ABSTRACT
The promising diagnostic performance of rapid antigen tests (RATs) using non-invasive anterior nasal (AN) swab specimens to diagnose COVID-19 has been reported. A large number of RATs are commercially available; however, the careful assessment of RATs is essential prior to their implementation in clinical practice. We evaluated the clinical performance of the GLINE-2019-nCoV Ag Kit as a RAT using AN swabs in a prospective, blinded study. Adult patients who visited outpatient departments and received SARS-CoV-2 tests between August 16 and September 8, 2022, were eligible for this study. Patients who were aged under 18 years and patients without appropriate specimens were excluded. Two sets of AN and nasopharyngeal (NP) swabs were collected from all patients. Each set of specimens was tested by the RAT and quantitative reverse-transcription polymerase chain reaction (RT-qPCR). Of the 138 recruited patients, 84 were positive and 54 were negative by RT-qPCR using NP swabs. The positive agreement rate between RT-qPCR using NP swabs and RAT using AN swabs was 78.6% (95% confidence interval [CI], 68.3%-86.8%), the negative agreement rate was 98.1% (95% CI, 90.1%-99.9%), and the overall agreement rate was 86.2% (95% CI, 79.3%-91.5%), with a κ coefficient of 0.73. The positive agreement rate in the early phase (≤3 days from symptom onset) was >80%, but this fell to 50% in the late phase (≥4 days). This study demonstrates that the GLINE-2019-nCoV Ag Kit using AN swabs has good clinical performance and might be a reliable alternative method for diagnosing COVID-19.
Subject(s)
COVID-19 , SARS-CoV-2 , Humans , COVID-19/diagnosis , Nasal Cavity , Prospective Studies , Immunologic Tests , Nasopharynx , Sensitivity and SpecificityABSTRACT
BackgroundWe analyzed antibody response patterns according to level of disease severity in patients with novel coronavirus disease 2019 (COVID-19) in Japan. MethodsWe analyzed 611 serum specimens from 231 patients with COVID-19 (mild, 170; severe, 31; critical, 30). IgM and IgG antibodies against nucleocapsid protein (N) and spike 1 protein (S1) were detected by enzyme-linked immunosorbent assays. FindingsThe peaks of fitting curves for the OD values of IgM and IgG antibodies against N appeared simultaneously, while those against S1 were delayed compared with N. The OD values of IgM against N and IgG against both N and S1 were significantly higher in the severe and critical cases than in the mild cases at 11 days after symptom onset. The seroconversion rates of IgG were higher than those of IgM against both N and S1 during the clinical course based on the optimal cut-off values defined in this study. The seroconversion rates of IgG and IgM against N and S1 were higher in the severe and critical cases than in the mild cases. ConclusionOur findings show that a stronger antibody response occurred in COVID-19 patients with greater disease severity and there were low seroconversion rates of antibodies against N and S1 in the mild cases. The antibody response patterns in our population suggest a second infection pattern, leading us to hypothesize that cross-reactivity occurs between SARS-CoV-2 and past infection with other human coronaviruses.
ABSTRACT
BackgroundWe evaluated clinical characteristics and the clinical utility of VITROS SARS-CoV-2 antibody tests according to COVID-19 severity in patients in Japan. MethodsWe analyzed 255 serum specimens from 130 COVID-19 patients and examined clinical records and laboratory data. Presence of total (IgA, IgM, and IgG) and specific IgG antibody for the spike 1 antigen of SARS-CoV2 was determined using VITROS Anti-SARS-CoV-2 antibody tests. FindingsOverall, 98 (75.4%) and 32 (24.6%) patients had mild and severe COVID-19, respectively. On admission, 76 (58.5%) and 45 (34.6%) patients were positive for total and IgG antibody assays. Among 91 patients at discharge, 90 (98.9%) and 81 (89.0%) patients were positive for total and IgG antibody, respectively. Clinical background and laboratory findings on admission, but not the prevalence or concentration of total or IgG antibody, were associated with disease prognosis. Total and IgG antibody intensity were significantly higher in severe cases than in mild cases in serum collected after 11 days from onset, but not within 10 days. ConclusionVITROS Anti-SARS-CoV-2 Total and IgG assays will be useful as supporting diagnostic and surveillance tools and for evaluation of humoral immune response to COVID-19. Clinical background and laboratory findings are preferable predictors of disease prognosis.
