Rapid SARS-CoV-2 antigen testing compared with RT-qPCR in patients suspected for COVID-19

Rapid SARS-CoV-2 antigen testing compared with RT-qPCR in patients suspected for COVID-19 Introduction: COVID-19 pandemic threatens global human health. Reverse-transcription quantitative polymerase chain reaction (RT-qPCR) is a reference test for identification of acute SARS-CoV-2 infection, but it is associated with results delay. There is a need of a fast and reliable tests which can improve the efforts of controlling the transmission of SARS-CoV-2. Aim: This work aims to determine the analytical value of the rapid SARS-CoV-2 Ag-test in relation to the Ct values of the RT-qPCR. Methods: Study group were outpatients suspected for COVID-19, sampled twice, first for the routine RT-qPCR, and second for SARS-CoV-2 antigen testing. The results obtained by the rapid antigen test (Panbio™ COVID-19) were evaluated in relation to the Ct values of the SARS-CoV-2 E-gene, obtained by RT-qPCR Allplex 19-nCoV multiplex assay platform. Results: SARS-CoV-2 prevalence, based on RT-qPCR, was 50.8% (186/366). Specificity of the PanbioTM COVID-19 Ag Rapid Test was 100%. Test sensitivity was 73.8%. Restricting RT-qPCR to Ct-values < 30 increased test sensitivities to 91.2%. Conclusion: The findings underscored the epidemiological value of the rapid Ag-test, since it reliably identifies contagious SARS-CoV-2 infected individuals who actively spread the virus in the community

Evaluation of the analytical value of SARS-CoV-2 antigen test in relation to Ct-values of RT-qPCR in patients suspected of COVID-19

Introduction. COVID-19 pandemic threatens global human health. Reverse-transcription quantitative polymerase chain reaction (RT-qPCR) is a reference test for identification of acute SARS-CoV-2 infection, but it is associated with results delay. There is a need of fast and reliable tests which can improve the efforts of controlling the transmission of SARS-CoV-2. Aim. The aim of this study was to determine the analytical value of the rapid SARS-CoV-2 Ag-test in relation to the Ct values of the RT-qPCR. Methods. The study group comprised outpatients suspected for COVID-19, sampled twice, first for the routine RT-qPCR, and second for SARS-CoV-2 antigen testing. The results obtained by the rapid antigen test (Panbio™ COVID-19) were evaluated in relation to Ct values of the SARS-CoV-2 E-gene, obtained by RTqPCR Allplex 19-nCoV multiplex assay platform. Results. SARS-CoV-2 prevalence, based on RT-qPCR, was 50.8% (186/366). Specificity of the PanbioTM COVID19 Ag Rapid Test was 100%. Test sensitivity was 73.8%. Restricting RT-qPCR to Ct-values<30 increased test sensitivity to 91.2%. Conclusion. The findings underscored the epidemiological value of the rapid Ag-test since it reliably identifies contagious SARS-CoV-2 infected individuals who actively spread the virus in the community. Keywords: COVID-19, RT-qPCR, rapid SARS-CoV-2 Ag test, sensitivity, specificity _________________________

Achalasia of the cardia - a pediatric case report

Introduction: Achalasia is an esophageal motor disorder characterized by aperistalsis of the esophageal body and lack of relaxation of the lower sphincter in response to swallows. It affects both sexes and all age groups. The exact etiology of this degeneration is unclear though many theories have been proposed. Possible etiology of achalasia can be familial, infection or autoimmune. Patients often present with progressive dysphagia to solids and liquids, heartburn, chest pain, regurgitation, and varying degrees of weight loss or nutritional deficiencies. Case report: In January 2020, a 10 years old boy was admitted to our hospital due to vomiting, chest pain during swallowing, and prolonged cough. A lot of investigations were performed. Fyberbronchoscopy showed that the trachea, the right main bronchus and the left main bronchus were with anteroposterior narrowed lumen. Computed tomography of thorax and abdomen showed dilated esophagus with largest diameter of 45 mm subcarinal with retained content.There is a compression of the right hillus. The finding indicates achalasia of the cardia. One month after the hospital stay, the child was admitted at the Clinic for pediatric surgery. Laparoscopic Heller Myotomy (LHM) with antireflux Dor fundoplication was performed. The following period the boy has no gastric or respiratory symptoms. Conclusion: We can conclude that it is worth to suspect achalasia in a pediatric patient with prolonged cough and recurrent respiratory infections refractory to conventional treatments such as bronchodilators, especially if the patient also has a history of vomiting and dysphagia

Multiplex PCR in diagnosing respiratory tract infections in hospitalized children

Objectives: To elaborate the utility of multiplex quantitative polymerase chain reaction (multiplex qPCR) for the accurate diagnosis of severe respiratory tract infections (RTIs) in hospitalized children. Methods: In two separate periods during 2022, 76 respiratory specimens (combined throat/nasopharyngeal swabs) were submitted for multiplex qPCR regarding 26 respiratory pathogens. The specimens were obtained from children with severe RTIs hospitalized in the Institute for Respiratory Diseases in Children, Skopje. Results: Multiplex qPCR detected at least one respiratory pathogen in all examined specimens (76/76), with 83% (63/76) rate of co-infections. Considering that positive results are only the ones with Ct value below 28, the rates of detected pathogens and co-infections decrease to 75% and 22%, respectively. The most commonly detected pathogens during the spring period were Parainfluenza type 3 (PIV3) followed by Adenovirus (AdV) and Respiratory syncytial virus type B (RSVB) with frequency rate of 23%, 19% and 19%, respectively. During the autumn period, the most common were RSVB and Streptococcus pneumoniae with frequency rate of 31% and 17%, respectively. Conclusion: Multiplex qPCR is a powerful tool for diagnosing RTIs. Semi-quantification of the viral load by reporting Ct values added higher level of evidence for accurate diagnosis. Seasonal detection of the examined viruses was notable with higher prevalence of PIV3 in spring and RSVB in autumn period

