), 96.7%(AUC=0.920), 97.8%, AUC=0.895, and 97.8% respectively, while Covid-19 pneumonia was the final diagnosis in 8 patients with LUS diagnostic accuracy of 97.8% (AUC=0.869) with no statistical significant difference p-value=0.818 with bacterial pneumonia in distribution of US profiles. A profile was the commonest detected US profile among the studied patients followed by B profile, C profile, A/B profile and A' profile in 37.2%, 24.6%, 15.8% 4.9%, and 3.8% of cases respectively. Bed side LUS has a reliable, valuable diagnostic performance when integrated with clinical and laboratory data for the diagnosis of most pulmonary diseases in RICU.Copyright © 2023, Colegio de Farmaceuticos de la Provincia de Buenos Aires. All rights reserved.

Comparison of Diagnostic Accuracy of CRP Versus Ferritin in COVID Patients as a Marker of Severity of Disease Taking who Severity Classification as Gold Standard

Objective: To determine the diagnostic accuracy of elevated C reactive protein (CRP) and ferritin in predicting severe Covid-19 infection using the World Health Organization's (WHO) Covid-19 severity classification as gold standard. Study Design: Descriptive study. Place and Duration of Study: This study was conducted at the Pak Emirates Military Hospital, Rawalpindi, from January 1st 2021 till April 30th 2021. Ethical review committee's (ERC) approval was taken and good clinical practice guidelines were followed. Material(s) and Method(s): Baseline blood samples were sent to the hospital laboratory for the measurement of C reactive protein and ferritin levels. PCR was taken as gold standard for the diagnosis of Corona virus disease. Patients were classified into severe and non-severe categories using WHO classification of severity. Sensitivity, specificity, diagnostic accuracy, negative predictive value and positive predictive value were calculated for elevated CRP and ferritin. Result(s): There were 65 (57.5%) patients who had severe Covid-19 disease and 48 (42.5%) patients who had non-severe Covid-19 disease. Among the patients with severe Covid-19, 57 (87.7%) had elevated CRP levels, and 50 (76.9%) patients had elevated ferritin levels. Testing ferritin levels, against the severity of Covid-19 patients, there was a sensitivity of 76.9%, specificity of 79.2%, positive predictive value (PPV) of 83.3%, negative predictive value (NPV) of 71.7% and diagnostic accuracy of 77.8%. Testing CRP levels, there was a sensitivity of 87.7%, specificity of 85.4%, PPV of 89.1%, NPV of 83.6% and diagnostic accuracy of 86.7%. Conclusion(s): The results from our study show that CRP has a slightly improved diagnostic accuracy as compared to ferritin. However, both these markers have value in the prediction of severity of Covid-19 infection.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.

Usefulness of C-reactive protein to determine the severity of SARS-CoV-2 infection in Peru.

Background: Recently, many biomarkers have been studied to determine severe cases of COVID-19. C-reactive protein (CRP) has shown high sensitivity in identifying patients with severe disease and utility comparable to computed tomography. Aim(s): To determine the usefulness of CRP to predict the severity of SARS-CoV-2 infection in patients hospitalized at the Naval Medical Center of Peru during the period January-September in the year 2021. Method(s): A quantita-tive, observational, analytical, retrospective, and diagnostic test type design was used. A sample size of 503 patients was calculated, which were divided into two groups according to their severity. Result(s): An optimal cut-off point of 10.92 mg/L for CRP levels was determined for the diagnosis of severe COVID-19. An area under the curve (AUC) of 0.762 was calculated and sensitivity, specificity, positive and negative predictive values and diagnostic accuracy values of 78.88%, 66.4%;41.42%;87.01%;and 67.27%;respectively. Fagan's normogram showed a post-test probability of 41%. In the adjusted model, CRP (aOR = 4.853;95% CI 2.987-7.886;p = 0.001), ferritin (aOR = 1.001;95% CI: 1.001-1.002;p = 0.001) and hypothyroidism (adjusted OR = 4899;95% CI: 1272-18872;p = 0.021) showed significance. Conclusion(s): The present study showed an association between CRP and the severity of SARS-CoV-2 infection in an adjusted model, showing its potential utility and contributing to determine the cut-off point of CRP in the Peruvian population and its international comparison.Copyright © 2023, Sociedad Chilena de Infectologia. All rights reserved.