ABSTRACT
BackgroundWe evaluated the clinical performance of an immunochromatographic (IC) IgM/IgG antibody assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) and chest computed tomography (CT) for the diagnosis of Coronavirus disease 2019 (COVID-19). MethodsWe examined 139 serum specimens collected from 112 patients with COVID-19 and 48 serum specimens collected from 48 non-COVID-19 patients. The presence of IgM/IgG antibody for SARS-CoV2 was determined using the One Step Novel Coronavirus (COVID-19) IgM/IgG Antibody Test. Chest CT was performed in COVID-19 patients on admission. FindingsOf the139 COVID-19 serum specimens, IgM was detected in 27.8%, 48.0%, and 95.8% of the specimens collected within 1 week, 1-2 weeks, and >2 weeks after symptom onset and IgG was detected in 3.3%, 8.0%, and 62.5%, respectively. Among the 48 non-COVID-19 serum specimens, 1 generated a false-positive result for IgM. Thirty-eight of the 112 COVID-19 patients were asymptomatic, of whom 15 were positive for IgM, and 74 were symptomatic, of whom 22 were positive for IgM and 7 were positive for IgG. The diagnostic sensitivity of CT scan alone and in combination with the IC assay was 57.9 % (22/38) and 68.4% (26/38) for the asymptomatic patients and 74.3% (55/74) and 82.4% (61/74) for the symptomatic patients, respectively. ConclusionThe IC assay had low sensitivity during the early phase of infection, and thus IC assay alone is not recommended for initial diagnostic testing for COVID-19. If RT-qPCR is not available, the combination of chest CT and IC assay may be useful for diagnosing COVID-19.
ABSTRACT
Although aortic annular abscess and rupture of the sinus of Valsalva are known as complications of infective endocarditis, few cases in children have been reported. We report a surgical case of a 6-year-old girl with active infective endocarditis complicated with an annular abscess and pseudoaneurysm of the sinus of Valsalva. The patient presented progressive symptoms of heart failure and a subsequent echocardiogram demonstrated severe aortic regurgitation. A computed tomography indicated pseudoaneurysm of sinus of Valsalva and an emergency operation was performed. At operation, a bicuspid aortic valve with vegetation was noted. The annular abscess caused a large tissue defect of the left coronary sinus of Valsalva and formed a pseudoaneurysm. The infected lesion was resected completely. The defective aortic annulus and sinus of Valsalva were repaired with a bovine pericardial patch and aortic valve was replaced with a mechanical valve. The postoperative course was uneventful and the patient was discharged after adequate antibiotic treatment.
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We report a rare case of a giant celiac aneurysm complicated with nosocomial acute aortic dissection and idiopathic thrombocytonenic purpura (ITP). A 75-year-old man with ITP complained of abdominal swelling. Enhanced computed tomography (CT) showed a giant celiac aneurysm 72 mm in size. Surgery repair was scheduled and platelet count increased by intravenous administration of immunoglobulin. After admission, he complained of back pain. CT showed aortic dissection (DeBakey classification : IIIb) and a celiac aneurysm enlarged to 78 mm. He underwent surgical repair for a giant celiac aneurysm and splenectomy after management with medial therapy.
ABSTRACT
Post-malaria neurological syndrome (PMNS) is a rare complication after the treatment of falciparum malaria. We describe a case of a 56-year-old man who developed ataxia, tremor, and confusion 16 days after a successful treatment of falciparum malaria with artesunate followed by mefloquine. Magnetic resonance imaging of the brain revealed no abnormality, and he recovered spontaneously without any specific treatment including corticosteroids. Inflammatory changes were found in the cerebrospinal fluid, suggesting a localized inflammatory reaction as the cause of the syndrome.
