A Comparison of Less Invasive Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Diagnostic Specimens in Nursing Home Residents—Arkansas, June–August 2020
Author:
Gable Paige1, Huang Jennifer Y1, Gilbert Sarah E1, Bollinger Susan1, Lyons Amanda K1, Sabour Sarah1, Surie Diya1, Biedron Caitlin1, Haney Tafarra2, Beshearse Elizabeth13, Gregory Christopher J1, Seely Kathryn A2, Clemmons Nakia S1, Patil Naveen2, Kothari Atul2, Gulley Trent2, Garner Kelley2, Anderson Karen1, Thornburg Natalie J1, Halpin Alison L1, McDonald L Clifford1, Kutty Preeta K1, Brown Allison C1, Ramachandran Sumathi, Hughes Holly, Bohannon Caitlin, Sexton D Joseph, Lonsway David, Bhatnagar Amelia, Breaker Erin, Adamczyk Michelle, McAllister Gillian A, Campbell Davina, Houston Hollis, Perry-Dow K Allison, Reese Natashia, Paulick Ashley, Spicer Lori, Harcourt Jennifer L, Coughlin Melissa M, Tamin Azaibi, Whitaker Brett, Stumpf Megan M, Mills Lisa, Ata Ur Rasheed Mohammad,
Affiliation:
1. COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 2. Arkansas Department of Health, Little Rock, Arkansas, USA 3. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Abstract
Abstract
Background
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing remains essential for early identification and clinical management of cases. We compared the diagnostic performance of 3 specimen types for characterizing SARS-CoV-2 in infected nursing home residents.
Methods
A convenience sample of 17 residents were enrolled within 15 days of first positive SARS-CoV-2 result by real-time reverse transcription polymerase chain reaction (RT-PCR) and prospectively followed for 42 days. Anterior nasal swabs (AN), oropharyngeal swabs (OP), and saliva specimens (SA) were collected on the day of enrollment, every 3 days for the first 21 days, and then weekly for 21 days. Specimens were tested for presence of SARS-CoV-2 RNA using RT-PCR and replication-competent virus by viral culture.
Results
Comparing the 3 specimen types collected from each participant at each time point, the concordance of paired RT-PCR results ranged from 80% to 88%. After the first positive result, SA and OP were RT-PCR-positive for ≤48 days; AN were RT-PCR–positive for ≤33 days. AN had the highest percentage of RT-PCR–positive results (21/26 [81%]) when collected ≤10 days of participants’ first positive result. Eleven specimens were positive by viral culture: 9 AN collected ≤19 days following first positive result and 2 OP collected ≤5 days following first positive result.
Conclusions
AN, OP, and SA were effective methods for repeated testing in this population. More AN than OP were positive by viral culture. SA and OP remained RT-PCR-positive longer than AN, which could lead to unnecessary interventions if RT-PCR detection occurred after viral shedding has likely ceased.
Funder
Centers for Disease Control and Prevention
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Microbiology (medical)
Cited by
4 articles.
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