Diagnosis of pediatric COVID-19

Accurate diagnosis of SARS-CoV-2 infection is critical for the management of individuals with suspected COVID-19 diseases, as well as instituting public health measures. The experience gained over twoyears of the pandemic has led to a better appreciation of the scope and utility of various diagnostic modalities. Laboratory tests to diagnose COVID-19 in human beings can be broadly categorized as direct and indirect tests. In children (as in adults), RT-PCR is the current gold standard for diagnosis. RT-PCR detects footprints of the virus and its variants. However, its sensitivity is still less than desired. Rapid antigen tests are less accurate than RT-PCR, but the quick availability of results helps in outbreak control. Antibody tests can be used for retrospective diagnosis of infection, but currently available tests do not correlate with protection conferred by vaccination. The initial hype around chest computed tomography scans for diagnosis has now settled, and it is no longer considered a primary diagnostic modality. There are nonspecific changes in many hematological and biochemical parameters, which are more useful for monitoring disease progression than diagnosis. © 2023 Elsevier Inc. All rights reserved.

Diagnostic value of sputum nucleic acid amplification testing for COVID-19 a meta-analysis

Objective: To systematically evaluate the diagnostic value of nucleic acid test in sputum for COVID-19 and to determine the suitable population for sputum specimens. Method(s): PubMed, CNKI, Scopus, Web of Science, medRxiv and bioRxiv databases were searched for the diagnostic value of sputum nucleic acid test for COVID-19 from December 2019 to April 2022. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias with QUADAS-2 in the included studies. We used sensitivity, specificity, AUC and DOR to evaluate the diagnostic value of sputum specimens. Result(s): A total of 25 studies were included, including 10,731 subjects. Meta-analysis results showed that: The combined sensitivity (SEN), specificity (SPE), diagnostic odds ratio (DOR), and area under operating characteristic curve (AUC) of sputum nucleic acid for the diagnosis of COVID-19 were 89.2% (95% CI, 86.6-91.4), 97.5% (95% CI, 97.2-97.8), 41.4 (95% CI, 11.7-145.9), 0.9474 (95% CI, 0.8964-0.9846). The results of subgroup analysis showed that the Asian group's DOR was 36.835 (95% CI, 10.83-134.570), and the Non-Asian group's DOR was 66.294 (95% CI, 0.719-6109.09). The DOR was 27.207 (95% CI, 2.860-258.780) in the OPS group and 44.165 (95% CI, 4.828-403.970) in the NPS group. DOR of mild patients was 84.255 (95% CI, 9.975-711.690), the DOR of the severe group was 14.216 (95% CI, 3.527-57.142) and was 19.464 (95% CI, 0.724-522.920) in the cured group. Conclusion(s): Current evidence shows that sputum nucleic acid test is of high diagnostic value for COVID-19. Study area and severity of disease are the influencing factors for the diagnostic accuracy of the sputum nucleic acid test. Due to the limitations on the number and quality of the included studies, the above conclusions need to be verified by more high-quality studies.Copyright © 2023, E-Century Publishing Corporation. All rights reserved.

Using telemedicine to facilitate social distancing in otolaryngology: A systematic review.

OBJECTIVES: As the coronavirus 2019 pandemic puts strains on current models of otolaryngology practice, telemedicine is an attractive way for otolaryngologists to reduce in-person appointments while still addressing the health of their patients. This systematic review of the literature aims to identify the evidence basis for using telemedicine in otolaryngology practice to limit person-to-person interactions while achieving comparable quality to in-person services. METHODS: The authors gathered articles from three databases (Embase, PubMed and Web of Science), performed a comprehensive literature review of articles published on telemedicine since 2002, and selected articles for inclusion based on their relevance to otolaryngology and the potential of the intervention to improve patient social distancing. RESULTS: A total of 7153 articles were identified from the initial query. After review, 35 met the inclusion criteria. Of the included articles, 32 (91%), found their specific telemedicine intervention to be effective when compared to in-person services. Twenty articles (57%) were related to remote otoscopy. Other telemedical interventions included videoconferencing for peri-operative visits, diagnosis of peritonsillar abscess, telephone-based voice evaluations and evaluation of nasal fractures. CONCLUSIONS: Video-otoscopy is the most well-supported telemedical intervention which limits physical contact between otolaryngologists and their patients. Other interventions have also demonstrated efficacy but have yet to be as widely validated as video-otoscopy. Telehealth facilitators play a key role in providing high-quality telehealth services. More invasive procedures, such as laryngoscopy, require further evidence to demonstrate definite benefits in a telemedicine setting.

