COVID-19 PCR Test, Cluster of False Positive and Importance of Quality Control

Joob, Beuy; Wiwantikit, Viroj

doi:10.7754/clin.lab.2020.200629

Cited by 4 publications

(3 citation statements)

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“…The CSF RBC count was only available for 7/16 (44%) patients we identified who had a positive SARS-CoV-2 CSF PCR, one of whom had a CSF RBC count of 1,685 with a CSF WBC count of 11 cells/μL, which may indicate the CSF SARS-CoV-2 PCR was falsely positive due to a traumatic lumbar puncture [ [26] , [27] , [28] , [29] , 153 , 164 , 180 , 184 , 195 , 199 , 224 , 225 , 227 , 236 , 238 , 241 ]. The SARS-CoV-2 PCR can also be falsely positive if there is a pre-analytical error [ 256 ]. The process by which CSF SARS-CoV-2 PCR was evaluated varied and this information was not always provided, so we did not delineate the testing technique for each patient who had CSF SARS-CoV-2 PCR testing performed in this review; however, it is important to note that the sensitivity and specificity varies between tests.…”

Section: Discussionmentioning

confidence: 99%

Cerebrospinal fluid in COVID-19: A systematic review of the literature

Lewis

Frontera

Placantonakis

et al. 2021

Journal of the Neurological Sciences

153

152

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We sought to review the literature on cerebrospinal fluid (CSF) testing in patients with COVID-19 for evidence of viral neuroinvasion by SARS-CoV-2. Methods: We performed a systematic review of Medline and Embase between December 1, 2019 and November 18, 2020 to identify case reports or series of patients who had COVID-19 diagnosed based on positive SARS-CoV-2 polymerase chain reaction (PCR) or serologic testing and had CSF testing due to a neurologic symptom. Results: We identified 242 relevant documents which included 430 patients with COVID-19 who had acute neurological symptoms prompting CSF testing. Of those, 321 (75%) patients had symptoms that localized to the central nervous system (CNS). Of 304 patients whose CSF was tested for SARS-CoV-2 PCR, there were 17 (6%) whose test was positive, all of whom had symptoms that localized to the central nervous system (CNS). The majority (13/17, 76%) of these patients were admitted to the hospital because of neurological symptoms. Of 58 patients whose CSF was tested for SARS-CoV-2 antibody, 7 (12%) had positive antibodies with evidence of intrathecal synthesis, all of whom had symptoms that localized to the CNS. Of 132 patients who had oligoclonal bands evaluated, 3 (2%) had evidence of intrathecal antibody synthesis. Of 77 patients tested for autoimmune antibodies in the CSF, 4 (5%) had positive findings. Conclusion: Detection of SARS-CoV-2 in CSF via PCR or evaluation for intrathecal antibody synthesis appears to be rare. Most neurological complications associated with SARS-CoV-2 are unlikely to be related to direct viral neuroinvasion.

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Section: Discussionmentioning

confidence: 99%

Cerebrospinal fluid in COVID-19: A systematic review of the literature

Lewis

Frontera

Placantonakis

et al. 2021

Journal of the Neurological Sciences

153

152

View full text Add to dashboard Cite

show abstract

“…The MRI field strength, scanner model, sequence, resolution, and time between contrast injection and image acquisition can impact the evaluation for CNS hyperintense lesions or leptomeningeal enhancement 2,140 . CSF SARS‐CoV‐2 PCR results can be affected by contamination from shed airborne virus or blood, rapid CSF clearance, low viral load, genetic variability in the virus itself, and technical factors, including preanalytical error 36,141–145 . Similarly, the sensitivity and specificity among serological tests vary 146,147 .…”

Section: Discussionmentioning

confidence: 99%

COVID‐19 associated brain/spinal cord lesions and leptomeningeal enhancement: A meta‐analysis of the relationship to CSF SARS‐CoV‐2

