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Covid 19 Throat Swab Test

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Last Updated: 02 July 2021

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General | Latest Info

Combine throat / nasal swabs demonstrate similar sensitivity to nasopharyngeal swabs alone in detecting SARS - CoV - 2, according to research results published in the European Journal of Clinical Microbiology & Infectious Diseases. Study investigators found that this sensitivity was achieved despite lower cycle threshold value for nasopharyngeal samples. According to investigators, combined throat / nasal sampling has several advantages. They compared both methods by sampling 107 healthcare workers with symptoms of coronavirus disease 2019. Detection of the virus was then performed by reverse transcription polymerase chain reaction. In total, 74. 8% of sampled healthcare workers tested negative with both sampling methods and 23. 4% test positive with both methods. Discrepant results with positive PCR in combined throat / nasal swabs and negative PCR in nasopharyngeal swabs occur twice. The Index for concordance between both methods was high and the median CT value of PCR on nasopharyngeal samples was significantly lower than that of PCR on combined throat / nasal samples at 19 vs 21 cycles. Investigators acknowledge that the study was limited by the low number of patients and positive samples. They do, however, determine that double sampling of additional workers was unnecessary because, we did not observe any positive nasopharyngeal samples with negative throat / nasal swab. They conclude that, despite lower CT value for nasopharyngeal samples, combined throat / nasal swabs yield similar sensitivity to detect SARS - CoV - 2. Investigators further suggest that in future studies assessing utility of different patient samples for diagnosis of COVID - 19, it would be interesting to compare combined throat / nasal swab with saliva specimens as well.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Diagnostic tests for current infection

Laboratories need a CLIA certificate to perform COVID - 19 testing. Under CLIA, laboratories are prohibited from testing human specimens for the purpose of diagnosis, prevention, treatment, or health assessment without a valid CLIA certificate. To become CLIA - certify, laboratories must comply with accuracy, quality, and reliability requirements as dictated by statute. The purpose of these requirements is to ensure that information that patients or their clinicians receive from clinical laboratory is accurate and reliable test results. No requirements are being waived in response to COVID - 19. However, to expedite access to testing, CLIA is allowing for testing to begin once CLIA number has been assigned as opposed to laboratories waiting for hard copy paper certificate to come in mail. Cms has provided updated guidance on available tests and the level of lab required for testing. On June 4 2020, US Department of Health and Human Services announced new guidance for reporting COVID - 19 testing. This guidance is pursuant to the CARES Act and impacts all laboratories that are performing or analyzing tests intended to detect SARS - CoV - 2 or diagnose possible cases of COVID - 19. The goal of this new guidance is to standardize required reporting information to better monitor disease incidence and trends. Laboratories are now required to report results from each test to the HHS Secretary via existing public health channels to ensure rapid initiation of case investigations.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Tests for past infection

Proper collection of specimens is the most important step in laboratory diagnosis of infectious disease. Specimens that are not collected correctly may lead to false negative test results. Cdc list following specimens acceptable for diagnostic testing for SARS - CoV - 2. Nasopharyngeal collected by Healthcare Professional Oropharyngeal collected by Healthcare Professional Nasal Mid - turbinate collected by Healthcare Professional or supervise onsite self - collection anterior nares collected by Healthcare Professional or self - collection onsite or home nasopharyngeal wash / aspirate or Nasal wash / aspirate collected by Healthcare Professional All swab specimens should be place immediately in sterile Transport tube containing viral Transport medium, Amies Transport medium or sterile saline, unless using POC test system which analyze Specimen directly. When collecting diagnostic respiratory specimens from patients with possible COVID - 19, following should occur: Specimen collection should be performed in a normal examination room with door close, if possible. Healthcare professionals collecting samples should wear N95, eye protection, gloves, and gown. Healthcare professionals assisting but not directly involved in collection and able to maintain 6 feet from patient should wear a face mask, eye protection, gloves and a gown. If N95 is not readily available, wear a facemask. N95 may be prioritize for other procedures at higher risk for producing infectious aerosols, instead of for collecting nasopharyngeal swabs. The number of healthcare professionals present during procedure should be limited to only those essential for patient care and procedure support. Visitors should not be present for Specimen collection. Clean and disinfect procedure room surfaces promptly. For handling and testing clinical specimens, use standard precautions to provide barrier between Specimen and HCP during Specimen manipulation. Require PPE include: eye protection & / or splash guard gloves, laboratory coats or gowns. Do not wear lab coat or gown outside of the testing area. Hand hygiene employers should select the appropriate PPE and provide it to HCP in accordance with OSHA PPE standards. Hcp must receive training on and demonstrate understanding of: when to use PPE, what PPE is necessary, how to properly don, use, and doff PPE in a manner to prevent self - contamination, how to properly dispose of or disinfect and maintain PPE limitations of PPE. Any reusable PPE must be properly clean, decontaminate, and maintained after and between uses. Facilities should have policies and procedures describing recommended sequences for safely donning and doffing PPE. If you are sending specimens directly to CDC or state health laboratory, check with your local health department for guidance on transporting and shipping of infectious substances. Most health departments have processes established to ship specimens to state labs or CDC. Suspect COVID - 19 specimens must be transported according to International Air Transport Association guidelines for Infectious substances, category B. Primary receptacle Secondary packaging Rigid outer packaging, labelled with UN3373 label. See CDC packaging schema diagram and IATA packing instructions 650 for UN 3373. Click on Infectious substances and download packing instructions. Requisition for submitting specimens to CDC for lab testing form must be completed electronically to use drop downs. Review guidance for completing form.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