Automatic detection of novel corona virus (SARS-CoV-2) infection in computed tomography scan based on local adaptive thresholding and kernel-support vectors

The recent studies have indicated the requisite of computed tomography scan analysis by radiologists extensively to find out the suspected patients of SARS-CoV-2 (COVID-19). The existing deep learning methods distribute one or more of the subsequent bottlenecks. Therefore, a straight forward method for detecting COVID-19 infection using real-world computed tomography scans is presented. The detection process consists of image processing techniques such as segmentation of lung parenchyma and extraction of effective texture features. The kernel-based support vector machine is employed over feature vectors for classification. The performance parameters of the proposed method are calculated and compared with the existing methodology on the same dataset. The classification results are found outperforming and the method is less probabilistic which can be further exploited for developing more realistic detection system.Copyright © 2023 Inderscience Enterprises Ltd.

Validation of Commercial Kits Using Standard ICMR Protocol

Background: SARS-CoV-2 highlighted worldwide, the need of enhance testing capacity. Government of India, under Atmanirbhar Bharat provided platform to private/public companies to develop and manufacture diagnostic reagents /kits for SARS CoV 2 testing. Objective(s): * Performance evaluation of commercial kits. * Handholding of private/public companies to improve the kits quality for its diagnostic accuracy to use for Covid 19 diagnosis Material(s) and Method(s): The SOP for the validation of diagnostic kits were prepared and approved by ICMR technical committee. The ICMR NIV single tube assay was used as gold slandered. The panels of known positives and negatives were prepared. Validation of commercially developed RT-PCRs, RNA extraction kits and virus transport medium were undertaken. The sensitivity and specificity of the kit were calculated and reported as per ICMR's acceptance. Result(s): Real time RT-PCR kits evaluation: Total 165 kits were evaluated, which includes 12 LAMP assay. Among domestic kits, 31 kits were satisfactory while 83 were not satisfactory. Among the imported kits, 25 kits were satisfactory while 26 were not satisfactory. RNA extraction kits evaluation:- Total 157 kits were evaluated, Among domestic kits, 57 kits were satisfactory while 53 were not satisfactory. Among the imported kits, 31 kits were satisfactory and 17 were not satisfactory. VTM kits evaluated = Total 89 kits were evaluated among which nine kits were imported while 80 kits were of domestic origin. Performance of 10 kits was not satisfactory. Conclusion(s): Kit validation is important to access the quality of commercial kits and to enhanced the testing capacity exponentially in country.

Worldwide research trends on bronchiolitis in pediatrics.

BACKGROUND: The COVID-19 pandemic has led to a significant increase in cases of bronchiolitis among children. As a result, there has been a corresponding increase in the number of publications on this topic. It is essential to examine the main areas of focus within the scientific literature to understand the current trends in research on pediatric bronchiolitis. This research aims to analyze the types of scientific advances related to pediatric bronchiolitis, the research trends being pursued, and the countries and research institutions leading these efforts. By understanding these aspects of bronchiolitis research, we can better understand the current state of knowledge and identify areas where further research is needed. METHODS: To conduct a bibliometric analysis of the scientific literature on pediatric bronchiolitis, all relevant publications were retrieved from the Scopus database. The Scopus API and the SW VosViewer software with optimized modularity functions were used. This analysis was intended to provide a comprehensive overview of the current state of research on this topic, including the types of scientific advances being developed, the research trends being pursued, and the countries and research institutions leading these efforts. RESULTS: A total of 3810 publications were reviewed. We observed an increasing number of publications, particularly in recent years. Of these, 73.7% were articles, 95% were written in English, and 29.4% were from the United States. The main keywords used in these publications included: human, bronchiolitis, child, preschool, preschool child, major clinical study, controlled study, pneumonia, asthma, adolescent, hospitalization, infant, and newborn. These keywords were grouped into six clusters: outpatient management, long-term consequences, etiology, intensive care management, diagnostic methods, and the main cluster, which focused on hospital treatment and clinical studies. CONCLUSIONS: The bibliometric analysis of bronchiolitis research in pediatrics reveals that there has been a significant increase in the number of publications on this topic, particularly in recent years. Most of these publications are articles written in English and published in the United States. The main keywords used in these studies relate to various aspects of bronchiolitis, including diagnosis, treatment, and long-term consequences. The results of this analysis suggest that bronchiolitis is a topic of significant interest and concern for researchers and practitioners in the field of pediatrics and that further research is needed to improve our understanding and management of this condition.

