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10.1016/S2213-2600(20)30315-5 http://scihub22266oqcxt.onion/10.1016/S2213-2600(20)30315-5 32717210!7380925!32717210     free     free     free Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 229.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 296.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Lancet+Respir+Med 2020 ; 8 (9): 885-894 Nephropedia Template TP {{tp|p=32717210|t=2020. Point-of-care serological assays for delayed SARS-CoV-2 case identification among health-care workers in the UK: a prospective multicentre cohort study |pdf=|usr=}}{{32717210}} gab.com Text Point-of-care serological assays for delayed SARS-CoV-2 case identification among health-care workers in the UK: a prospective multicentre cohort study JO: Lancet Respir Med http://www.kidney.de/pget.php?&tw=1&pmid=32717210 #FOAvip BACKGROUND: Health-care workers constitute a high-risk population for acquisition of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Capacity for acute diagnosis via PCR testing was limited for individuals with mild to moderate SARS-CoV-2 infection in the early phase of the COVID-19 pandemic and a substantial proportion of health-care workers with suspected infection were not tested. We aimed to investigate the performance of point-of-care and laboratory serology assays and their utility in late case identification, and to estimate SARS-CoV-2 seroprevalence. METHODS: We did a prospective multicentre cohort study between April 8 and June 12, 2020, in two phases. Symptomatic health-care workers with mild to moderate symptoms were eligible to participate 14 days after onset of COVID-19 symptoms, as per the Public Health England (PHE) case definition. Health-care workers were recruited to the asymptomatic cohort if they had not developed PHE-defined COVID-19 symptoms since Dec 1, 2019. In phase 1, two point-of-care lateral flow serological assays, the Onsite CTK Biotech COVID-19 split IgG/IgM Rapid Test (CTK Bitotech, Poway, CA, USA) and the Encode SARS-CoV-2 split IgM/IgG One Step Rapid Test Device (Zhuhai Encode Medical Engineering, Zhuhai, China), were evaluated for performance against a laboratory immunoassay (EDI Novel Coronavirus COVID-19 IgG ELISA kit [Epitope Diagnostics, San Diego, CA, USA]) in 300 samples from health-care workers and 100 pre-COVID-19 negative control samples. In phase 2 (n=6440), serosurveillance was done among 1299 (93.4%) of 1391 health-care workers reporting symptoms, and in a subset of asymptomatic health-care workers (405 [8.0%] of 5049). FINDINGS: There was variation in test performance between the lateral flow serological assays; however, the Encode assay displayed reasonable IgG sensitivity (127 of 136; 93.4% [95% CI 87.8-96.9]) and specificity (99 of 100; 99.0% [94.6-100.0]) among PCR-proven cases and good agreement (282 of 300; 94.0% [91.3-96.7]) with the laboratory immunoassay. By contrast, the Onsite assay had reduced sensitivity (120 of 136; 88.2% [95% CI 81.6-93.1]) and specificity (94 of 100; 94.0% [87.4-97.8]) and agreement (254 of 300; 84.7% [80.6-88.7]). Five (7%) of 70 PCR-positive cases were negative across all assays. Late changes in lateral flow serological assay bands were recorded in 74 (9.3%) of 800 cassettes (35 [8.8%] of 400 Encode assays; 39 [9.8%] of 400 Onsite assays), but only seven (all Onsite assays) of these changes were concordant with the laboratory immunoassay. In phase 2, seroprevalence among the workforce was estimated to be 10.6% (95% CI 7.6-13.6) in asymptomatic health-care workers and 44.7% (42.0-47.4) in symptomatic health-care workers. Seroprevalence across the entire workforce was estimated at 18.0% (95% CI 17.0-18.9). INTERPRETATION: Although a good positive predictive value was observed with both lateral flow serological assays and ELISA, this agreement only occurred if the pre-test probability was modified by a strict clinical case definition. Late development of lateral flow serological assay bands would preclude postal strategies and potentially home testing. Identification of false-negative results among health-care workers across all assays suggest caution in interpretation of IgG results at this stage; for now, testing is perhaps best delivered in a clinical setting, supported by government advice about physical distancing. FUNDING: None. Twit Text FOAVip Point-of-care serological assays for delayed SARS-CoV-2 case identification among health-care workers in the UK: a prospective multicentre cohort study ????Lancet Respir Med http://www.kidney.de/pget.php?