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Background: Rapid mobilisation from industry and academia\ud following the outbreak of the novel coronavirus, severe acute\ud respiratory syndrome coronavirus 2 (SARS-CoV-2), led to the\ud development and availability of SARS-CoV-2 lateral flow\ud immunoassays (LFAs). High quality LFAs are urgently needed at the\ud point of care to add to currently available diagnostic tools. In this\ud study, we provide evaluation data for ten LFAs suitable for use at the\ud point of care.\ud Methods: COVID-19 positive patients (N=45), confirmed by reverse\ud transcription – quantitative polymerase chain reaction (RT-qPCR), were\ud recruited through the International Severe Acute Respiratory and\ud Emerging Infection Consortium - Coronavirus Clinical Characterisation\ud Consortium (ISARIC4C) study. Sera collected from patients with\ud influenza A (N=20), tuberculosis (N=5), individuals with previous\ud flavivirus exposure (N=21), and healthy sera (N=4), collected preOpen Peer Review\ud Reviewer Status AWAITING PEER REVIEW\ud Any reports and responses or comments on the\ud article can be found at the end of the article.\ud Page 1 of 9\ud Wellcome Open Research 2021, 6:18 Last updated: 01 FEB 2021\ud pandemic, were used as negative controls. Ten LFAs manufactured or\ud distributed by ASBT Holdings Ltd, Cellex, Fortress Diagnostics,\ud Nantong Egens Biotechnology, Mologic, NG Biotech, Nal von Minden\ud and Suzhou Herui BioMed Co. were evaluated.\ud Results: Compared to RT-qPCR, sensitivity of LFAs ranged from 87.0-\ud 95.7%. Specificity against pre-pandemic controls ranged between\ud 92.0-100%. Compared to IgG ELISA, sensitivity and specificity ranged\ud between 90.5-100% and 93.2-100%, respectively. Percentage\ud agreement between LFAs and IgG ELISA ranged from 89.6-92.7%.\ud Inter-test agreement between LFAs and IgG ELISA ranged between\ud kappa=0.792-0.854.\ud Conclusions: LFAs may serve as a useful tool for rapid confirmation of\ud ongoing or previous infection in conjunction with clinical suspicion of\ud COVID-19 in patients attending hospital. Impartial validation prior to\ud commercial sale provides users with data that can inform best use

Fungal keratitis is a severe corneal infection that often results in blindness and eye loss. The disease is most prevalent in tropical and subtropical climates, and infected individuals are frequently young agricultural workers of low socioeconomic status. Early diagnosis and treatment can preserve vision. Here, we discuss the fungal keratitis diagnostic literature and estimate the global burden through a complete systematic literature review from January, 1946 to July, 2019. An adapted GRADE score was used to evaluate incidence papers-116 studies provided the incidence of fungal keratitis as a proportion of microbial keratitis and 18 provided the incidence in a defined population. We calculated a minimum annual incidence estimate of 1 051 787 cases (736 251-1 367 323), with the highest rates in Asia and Africa. If all culture-negative cases are assumed to be fungal, the annual incidence would be 1 480 916 cases (1 036 641-1 925 191). In three case series, 8-11% of patients had to have the eye removed, which represents an annual loss of 84 143-115 697 eyes. As fungal keratitis probably affects over a million people annually, an inexpensive, simple diagnostic method and affordable treatment are needed in every country.