Automated Covid-19 Disease Identification on Chest-Ct Images Using Cnn and Vgg16

The human respiratory system is most affected by COVID-19, a coronavirus illness that has been identified. Infectious disease COVID-19 was brought on by a virus that emerged in Wuhan, China, in December 2019. The key problem for healthcare professionals is early diagnosis. Medical organizations were confused in the early stages because there were no suitable medical tools or medications to detect COVID-19. Reverse Transcription Polymerase Chain Reaction, a novel diagnostic technique, was released. The COVID-19 virus congregates in the patient's nose or throat, thus swab samples from those areas are collected. There are various accuracy and testing time restrictions with this method. Medical professionals advise using a different method called CT (Computerized Tomography), which can rapidly identify the infected lung regions and detect COVID-19 at an earlier stage. With the help of chest CT images, computer scientists created a number of deep learning models to recognize the COVID-19 condition. In this paper, a model for automatic COVID-19 recognition on chest CT images is presented that is based on Convolutional Neural Networks (CNN) and VGG16. A public dataset of 14320 CT scans was used in the experiment, and the findings revealed classification accuracy for CNN and VGG16 of 96.34% and 96.99%, respectively.Copyright © 2022, Anka Publishers. All rights reserved.

Pseudo-V1 ECG lead recording with quality smartwatches and medical interpretation may be necessary for timely and accurate remote detection of atrial flutter/fibrillation

Background: Remote rhythm monitoring with wearable devices is increasingly used especially for early detection of atrial fibrillation/flutter (AF/Afl), being the access to hospital discouraged, especially for frail elderly patients, due to the burden and risk of COVID-19 pandemic. Whereas devices using photo plethysmography (PPG) may misinterpret as AF pulse irregularities due to extrasystoles, patient-directed recording of a single (usually wrist-to-wrist) lead ECG (LEAD I) with hand-held devices or smartwatches have been developed to increase accuracy in AF detection. However, although recent studies validating such devices single-lead ECG recording have shown high sensitivity and specificity, false negative findings such as those reported here are still possible and must be prevented [1]. Purpose(s): Given previous experience of diagnostic uncertainty or failure of the smartwatch ECG (SW-ECG) LEAD I to detect AF/Afl, we have tested if false negative diagnosis could be avoided by recording in addition at least one right precordial (pseudo-V1) lead analyzed by a trained healthcare professional. Method(s): Over one calendar year observation, five patients with previous history of ablated supraventricular arrhythmias suffering sudden palpitations suspected of paroxysmal AF/Afl were instructed to record with their smartwatch at least one precordial lead in addition to LEAD I, to monitor ECG until the termination of symptoms. The SW-ECG strips were sent by telephone for professional interpretation. Diagnostic accuracy based on LEAD I and pseudo-V1 were independently validated by two cardiologists (diagnostic goldstandard - DGS). Result(s): 22 AF/Afl events occurred. Pharmacological cardioversion to sinus rhythm (SR) was obtained in 64%. 192 ECG strips were transmitted. 43,7% of the strips were automatically classified as not significant (or not valid ). Compared to DGS, out of 108 valid strips, correct automatic identification of AF/Afl was obtained in 36,4% with LEAD I, in 33,3% with pseudo V1 and in 54,5% with combined leads, respectively. Interestingly, the SW algorithm has wrongly diagnosed as SR, not only LEAD I, but also 39,4% of pseudo-V1 strips, despite clear-cut evidence of typical flutter waves (Figure 1), when RR intervals were regular due to high degree (e.g., 4:1) A-V block. Conclusion(s): With simple instructions, patients (or their relatives) can easily record an additional precordial (pseudo-V1) SW-ECG lead, that may enhance sensitivity and specificity for remote detection of AF/Afl. However, at present, visual interpretation of SW-ECG by a trained healthcare professional is still needed to guarantee 100% correct diagnosis of AF/Afl, crucial to reduce thromboembolic risk and timely initiate the appropriate treatments. The automatic interpretation of SW's ECG could be improved by appropriate training of a machine learning approach to detect and analyze the atrial waveform provided by an additional pseudo-V1 lead.