Lewis

Jain

Frontera

et al. 2021

Journal of Neuroimaging

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Background and Purpose We reviewed the literature to evaluate cerebrospinal fluid (CSF) results from patients with coronavirus disease 2019 (COVID‐19) who had neurological symptoms and had an MRI that showed (1) central nervous system (CNS) hyperintense lesions not attributed to ischemia and/or (2) leptomeningeal enhancement. We sought to determine if these findings were associated with a positive CSF severe acute respiratory syndrome associated coronavirus 2 (SARS‐CoV‐2) polymerase chain reaction (PCR). Methods We performed a systematic review of Medline and Embase from December 1, 2019 to November 18, 2020. CSF results were evaluated based on the presence/absence of (1) ≥ 1 CNS hyperintense lesion and (2) leptomeningeal enhancement. Results In 117 publications, we identified 193 patients with COVID‐19 who had an MRI of the CNS and CSF testing. There were 125 (65%) patients with CNS hyperintense lesions. Patients with CNS hyperintense lesions were significantly more likely to have a positive CSF SARS‐CoV‐2 PCR (10% [9/87] vs. 0% [0/43], p = 0.029). Of 75 patients who had a contrast MRI, there were 20 (27%) patients who had leptomeningeal enhancement. Patients with leptomeningeal enhancement were significantly more likely to have a positive CSF SARS‐CoV‐2 PCR (25% [4/16] vs. 5% [2/42], p = 0.024). Conclusion The presence of CNS hyperintense lesions or leptomeningeal enhancement on neuroimaging from patients with COVID‐19 is associated with increased likelihood of a positive CSF SARS‐CoV‐2 PCR. However, a positive CSF SARS‐CoV‐2 PCR is uncommon in patients with these neuroimaging findings, suggesting they are often related to other etiologies, such as inflammation, hypoxia, or ischemia.

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“…COVID-19 has caused 6.26 million deaths and 522.06 million confirmed cases till 17/May/2022. The polymerase chain reaction (PCR) can effectively detect its existence; however, the cluster of false-positive [ 1 ] perplexes clinicians. The chest computed tomography (CCT) [ 2 ] is another precise way to help clinicians to diagnose COVID-19 patients.…”

Section: Introductionmentioning

confidence: 99%

SNELM: SqueezeNet-Guided ELM for COVID-19 Recognition

Zhang¹,

Khan²,

Zhu³

et al. 2023

Computer Systems Science and Engineering

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Aim) The COVID-19 has caused 6.26 million deaths and 522.06 million confirmed cases till 17/May/2022. Chest computed tomography is a precise way to help clinicians diagnose COVID-19 patients. (Method) Two datasets are chosen for this study. The multiple-way data augmentation, including speckle noise, random translation, scaling, salt-and-pepper noise, vertical shear, Gamma correction, rotation, Gaussian noise, and horizontal shear, is harnessed to increase the size of the training set. Then, the SqueezeNet (SN) with complex bypass is used to generate SN features. Finally, the extreme learning machine (ELM) is used to serve as the classifier due to its simplicity of usage, quick learning speed, and great generalization performances. The number of hidden neurons in ELM is set to 2000. Ten runs of 10-fold cross-validation are implemented to generate impartial results. (Result) For the 296-image dataset, our SNELM model attains a sensitivity of 96.35 ± 1.50%, a specificity of 96.08 ± 1.05%, a precision of 96.10 ± 1.00%, and an accuracy of 96.22 ± 0.94%. For the 640-image dataset, the SNELM attains a sensitivity of 96.00 ± 1.25%, a specificity of 96.28 ± 1.16%, a precision of 96.28 ± 1.13%, and an accuracy of 96.14 ± 0.96%. (Conclusion) The proposed SNELM model is successful in diagnosing COVID-19. The performances of our model are higher than seven state-of-the-art COVID-19 recognition models.

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COVID-19 PCR Test, Cluster of False Positive and Importance of Quality Control

Cited by 4 publications

References 0 publications

Cerebrospinal fluid in COVID-19: A systematic review of the literature

Cerebrospinal fluid in COVID-19: A systematic review of the literature

COVID‐19 associated brain/spinal cord lesions and leptomeningeal enhancement: A meta‐analysis of the relationship to CSF SARS‐CoV‐2

SNELM: SqueezeNet-Guided ELM for COVID-19 Recognition

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