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Performance of a qualitative rapid chromatographic immunoassay to diagnose COVID-19 in patients in a middle-income country.

ABSTRACT: OBJECTIVES:We evaluated a rapid chromatographic immunoassay (IgG/IgM antibodies) and an ELISA assay to diagnose COVID-19 in patient sat two Brazilian hospitals. METHODS:A total of 122 subjects with COVID-19 were included: 106 SARS-COV-2 RT-PCR-positive patients and 16 RT-PCR-negative patients with symptoms and chest computed tomography (CT) consistent with COVID-19. Ninety-six historical blood donation samples were used as controls. Demographic and clinical characteristics were retrieved from electronic records. Sensitivity and specificity were calculated, as were their 95% binomial confidence intervals using the Clopper-Pearson method. All analyses were performed in R version 3.6.3. RESULTS:The sensitivity of the chromatographic immunoassay in all RT-PCR-positive patients, irrespective of the timing of symptom onset, was 85.8% (95% binomial CI 77.7% to 91.9%). This increased with time after symptom onset, and at >14 days was 94.9% (85.9% to 98.9%). The specificity was 100% (96.4% to 100%). 15/16 (94%) RT- PCR-negative cases tested positive. The most frequent comorbidities were hypertension and diabetes mellitus and the most frequent symptoms were fever, cough, and dyspnea. All RT-PCR-negative patients had pneumonia. The most frequent thoracic CT findings were ground glass changes (n?=?11, 68%), which were bilateral in 9 (56%) patients, and diffuse reticulonodular infiltrates (n?=?5, 31%). CONCLUSIONS:The COVID-19 rapid chromatographic immunoassay evaluated in this study had a high sensitivity and specificity using plasma, particularly after 14 days from symptom onset. ELISA and qualitative rapid chromatographic immunoassays can be used for the diagnosis of RT-PCR-negative patients.

SUBMITTER: Costa SF

PROVIDER: S-EPMC7427616 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Performance of a qualitative rapid chromatographic immunoassay to diagnose COVID-19 in patients in a middle-income country.

Costa Silvia Figueiredo SF Buss Lewis L Espinoza Evelyn Patrícia Sanchez EPS Vieira Jose Mauro JM de Oliveira da Silva Lea Campos LC de Souza Regina Maia RM Neto Lauro Perdigão LP Porto Ana Paula Matos APM Lazari Carolina C Dos Santos Vera Aparecida VA da Silva Duarte Alberto A Nastri Ana Catharina AC da Costa Leite Gabriel Fialkovitz GF Manuli Erika E de Oliveira Maura Salaroli MS Zampelli Daniella Bosco DB Pastore Laerte L Segurado Aluísio Cotrim AC Levin Anna S AS Sabino Ester E

Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology 20200814

<h4>Objectives</h4>We evaluated a rapid chromatographic immunoassay (IgG/IgM antibodies) and an ELISA assay to diagnose COVID-19 in patient sat two Brazilian hospitals.<h4>Methods</h4>A total of 122 subjects with COVID-19 were included: 106 SARS-COV-2 RT-PCR-positive patients and 16 RT-PCR-negative patients with symptoms and chest computed tomography (CT) consistent with COVID-19. Ninety-six historical blood donation samples were used as controls. Demographic and clinical characteristics were re ...[more]

PMID: 32827898

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Project description:BackgroundStudies around the world have shown that interactions between pharmaceutical companies, pharmacists and physicians have a great influence on prescribing and drug dispensing practices. In middle-income countries, the nature and extent of these interactions have not been well researched. Our objectives were to qualitatively explore the nature of the interactions between pharmaceutical companies, physicians and pharmacists, their impact on drug prescription and dispensing practices in Lebanon.Methods and findingsWe used grounded theory approach as well as the known sponsor, purposive, and snowballing sampling strategies to identify interviewees from the three respective groups: physicians, pharmacists, and pharmaceutical representatives. We conducted semi-structured and analyzed transcripts thematically. This study encompassed 6 pharmaceutical representatives, 13 physicians and 13 pharmacists. The following themes emerged: purpose and driver for the interactions, nature of the interactions, incentives, impact on prescription practices, ethical considerations, and suggestions for managing the interactions. The main purposes for the interaction were educational, promotional, and monitoring prescription practices and dispensing, while the main drivers for these interactions were market potential and neighborhood socio-economic status. Physicians, pharmacists and pharmaceutical representatives who engage in these interactions benefit from a variety of incentives, some of which were characterized as unethical. It appears that pharmaceutical companies give prominence to selected physicians within their communities. Although members of the three interviewed groups refer to some of the interactions as being problematic, they described a culture of acceptance of gift giving. We developed a framework that depicts the prevailing politico-cultural environment, the interactions between the three professional groups, and their impact on drug prescription. Underreporting is the main limitation of this study.ConclusionInteractions between physicians, pharmacists and pharmaceutical representatives are frequent. Although these interactions can be beneficial, they still have a substantial effect on drug prescription and dispensing practices. Hence, the need for new policies that regulate these interactions and penalize any misconduct.