&tw=1&pmid=32717210 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=32717210 #FOAvip English Wikipedia <ref>{{Cite pmid|32717210}}</ref> Point-of-care serological assays for delayed SARS-CoV-2 case identification among health-care workers in the UK: a prospective multicentre cohort study #MMPMID32717210 Pallett SJC; Rayment M; Patel A; Fitzgerald-Smith SAM; Denny SJ; Charani E; Mai AL; Gilmour KC; Hatcher J; Scott C; Randell P; Mughal N; Jones R; Moore LSP; Davies GW Lancet Respir Med 2020[Sep]; 8 (9): 885-894 PMID32717210show ga BACKGROUND: Health-care workers constitute a high-risk population for acquisition of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Capacity for acute diagnosis via PCR testing was limited for individuals with mild to moderate SARS-CoV-2 infection in the early phase of the COVID-19 pandemic and a substantial proportion of health-care workers with suspected infection were not tested. We aimed to investigate the performance of point-of-care and laboratory serology assays and their utility in late case identification, and to estimate SARS-CoV-2 seroprevalence. METHODS: We did a prospective multicentre cohort study between April 8 and June 12, 2020, in two phases. Symptomatic health-care workers with mild to moderate symptoms were eligible to participate 14 days after onset of COVID-19 symptoms, as per the Public Health England (PHE) case definition. Health-care workers were recruited to the asymptomatic cohort if they had not developed PHE-defined COVID-19 symptoms since Dec 1, 2019. In phase 1, two point-of-care lateral flow serological assays, the Onsite CTK Biotech COVID-19 split IgG/IgM Rapid Test (CTK Bitotech, Poway, CA, USA) and the Encode SARS-CoV-2 split IgM/IgG One Step Rapid Test Device (Zhuhai Encode Medical Engineering, Zhuhai, China), were evaluated for performance against a laboratory immunoassay (EDI Novel Coronavirus COVID-19 IgG ELISA kit [Epitope Diagnostics, San Diego, CA, USA]) in 300 samples from health-care workers and 100 pre-COVID-19 negative control samples. In phase 2 (n=6440), serosurveillance was done among 1299 (93.4%) of 1391 health-care workers reporting symptoms, and in a subset of asymptomatic health-care workers (405 [8.0%] of 5049). FINDINGS: There was variation in test performance between the lateral flow serological assays; however, the Encode assay displayed reasonable IgG sensitivity (127 of 136; 93.4% [95% CI 87.8-96.9]) and specificity (99 of 100; 99.0% [94.6-100.0]) among PCR-proven cases and good agreement (282 of 300; 94.0% [91.3-96.7]) with the laboratory immunoassay. By contrast, the Onsite assay had reduced sensitivity (120 of 136; 88.2% [95% CI 81.6-93.1]) and specificity (94 of 100; 94.0% [87.4-97.8]) and agreement (254 of 300; 84.7% [80.6-88.7]). Five (7%) of 70 PCR-positive cases were negative across all assays. Late changes in lateral flow serological assay bands were recorded in 74 (9.3%) of 800 cassettes (35 [8.8%] of 400 Encode assays; 39 [9.8%] of 400 Onsite assays), but only seven (all Onsite assays) of these changes were concordant with the laboratory immunoassay. In phase 2, seroprevalence among the workforce was estimated to be 10.6% (95% CI 7.6-13.6) in asymptomatic health-care workers and 44.7% (42.0-47.4) in symptomatic health-care workers. Seroprevalence across the entire workforce was estimated at 18.0% (95% CI 17.0-18.9). INTERPRETATION: Although a good positive predictive value was observed with both lateral flow serological assays and ELISA, this agreement only occurred if the pre-test probability was modified by a strict clinical case definition. Late development of lateral flow serological assay bands would preclude postal strategies and potentially home testing. Identification of false-negative results among health-care workers across all assays suggest caution in interpretation of IgG results at this stage; for now, testing is perhaps best delivered in a clinical setting, supported by government advice about physical distancing. FUNDING: None. |*Betacoronavirus[MESH] |*Point-of-Care Systems[MESH] |Adult[MESH] |COVID-19[MESH] |COVID-19 Testing[MESH] |Clinical Laboratory Techniques/*methods[MESH] |Coronavirus Infections/*diagnosis/epidemiology/virology[MESH] |Enzyme-Linked Immunosorbent Assay/statistics & numerical data[MESH] |Female[MESH] |Health Personnel[MESH] |Humans[MESH] |Immunoassay/statistics & numerical data[MESH] |Male[MESH] |Middle Aged[MESH] |Occupational Diseases/*diagnosis/epidemiology/virology[MESH] |Pandemics[MESH] |Pneumonia, Viral/*diagnosis/epidemiology/virology[MESH] |Predictive Value of Tests[MESH] |Prospective Studies[MESH] |Reproducibility of Results[MESH] |SARS-CoV-2[MESH] |Sensitivity and Specificity[MESH] |Seroepidemiologic Studies[MESH]Point-of-care serological assays for delayed SARS-CoV-2 case identific(epmc).pdf DeepDyve Pubget Overpricing