Diagnostic Performance of Human Readers and Artificial Intelligence Model in Classification Task of Computed Tomography Images of Different Types of Viral Pneumonia

Purposes: Artificial Intelligence (AI) models are constantly developing to help clinicians in challenging tasks such as classification of images in radiological practice. The aim of this work was to compare the diagnostic performance of an AI classifier model developed in our hospital with the results obtained from the radiologists reading the CT images in discriminating different types of viral pneumonia. Material(s) and Method(s): Chest CT images of 1028 patients with positive swab for SARS-CoV-2 (n=646) and other respiratory viruses (n=382) were segmented automatically for lung extraction and Radiomic Features (RF) of first (n=18) and second (n=120) order were extracted using PyRadiomics tools. RF, together with patient age and sex, were used to develop a Multi-Layer Perceptron classifier to discriminate images of patients with COVID-19 and non-COVID-19 viral pneumonia. The model was trained with 808 CT images performing a LASSO regression (Least Absolute Shrinkage and Selection Operator), a hyper-parameter tuning and a final 4-fold cross validation. The remaining 220 CT images (n=151 COVID-19, n=69 non-COVID-19) were used as independent validation (IV) dataset. Four readers (three radiologists with >10 years of experience and one radiology resident with 3 years of experience) were recruited to blindly evaluate the IV dataset using the 5-points scale CO-RADS score. CT images with CO-RADS >=3 were considered "COVID-19". The same images were classified as "COVID-19" or "non-COVID-19" by applying the AI model with a threshold on the predicted values of 0.5. Diagnostic accuracy, specificity, sensibility and F1 score were calculated for human readers and AI model. Result(s): The AI model was trained using 24 relevant features while the Area under ROC curve values after 4-fold cross validation and its application to the IV dataset were, respectively, 0.89 and 0.85. Interreader agreement in assigning CO-RADS class, analyzed with Fleiss' kappa with ordinal weighting, was good (k=0.68;IC95% 0.63-0.72) and diagnostic performance were then averaged among readers. Diagnostic accuracy, specificity, sensibility and F1 score resulted 78.6%, 78.3%, 78.8% and 78.5% for AI model and 77.7%, 65.6%, 83.3% and 72.0% for human readers. The difference between specificity and sensitivity observed in human readers could be related to the higher rate of false positive due to the higher incidence of COVID-19 patients in comparison with other types of viral pneumonitis during the last 2 years. Conclusion(s): A model based on RF and artificial intelligence provides comparable results with human readers in terms of diagnostic performance in a classification task.Copyright © 2023 Southern Society for Clinical Investigation.

Rapid Detection of Sars Cov-2 Infection in Comparision with Rt-Pcr in Tertiary Care Hospital