Sputum Quality Assessment Regarding Sputum Culture for Diagnosing Lower Respiratory Tract Infections in Children

BACKGROUND: The clinical relevance of specimens from the lower airways is often debatable. However, they are most commonly examined for diagnosing lower respiratory tract infections (LRTIs).AIM: This study aimed to determine the diagnostic value of sputum quality assessment about sputum culture for diagnosing LRTIs in children.METHODS: In six months, a total of 1485 sputum samples were quality assessed by using Bartlett’s grading system. All samples, regardless of their quality, were cultured, identified, and antimicrobial susceptibility testing was performed by Kirby-Bauer disc-diffusion method.RESULTS: Among the acceptable category, defined by Bartlett’s grading system, 132 (63.2%) samples showed culture positivity of which Streptococcus pneumoniae 48 (36.4%) was most commonly isolated, followed by Moraxella catarrhalis 22 (16.7%) and Haemophilus influenza 21 (15.9%). Among the non-acceptable category, 185 (14.5%) samples were culture positive of which most commonly isolated were Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa with 64 (34.6%), 54 (29.2%) and 28 (15.1%), respectively.CONCLUSION: Sputum quality assessment is a useful tool for distinguishing the true respiratory pathogens from possible colonising flora for which antibiotic treatment should not be highly considered. &nbsp

Covid-19 in children with Down syndrome - case series

Down syndrome (DS) is the most common genetic disease and presents with cognitive impairment, cardiac and gastrointestinal abnormalities, increased risk of hematological malignancy and several autoimmune conditions in addition to other miscellaneous clinical conditions The aim is to show if the comorbidities that children with Down Sy have, were risk factors for more severe form of COVID-19. We present three cases of children with Down Sy and COVID-19, with different clinical features. All of them had good clinical outcome, only the first child had more severe form of Covid 19 with need for oxygen support, longer hospitalization but with good clinical improvement and withdrawal of the X-ray changes. Children with Down Sy are always a high-risk group for more severe and prolonged course of disease, which are partially attributed to defects of the immune system

Comparison of oxidative stress levels in healthy children and children with allergic rhinitis

Background/aim: Allergic rhinitis (AR) is characterized by chronic inflammation of the nasal mucosa. Under the influence of exogenous factors - allergens, reactive oxygen species (ROS) are released during cellular metabolism. They induce a series of pathological changes in the mucosa. Oxidative stress is а result of an imbalance between the production of ROS and the ability to neutralize them. The aim of this study is to compare the levels of oxidative stress between healthy children and children with allergic rhinitis. Material and methods: A total number of 60 children were included (30 healthy children and 30 children with AR). The oxidative stress index was determined by using the FRAS 5 (Free Radical Analytical System) Bravo system. Demographic characteristics, medical history, children's living conditions and eating habits were obtained from the questionnaire. Anthropometric measurements and the absolute number of eosinophils in the peripheral smear were performed on each child. Results: This study showed high oxidative stress index and a significantly higher value of the absolute number of eosinophils in the peripheral smear in children with AR in comparison to healthy children (p<0.05). The group of children with AR had more atopic characteristics and was more exposed to passive smoking than healthy children. Conclusion: Compared to healthy children, children with AR have a high index of oxidative stress, despite of the very high mean value of the concentration of water-soluble antioxidants in serum (PAT test) in the group of children with AR

Impact of COVID-19 infection on lung function and nutritional status amongst individuals with cystic fibrosis: A global cohort study

International audienceBackground: Factors associated with severe COVID-19 infection have been identified; however, the impact of infection on longer-term outcomes is unclear. The objective of this study was to examine the impact of COVID-19 infection on the trajectory of lung function and nutritional status in people with cystic fibrosis (pwCF).Methods: This is a retrospective global cohort study of pwCF who had confirmed COVID-19 infection diagnosed between January 1, 2020 and December 31, 2021. Forced expiratory volume in one second percent predicted (ppFEV 1 ) and body mass index (BMI) twelve months prior to and following a diagnosis of COVID-19 were recorded. Change in mean ppFEV 1 and BMI were compared using a t-test. A linear mixed-effects model was used to estimate change over time and to compare the rate of change before and after infection.Results: A total of 6,500 cases of COVID-19 in pwCF from 33 countries were included for analysis. The mean difference in ppFEV 1 pre-and post-infection was 1.4 %, (95 % CI 1.1, 1.7). In those not on modulators, the difference in rate of change pre-and post-infection was 1.34 %, (95 % CI -0.88, 3.56) per year (p = 0.24) and -0.74 % (-1.89, 0.41) per year (p = 0.21) for those on elexacaftor/tezacaftor/ivacaftor. No clinically significant change was noted in BMI or BMI percentile before and after COVID-19 infection.Conclusions: No clinically meaningful impact on lung function and BMI trajectory in the year following infection with COVID-19 was identified. This work highlights the ability of the global CF community to unify and address critical issues facing pwCF