Evaluation of two RT-PCR techniques for SARS-CoV-2 RNA detection in serum for microbiological diagnosis

Ramírez, Alexandra Martín; Cruz, Nelly Daniela Zurita; Gutiérrez-Cobos, Ainhoa; Serrano, D.A. Rodríguez; Álvaro, Isidoro González; Roy-Vallejo, Emilia; Frutos, Sara Gómez de; García–Rodrigo, Leticia Fontán; Domingo, Laura Cardeñoso

doi:10.1016/j.jviromet.2021.114411

Cited by 11 publications

(4 citation statements)

References 18 publications

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“…At the Department of Microbiology at the Karolinska University Hospital, Huddinge, Stockholm, the following commercial techniques approved for diagnosing SARS-CoV-2 were used: cobas SARS-CoV-2 assay (Roche, Pleasanton, California), targeting the Envelope (E) and Open Reading Frame (ORF) 1 gene [ 19 ] or NeuMoDx SARS-CoV-2 assay (NeuMoDx, Ann Arbor, Michigan) targeting non-structural protein 2 (Nsp 2 ), RNA-dependent RNA polymerase ( RdRp ) and nucleocapsid (N) genes. In addition, a validated in-house method targeting the RdRp and E-genes was utilised.…”

Section: Methodsmentioning

confidence: 99%

The kinetics of SARS-CoV-2 viremia in COVID-19 patients receiving remdesivir

Krifors

Karlsson

Ekman

et al. 2023

Eur J Clin Microbiol Infect Dis

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Detection of SARS-CoV-2 RNA in serum, viremia, has been linked to disease severity and outcome. The kinetics of viremia in patients receiving remdesivir has not been thoroughly studied and could help predict treatment response and outcome. We investigated the kinetics of SARS-CoV-2 viremia and factors associated with baseline viremia, viral clearance and 30-day mortality in patients receiving remdesivir. An observational study including 378 hospitalised patients (median age 67 years, 67% male) sampled with serum SARS-CoV-2 RT-PCR within ± 24 h of initiation of remdesivir treatment. Baseline viremia was present in 206 (54%) patients with a median Ct value of 35.3 (IQR = 33.3–37.1). In patients with baseline viremia, the estimated probability of viral clearance was 72% by day 5. Ct values decreased significantly during remdesivir treatment for viremic patients, indicating an increase in viral load. In total, 44 patients (12%) died within 30 days, and mortality was significantly associated with viremia at baseline (OR = 2.45, p = 0.01) and lack of viral clearance by day 5 (OR = 4.8, p = < 0.01). Viral clearance was not associated with any individual risk factor. Viremia appears to be a prognostic marker before and during remedesivir treatment. The resolution of viremia was similar to patients not receiving remdesivir in other studies, and the decrease in Ct values during treatment questions the antiviral capacity of remdesivir in vivo. Prospective studies are warranted to confirm our findings.

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Section: Methodsmentioning

confidence: 99%

The kinetics of SARS-CoV-2 viremia in COVID-19 patients receiving remdesivir

Krifors

Karlsson

Ekman

et al. 2023

Eur J Clin Microbiol Infect Dis

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“…The sample size was estimated in 49 patients to validate the primary objective of the study “SARS-CoV-2 viremia as a biomarker of disease severity” (ongoing manuscript) based on the results of our previous retrospective studies ( 10 , 15 ); nevertheless, 57 patients were finally included.…”

Section: Methodsmentioning

confidence: 99%

SARS-CoV-2 Viremia Precedes an IL6 Response in Severe COVID-19 Patients: Results of a Longitudinal Prospective Cohort