Objectives: The goal of the present study was to assess the SARS-CoV-2 antigen detection test's performance features and compare them to the real-time reverse transcription polymerase chain reaction (RT-PCR) test, the gold standard test for the diagnosis of COVID-19 cases. Method(s): From October 2020 to May 2021, patients attending the OPD, including those undergoing surgery, at a Tertiary Care Teaching Hospital in Telangana provided 1000 respiratory samples, primarily nasopharyngeal swabs. A skilled technician had collected two nasopharyngeal swabs from each person in a COVID sample collection room while wearing personal protective equipment and following strict infection control procedures. One swab was used for the rapid antigen test given by the standard Q COVID-19 Ag test kit and placed into the extraction buffer tube. Second swab was kept in the viral transport medium and used for AllplexTM 2019-nCoV Assay (Seegene, Korea), which targets envelope gene (E), and RNA dependent RNA polymerase (RdRp) and nucleocapsid (N) genes of SARS CoV-2, was used for SARS-CoV-2 RNA detection according to the manufacturer's instructions. Result(s): Out of 1000 samples tested for COVID-19, 623 (63.7%) were males and 377 (36.3%) were females. Out of 1000 samples, 347 samples were RT-PCR positive and 653 were RT-PCR negative. Out of 347 RT-PCR samples positive, 341 were Rapid antigen test positive samples and six were negative. Overall sensitivity and specificity are 98.27% and 99.85%, respectively. Conclusion(s): The real-time RT-PCR assay's sensitivity and specificity were comparable to those of the rapid assay for SARS-CoV-2 antigen detection. It can be utilized for contact tracing measures to control the COVID-19 pandemic in places such as border crossings, airports, interregional bus and train stations, and mass testing campaigns needing quick findings. This is especially true in areas with a high prevalence of the disease.Copyright © 2023 The Authors. Published by Innovare Academic Sciences Pvt Ltd.

Should rapid antigen tests be first-line for COVID-19 testing? Results of a prospective urban cohort study.

BACKGROUND: A highly accurate, rapid, and low-cost COVID-19 test is essential for guiding isolation measures. To date, the most widely used tests are either nucleic acid amplification tests or antigen tests. The objective of this study is to further assess the diagnostic performance of the Binax-CoV2 rapid antigen test in comparison to the current gold standard reverse transcription quantitative polymerase chain reaction (RT-qPCR), with additional analysis of symptomatology and cycle threshold utility. METHODS: This is a prospective cohort study performed between November and December 2020. Individuals who presented to COVID-19 testing events and received both RT-qPCR and a rapid antigent test were included. Testing occurred at the emergency department of an urban hospital and at a community mobile unit. No fees or appointments were required. Individuals self-reported the presence or absence of symptoms and history of positive COVID-19 test within the previous two weeks. Trained staff collected two subsequent nasopharyngeal swabs of both nares. One set of swabs underwent RT-qPCR and the other underwent Binax-CoV2 assay per manufacturer guidelines. RESULTS: A total of 390 patients were included, of which 302 were from the community site. Of these 302, 42 (14%) were RT-qPCR positive. Of the 42 RT-qPCR positive, 30 (71.4%) were also positive by Binax-CoV2. The Binax-CoV2 test had a sensitivity of 71.4% (95% CI: 55%-84%) and a specificity of 99.6% (95% CI: 98%-100%) in this population. Performance of the Binax-CoV2 test performed better in individuals with higher viral load. For symptomatic patients with cycle threshold < 20, sensitivity reached 100%. CONCLUSIONS: The Binax-CoV2 assay's specificity and sensitivity in individuals with high viral load makes it a suitable first-line test for detecting COVID-19. However, given the assay's measured sensitivity, a negative result on the Binax-CoV2 assay may warrant additional testing with more sensitive tests, such as the RT-qPCR. This is particularly the case with high clinical suspicion for an active SARS-CoV-2 infection even after a negative Binax-CoV2 result.

Prospective Performance Evaluation of the miDiagnostics COVID-19 PCR Test for Rapid SARS-CoV-2 Detection on Nasopharyngeal Swabs.