The bottom line

After a slow start, testing for COVID - 19 has begun to ramp up in recent weeks. Giant commercial labs have jumped into the effort, drive - up testing sites have been established in some places, and new types of tests have been approved under emergency rules set by the Food and Drug Administration. But even for people who are able to get the test, there can be a frustratingly long wait for results, not just hours, but often days. Even Sen. Rand Paul, R - Ky., Didn't get his positive test results for six days and has been criticized for not self - quarantining during that time. We ask experts to help explain why the turnaround time for results can vary widely from hours to days or even weeks and how that might be changing. First, sample is taken from the patient's nose or throat, using a special swab. That swab goes into the tube and is sent to the lab. Some large hospitals have on - site molecular test labs, but most samples are sent to outside laboratories for processing. More on that later. That transit time usually runs about 24 hours, but it could be longer, depending on how far the hospital is from the processing laboratory. Once in the lab, specimen is process, which means lab workers extract the virus's RNA, molecule that helps regulate genes. That step of cleaning RNA extraction step is one limiting factor, say Cathie Klapperich, vice chair of the department of biomedical engineering at Boston University. Only the very biggest labs have automated ways of extracting RNA from samples and doing it quickly. After RNA is extract, technicians also must carefully mix special chemicals with each sample and run those combinations in a machine for analysis, process called polymerase chain reaction, which can detect whether the sample is positive or negative for COVID. Typically, PCR tests take six hours from start to finish to complete, say Kelly Wroblewski, director of infectious Disease programs at Association of Public Health Laboratories. Some labs have larger staffs and more machines, so they can process more tests at time than others. But even for those labs, as demand grows, so does backlog. Initially, only a few Public Health labs and federal Centers for Disease Control and Prevention processed COVID - 19 tests. Problems with first CDC test kits also led to delays. Now the CDC has better kit, and 94 Public Health labs across the country do COVID - 19 testing, say Wroblewski. But those labs can't possibly do all that's needed in normal times, Their main function is regular public health surveillance, detecting more common threats such as outbreaks of measles or monitoring seasonal influenza, but not to do diagnostic testing of the magnitude that is required in this response, she say. Large commercial labs like those run by companies such as Quest Diagnostics and LabCorp were given the go - ahead by the FDA late last month to start testing, too.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Specimen Type and Priority

Samples for diagnostic tests for SARS - CoV - 2 can be taken from the upper or lower respiratory tract. Data comparing accuracy of RT - PCR testing suggests that test sensitivity may vary by type of specimen. One study suggests that viral RNA levels are higher and RNA is more frequently detected in nasal specimens as compared to oral specimens, however this finding was based on a small number of nasal Swabs test. The COVID - 19 investigation team in the US compared 117 pairs of Nasopharyngeal and oropharyngeal specimens from 12 patients simultaneously, FIND that 32 pairs were discordant with one testing positive and the other negative: Nasopharyngeal specimen testing positive in 66% of those pairs compared with 34% for oropharyngeal specimen. Another study does not show higher viral RNA levels in Nasopharyngeal compared with oropharyngeal Specimens. When comparing different types of specimens, preliminary results from pre - print Article not yet peer - reviewed show that the most accurate sample for diagnosis of SARS - CoV - 2 was sputum, followed by nasal Swabs and throat Swabs. A Meta - analysis of saliva testing studies FIND 91% sensitivity for saliva tests and 98% sensitivity for Nasopharyngeal swab tests in previously confirmed COVID - 19 infected patients, with Moderate heterogeneity among studies. Another study showed that saliva was the most appropriate sample for diagnosis of SARS - CoV - 2. Saliva offers non - invasive specimens that can also be considered for self - sampling. In situations where Nasopharyngeal or other above mentioned specimen is not acceptable, saliva could be considered as an alternative specimen. Combination of Nasopharyngeal / oropharyngeal swab samples prove more sensitive for diagnosis of SARS - CoV - 2 compared to Nasopharyngeal swab only in three different studies.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Continued