et al. 2022

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BackgroundInterleukin 6 (IL6) levels and SARS-CoV-2 viremia have been correlated with COVID-19 severity. The association over time between them has not been assessed in a prospective cohort. Our aim was to evaluate the relationship between SARS-CoV-2 viremia and time evolution of IL6 levels in a COVID-19 prospective cohort.MethodsSecondary analysis from a prospective cohort including COVID-19 hospitalized patients from Hospital Universitario La Princesa between November 2020 and January 2021. Serial plasma samples were collected from admission until discharge. Viral load was quantified by Real-Time Polymerase Chain Reaction and IL6 levels with an enzyme immunoassay. To represent the evolution over time of both variables we used the graphic command twoway of Stata.ResultsA total of 57 patients were recruited, with median age of 63 years (IQR [53–81]), 61.4% male and 68.4% Caucasian. The peak of viremia appeared shortly after symptom onset in patients with persistent viremia (more than 1 sample with > 1.3 log10 copies/ml) and also in those with at least one IL6 > 30 pg/ml, followed by a progressive increase in IL6 around 10 days later. Persistent viremia in the first week of hospitalization was associated with higher levels of IL6. Both IL6 and SARS-CoV-2 viral load were higher in males, with a quicker increase with age.ConclusionIn those patients with worse outcomes, an early peak of SARS-CoV-2 viral load precedes an increase in IL6 levels. Monitoring SARS-CoV-2 viral load during the first week after symptom onset may be helpful to predict disease severity in COVID-19 patients.

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“…Ramírez AM et al [96] reported a sensitivity, specificity, PPV, NPV, and kappa coefficient of 73.63%, 97.6%, 96.73%, 75%, and 0.69, respectively. The details are provided in Table 3.…”

Section: Serum Samplesmentioning

confidence: 99%

The Diagnostic Performance of Various Clinical Specimens for the Detection of COVID-19: A Meta-Analysis of RT-PCR Studies

Al-Shaibari,

Mousa,

Alqumber

et al. 2023

Diagnostics

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Background: The diagnostic performance of numerous clinical specimens to diagnose COVID-19 through RT-PCR techniques is very important, and the test result outcome is still unclear. This review aimed to analyze the diagnostic performance of clinical samples for COVID-19 detection by RT-PCR through a systematic literature review process. Methodology: A compressive literature search was performed in PubMed/Medline, Scopus, Embase, and Cochrane Library from inception to November 2022. A snowball search on Google, Google Scholar, Research Gate, and MedRxiv, as well as bibliographic research, was performed to identify any other relevant articles. Observational studies that assessed the clinical usefulness of the RT-PCR technique in different human samples for the detection or screening of COVID-19 among patients or patient samples were considered for this review. The primary outcomes considered were sensitivity and specificity, while parameters such as positive predictive value (PPV), negative predictive value (NPV), and kappa coefficient were considered secondary outcomes. Results: A total of 85 studies out of 10,213 non-duplicate records were included for the systematic review, of which 69 articles were considered for the meta-analysis. The meta-analysis indicated better pooled sensitivity with the nasopharyngeal swab (NPS) than saliva (91.06% vs. 76.70%) and was comparable with the combined NPS/oropharyngeal swab (OPS; 92%). Nevertheless, specificity was observed to be better with saliva (98.27%) than the combined NPS/OPS (98.08%) and NPS (95.57%). The other parameters were comparable among different samples. The respiratory samples and throat samples showed a promising result relative to other specimens. The sensitivity and specificity of samples such as nasopharyngeal swabs, saliva, combined nasopharyngeal/oropharyngeal, respiratory, sputum, broncho aspirate, throat swab, gargle, serum, and the mixed sample were found to be 91.06%, 76.70%, 92.00%, 99.44%, 86%, 96%, 94.4%, 95.3%, 73.63%, and above 98; and 95.57%, 98.27%, 98.08%, 100%, 37%, 100%, 100%, 97.6%, and above 97, respectively. Conclusions: NPS was observed to have relatively better sensitivity, but not specificity when compared with other clinical specimens. Head-to-head comparisons between the different samples and the time of sample collection are warranted to strengthen this evidence.

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Evaluation of two RT-PCR techniques for SARS-CoV-2 RNA detection in serum for microbiological diagnosis

Cited by 11 publications

References 18 publications

The kinetics of SARS-CoV-2 viremia in COVID-19 patients receiving remdesivir

The kinetics of SARS-CoV-2 viremia in COVID-19 patients receiving remdesivir

SARS-CoV-2 Viremia Precedes an IL6 Response in Severe COVID-19 Patients: Results of a Longitudinal Prospective Cohort

The Diagnostic Performance of Various Clinical Specimens for the Detection of COVID-19: A Meta-Analysis of RT-PCR Studies

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