1. Rapid Implementation of Severe Acute Respiratory Syndrome Coronavirus 2 Emergency Use Authorization RT-PCR Testing and Experience at an Academic Medical Institution
- Author
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John Sipley, Hanna Rennert, Priya Velu, Arryn Craney, P. Ruggiero, Melissa M. Cushing, Massimo Loda, Erika Hissong, Lars F. Westblade, and Lin Cong
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Emergency Use Authorization ,Adolescent ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Sensitivity and Specificity ,Pathology and Forensic Medicine ,Cohort Studies ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,COVID-19 Testing ,Limit of Detection ,Internal medicine ,Nasopharynx ,Medicine ,Humans ,Young adult ,Child ,Aged ,Aged, 80 and over ,business.industry ,Reverse Transcriptase Polymerase Chain Reaction ,SARS-CoV-2 ,Academies and Institutes ,Infant, Newborn ,Sputum ,Outbreak ,COVID-19 ,Infant ,Reproducibility of Results ,Regular Article ,Middle Aged ,030104 developmental biology ,medicine.anatomical_structure ,Real-time polymerase chain reaction ,030220 oncology & carcinogenesis ,Child, Preschool ,Molecular Medicine ,Biological Assay ,Female ,medicine.symptom ,business ,Respiratory tract ,Cohort study - Abstract
An epidemic caused by an outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China in December 2019 has since rapidly spread internationally, requiring urgent response from the clinical diagnostics community. We present a detailed overview of the clinical validation and implementation of the first laboratory-developed real-time RT-PCR test offered in the NewYork-Presbyterian Hospital system following the Emergency Use Authorization issued by the US Food and Drug Administration. Validation was performed on nasopharyngeal and sputum specimens (n = 174) using newly designed dual-target real-time RT-PCR (altona RealStar SARS-CoV-2 Reagent) for detecting SARS-CoV-2 in upper respiratory tract and lower respiratory tract specimens. Accuracy testing demonstrated excellent assay agreement between expected and observed values and comparable diagnostic performance to reference tests. The limit of detection was 2.7 and 23.0 gene copies per reaction for nasopharyngeal and sputum specimens, respectively. Retrospective analysis of 1694 upper respiratory tract specimens from 1571 patients revealed increased positivity in older patients and males compared with females, and an increasing positivity rate from approximately 20% at the start of testing to 50% at the end of testing 3 weeks later. Herein, we demonstrate that the assay accurately and sensitively identifies SARS-CoV-2 in multiple specimen types in the clinical setting and summarize clinical data from early in the epidemic in New York City.
- Published
- 2021
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