Variation in SARS-CoV-2 molecular test sensitivity by specimen types in a large sample of emergency department patients
| Autor: | Steven McLaren, Claire H. Park, Cheryl Mercado, Jeff Slezak, Katherine Wong, Jonathan C. Gullett, Michael Aragones, Katia Bruxvoort, Steven J. Jacobsen, Christopher F. Tenggardjaja, Benjamin Broder |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Saliva Adolescent Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Oropharynx Logistic regression Sensitivity and Specificity Article Specimen Handling Young Adult Internal medicine Nasopharynx medicine Humans Molecular diagnostic test Anterior nares business.industry Reverse Transcriptase Polymerase Chain Reaction SARS-CoV-2 COVID-19 General Medicine Odds ratio Emergency department Confidence interval Pre- and post-test probability medicine.anatomical_structure COVID-19 Nucleic Acid Testing Emergency Medicine Female Nasal Cavity business Emergency Service Hospital Self-collection |
| Zdroj: | The American Journal of Emergency Medicine |
| ISSN: | 1532-8171 |
| Popis: | BACKGROUND: Provider-collected nasopharyngeal specimens for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) molecular testing are the standard of care in many clinical settings, but patient-collected saliva and anterior nares specimens are less invasive and more flexible alternatives. Prior studies comparing specimen types for SARS-CoV-2 molecular testing have been limited by small sample sizes and low pretest probability. We conducted a large observational study among symptomatic adults at 7 emergency departments of Kaiser Permanente Southern California to examine sensitivity of SARS-CoV-2 molecular tests by specimen type and patient characteristics. METHODS: Provider-collected nasopharyngeal/oropharyngeal (NP/OP) specimens and patient-collected saliva and anterior nares specimens were collected at the same visit and analyzed with the Roche cobas® SARS-CoV-2 assay. Patients were considered truly positive for SARS-CoV-2 if any of the three specimens was positive and negative if all three specimens were negative. Factors associated with discordant and missed positive results were examined with multivariable logistic regression. RESULTS: Of 2112 patients, 350 (16.6%) were positive for SARS-CoV-2. Sensitivity of NP/OP was 93.7% (95% confidence interval [CI] 90.6%-96.0%), sensitivity of saliva was 87.7% (83.8%-91.0%), and sensitivity of anterior nares was 85.4% (81.3%-89.0%). Patients ages 18-39 years versus ≥40 years were more likely to have discordant results [adjusted odds ratio (aOR) 1.97 (1.12-3.45)], as were patients with |
| Databáze: | OpenAIRE |
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