Saliva tests also could be easily adapted for rapid home testing, Wyllie add, noting that most people would find it hard to shove swab deep enough into their own noses to get a good sample. I can't imagine reliably doing that to myself, Wyllie says of performing self - swab. The US Food and Drug Administration gave emergency use authorization on April 13 for saliva - base test for COVID - 19 developed by researchers at RUCDR Infinite Biologics, Rutgers University - back Group. An Approve test must be conducted in a health care setting under supervision of a qualified professional. Wyllie notes that a number of other research teams are also testing the reliability and accuracy of saliva testing, and coming up with good results. Jill Taylor, Director of New York State Public Health Department's Wadsworth Center, said her institution might switch to combined light nasal swab and saliva test instead of deep nasopharyngeal swabbing, based on in - house study they conduct. Swab run around the inside of the nose combined with saliva test would only miss 5% of positive COVID - 19 cases, compared with 2% missed by nasopharyngeal swab testing, New York researchers found in a study of 226 specimens. Swab was clearly the best sample, but nasal swab and saliva were quite good also, Taylor say. So, at the moment we are looking at combining nasal swab and saliva so that compared to nasopharyngeal we would be close to sensitivity. Wyllie believes that saliva testing will become standard for COVID - 19 testing in future, particularly given the need for quick testing as the United States and other nations start to emerge from lockdown. It's going to take a lot of pressure off different aspects of supply chains. It's going to be so much quicker and easier to get saliva samples. I really think this is going to be the way forward, Wyllie say.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Monday 31 August 2020

Table

Racial/Ethnic groupMean of estimated differences, % (range)Mean of estimated ratios of proportion of cases to proportion of population (range)
Hispanic/Latino30.2 (8.0 to 68.2)4.4 (1.2 to 14.6)
Black/African American14.5 (2.3 to 31.7)2.3 (1.2 to 7.0)
American Indian/Alaska Native39.3 (16.4 to 57.9)4.2 (1.9 to 6.4)
Asian4.7 (2.7 to 6.8)2.9 (2.0 to 4.7)
Native Hawaiian/Other Pacific Islander4.5 (0.1 to 31.5)8.5 (2.7 to 18.4)

The Systematic Review found Children and Adolescents Have Lower Susceptibility to COVID - 19 but has limited data on Infectivity. These authors do Limited Systematic Review to identify studies reporting contact tracing or Prevalence of proven COVID - 19 in Children and Adolescents. Studies also had to include secondary infection rates. Adding this inclusion criterion may have limited the number of potential studies compared with looking at Prevalence and secondary Infection Alone. In any case, they include 32 studies with 41 640 children and adolescents plus 268 945 adults. Eighteen studies were contact tracing or School - base studies, and 14 were population - base. Only two studies, both population - base, were judged to be high quality. Overall, compared with adults, pool odds ratio of child or adolescent being infected was 0. 56. Authors stratify their analysis by study quality and by age and still find mark residual heterogeneity. Not surprising, studies come from all over the world, raising background and unmeasured issue of how testing strategies vary and likely contribute to marked heterogeneity in data. Three medium - quality School - base contact - tracing studies with only 36 index cases found no evidence of child - to - adult Transmission. Bottom line, whereas it appears that children and adolescents are less susceptible to contracting SARS - CoV - 2 than adults, data on infectivity is inadequate to draw conclusions. Once again, our mantra is to proceed with abundance of caution. Sherlock One - Pot Testing Is 93% Sensitive and 98% Specific in Detecting SARS - CoV - 2. If you are the nerdy type who is fascinated by lab methods and application of new technology, this paper is for you! I wo go into all the details, but the terminology is truly fascinating and colorful. These researchers used nasopharyngeal swabs from 402 patients who were tested with CDC standard antigen assay, 202 of whom had Test Positive. They apply their new test that is simpler to perform and can be performed at a single temperature in less than hour: Specific High - sensitivity enzymatic reporter unlocking Testing in One Pot. Authors report that in blind testing at an external laboratory, new test was 93. 1% Sensitive and 98. 5% Specific. That translates to a positive likelihood ratio of 62 and a negative likelihood ratio of 0. 07. In other words, this test is pretty good at ruling in and ruling out SARS - CoV - 2 Infection. Now we just need confirmatory studies so that it can become available! Stopping COVID - 19 Pandemic with Vaccine Would Require Effective Vaccine and High Vaccination Rate. We do not know how effective vaccine will be to stop the COVID - 19 Pandemic. These researchers use computational modeling techniques to determine how effective the vaccine must be and what proportion of residents of the United States would need to take vaccine to reduce transmission sufficiently to prevent pandemic or to stop the existing Pandemic.


What kinds of flu tests are there?

During an influenza outbreak, positive rapid flu test is likely to indicate influenza infection. However, rapid tests vary in their ability to detect flu viruses, depending on the type of rapid test used and on the type of flu viruses circulating. Also, rapid tests appear to be better at detecting flu in children than adults. This variation in ability to detect viruses can result in some people who are infected with flu having negative rapid test result. Despite the negative rapid test result, your health care provider may diagnose you with flu based on your symptoms and their clinical judgment.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sources

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

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