Rapid diagnosis or exclusion of SARS-CoV-2 infection is essential for correct medical management decisions regarding COVID-19. High-throughput laboratory-based reverse transcriptase (RT)-PCR testing is accurate with longer turnaround times, while rapid antigen tests show moderate sensitivity. In search of a fast and reliable COVID-19 test, we aimed to validate the rapid miDiagnostics COVID-19 PCR test. We recruited symptomatic and asymptomatic participants in a mobile COVID-19 test center in Belgium. We collected three nasopharyngeal samples from each participant. The index sample was tested on the miDiagnostics COVID-19 PCR reader, the reference sample was tested on the reference TaqPath COVID-19 PCR test in the Belgian Reference Center for Respiratory Pathogens of University Hospitals Leuven, and a third sample was collected for discordance testing with the PerkinElmer SARS-CoV-2 PCR kit. A total of 770 participants yielded 763 sets of included nasopharyngeal samples. Overall positive percent agreement and negative percent agreement of the miDiagnostics COVID-19 PCR test were 95.5% (92.6% to 97.4%) and 94.9% (92.3 to 96.8%), rising to 98.6% (96.5% to 99.6%) and 96.5% (92.6% to 98.7%) in symptomatic patients. Discordance testing reclassified 15 of 21 false-positive cases as true positive. A retest of the miDiagnostics PCR test was performed in 61 tests (7.4%) due to a technical error. The miDiagnostics COVID-19 PCR test showed excellent clinical accuracy. The fast and reliable results allow for rapid correct diagnosis and tailored medical management decisions regarding COVID-19.

Performance of saliva compared with nasopharyngeal swab for diagnosis of COVID-19 by NAAT in cross-sectional studies: Systematic review and meta-analysis.

Nucleic acid amplification testing (NAAT) is the preferred method to diagnose coronavirus disease 2019 (COVID-19). Saliva has been suggested as an alternative to nasopharyngeal swabs (NPS), but previous systematic reviews were limited by the number and types of studies available. The objective of this systematic review and meta-analysis was to assess the diagnostic performance of saliva compared with NPS for COVID-19. We searched Ovid MEDLINE, Embase, Cochrane, and Scopus databases up to 24 April 2021 for studies that directly compared paired NPS and saliva specimens taken at the time of diagnosis. Meta-analysis was performed using an exact binomial rendition of the bivariate mixed-effects regression model. Risk of bias was assessed using the QUADAS-2 tool. Of 2683 records, we included 23 studies with 25 cohorts, comprising 11,582 paired specimens. A wide variety of NAAT assays and collection methods were used. Meta-analysis gave a pooled sensitivity of 87 % (95 % CI = 83-90 %) and specificity of 99 % (95 % CI = 98-99 %). Subgroup analyses showed the highest sensitivity when the suspected individual is tested in an outpatient setting and is symptomatic. Our results support the use of saliva NAAT as an alternative to NPS NAAT for the diagnosis of COVID-19.

The role of Trans-thoracic ultrasonography for rapid detection of Covid-19 pandemic-pneumonia(262cases)?

Background: Corona virus pandemic pneumonia has caused unmatchable damage to humanity. Early detection and prompt treatment is the only answer for effective control. RT-PCR is the gold standard diagnostic test but displays high false-negative rate. A large number of undetected patients remain a constant source of inadvertent disease dissemination in community, potentiating the ongoing pandemic. Objective(s): To determine the usefulness of transthoracic ultrasonography for early detection of covid-19 pulmonary infection during a pandemic. Methodology: This cross-sectional study was conducted in Pulmonology-OPD of Gulab Devi Teaching Hospital, Lahore-Pakistan, from April 21, 2020 to September 30, 2020. Total 262 patients with dry cough, fever and shortness of breath of sudden onset were included. Patients were investigated with chest x-ray/HRCT, transthoracic ultrasonography, covid-19-PCR and hematological tests. Sensitivity, Specificity, positive predictive value(PPV), negative predictive value(NPV) and diagnostic accuracy was calculated with clinical diagnosis as reference. Data was analyzed by SPSS-24-software. Result(s): Of 262-patients, 248 were detected as covid-19 pneumonia by ultrasound. Bilateral, multifocal, posteriolateral involvement and B-lines were common features. Ultrasound displayed sensitivity 99.60%, specificity, 69.23%, PPV 98.41%, NPV 90.0% and diagnostic accuracy 98.09%. PCR diagnosed 155/228(59.16%) cases. The P-value was 0.00001-significant at P<.05. Conclusion(s): Transthoracic ultrasonography is a tremendous tool furnishing instant detection of covid-19 pneumonia with high sensitivity and provides foundations for evidence based management during pandemic.