Project description:BackgroundThe COVID-19 pandemic catalyzed the adoption of telerehabilitation in various health care settings. However, there was neither a preexisting national guideline in the Philippines nor an internationally agreed upon standard for telerehabilitation. The literature lacks nationwide studies documenting how physiatrists perceived and experienced telerehabilitation during the pandemic.ObjectiveTo determine the perceptions and experiences of physiatrists in the Philippines regarding telerehabilitation.DesignOnline survey originally developed by the authors with inputs from local experts in telehealth or telerehabilitation.SettingNationwide, involving board-certified physiatrists practicing in the Philippines.ParticipantsFellows of the Philippine Academy of Rehabilitation Medicine (PARM) (N = 259) with Internet access.Main outcome measuresSelf-reported telerehabilitation knowledge, skills, and experience; key concerns; preferred clients, service offerings, and methods (technology, duration, charging).ResultsThe respondents (n = 161; 62.2% response rate) had a mean age of 48.1 ± 9.6 years, were mostly female (57.8%), and mostly practiced in private hospitals and urban settings. The majority reported inadequate telerehabilitation knowledge (61.5%), skills (58.4%), and experience (72.1%). The most common sources of telerehabilitation knowledge were colleagues (52.8%), PARM (51.6%), and telemedicine-related websites (41.6%). Most of the respondents preferred to conduct telerehabilitation with former patients over new ones and prescribe telerehabilitation programs for physical, occupational, psychological, and speech-language therapy but not for swallowing therapy. Videoconferencing was the most common telerehabilitation method. More than half of the respondents charged lesser fees for telerehabilitation compared to in-person consultations. Although the majority recognized the need for telerehabilitation, their key concerns included the lack of thorough patient examination and medicolegal liability issues.ConclusionDespite their limited baseline knowledge, skills, and experience regarding telerehabilitation, many physiatrists in the Philippines learned to adopt this service delivery method during the pandemic. Their perceptions and experiences could be used in formulating practice-based guidelines and strategies to improve the conduct of telerehabilitation in the country.

Project description:BackgroundUnderstanding contextual needs and preferences is important for a successful design and effective outcome of a mHealth strategy.ObjectivesThis formative study aimed to explore the perspectives of patients and providers on the acceptability of a mHealth (text message) strategy and elicit preferred features of a mHealth strategy for hypertension management.DesignA qualitative study was conducted using in-depth interviews and focus group discussions guided by the technology acceptance model.SettingThe study was conducted at primary healthcare facilities and at a tertiary level referral hospital in Kathmandu, Nepal.ParticipantsA total of 61 participants, patients with hypertension (n=41), their family members (n=5), healthcare workers (n=11) and key informants (n=4) were included. We purposively recruited patients with hypertension aged 30-70 who attended the selected healthcare facilities to obtain maximum variation based on their age, sex and literacy.ResultsThe respondents perceived the mHealth strategy to be useful as it would reinforce medication compliance and behaviour change. Participants valued the trustworthiness of information from health authorities that could be delivered privately. Some implementation challenges were identified including a lack of technical manpower, resources for software development, gaps in recording a patient's essential information and digital illiteracy. Solutions proposed were having system-level preparedness for recording the patient's details, establishing a separate technical department in the hospital and involving a family member to assist illiterate/elderly patients. In addition, participants preferred text messages in the local language, containing comprehensive contextual content (disease, treatment, cultural foods and misconceptions) delivered at regular intervals (2-3 times/week) preferably in the morning or evening.ConclusionsWe found that a simple text messaging strategy was acceptable for hypertension management in this low/middle-income country setting. However, meticulous planning must address the needs of a diverse range of participants to ensure the mHealth strategy is acceptable to wider groups.

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Performance of a qualitative rapid chromatographic immunoassay to diagnose COVID-19 in patients in a middle-income country.

Publications

Performance of a qualitative rapid chromatographic immunoassay to diagnose COVID-19 in patients in a middle-income country.

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