28 research outputs found
Serotonin metabolism in rat mesangial cells: Involvement of a serotonin transporter and monoamine oxidase A
Discordant SARSâCoV
OBJECTIVES/HYPOTHESIS: Patients with tracheostomies have an anatomically altered connection between their upper and lower airways that could impact SARSâCoVâ2 testing. Our goal was to evaluate for discordance in SARSâCoVâ2 detection in hospitalized patients with COVIDâ19 and tracheostomies based on the site analyzed. STUDY DESIGN: Retrospective chart review METHODS: This singleâinstitution study evaluated hospitalized patients with COVIDâ19 who had tracheostomies placed during their treatment. We analyzed SARSâCoVâ2 RNA nucleic acid amplification test (NAAT) results after tracheostomy. All included patients had nasopharyngeal (NP) and tracheal (TR) samples taken within a 48âhour period, allowing us to characterize rate of test concordance. RESULTS: Fortyâfive patients met our inclusion criteria. Thirtyâtwo (71.1%) patients had entirely concordant results after tracheostomy. However, 13 (28.9%) patients had at least one set of discordant results, the majority of which were NP negative and TR positive. There were no statistically significant differences in demographic or clinical variables, including time to tracheostomy and time to testing, among patients with concordant versus discordant SARSâCoVâ2 results. CONCLUSION: This represents the first study to examine SARSâCoVâ2 RNA NAAT concordance between NP and TR sites in hospitalized patients with COVIDâ19 and tracheostomies. Oneâthird of patients demonstrated discordant testing when NP and TR specimens were collected within a 48âhour time period. Thus, patients with tracheostomies may have a higher falseânegative rate if only one site is assessed for SARSâCoVâ2. We recommend analyzing samples from both the nasopharynx and trachea for these patients until more prospective data exist. LEVEL OF EVIDENCE: IV Laryngoscope, 202