Test sensitivity is secondary to frequency and turnaround time for COVID-19 screening.
Daniel B. Larremore,Bryan Wilder,Evan Lester,Evan Lester,Soraya Shehata,Soraya Shehata,James M. Burke,James A. Hay,Milind Tambe,Michael J. Mina,Michael J. Mina,Roy Parker +11 more
TLDR
It is demonstrated that effective screening depends largely on frequency of testing and speed of reporting and is only marginally improved by high test sensitivity, and should prioritize accessibility, frequency, and sample-to-answer time.Abstract:
The COVID-19 pandemic has created a public health crisis. Because SARS-CoV-2 can spread from individuals with presymptomatic, symptomatic, and asymptomatic infections, the reopening of societies and the control of virus spread will be facilitated by robust population screening, for which virus testing will often be central. After infection, individuals undergo a period of incubation during which viral titers are too low to detect, followed by exponential viral growth, leading to peak viral load and infectiousness and ending with declining titers and clearance. Given the pattern of viral load kinetics, we model the effectiveness of repeated population screening considering test sensitivities, frequency, and sample-to-answer reporting time. These results demonstrate that effective screening depends largely on frequency of testing and speed of reporting and is only marginally improved by high test sensitivity. We therefore conclude that screening should prioritize accessibility, frequency, and sample-to-answer time; analytical limits of detection should be secondary.read more
Citations
More filters
Journal ArticleDOI
Validation of an At-Home Direct Antigen Rapid Test for COVID-19.
Journal ArticleDOI
Optimizing direct RT-LAMP to detect transmissible SARS-CoV-2 from primary nasopharyngeal swab samples.
Dawn M. Dudley,Christina M. Newman,Andrea M. Weiler,Mitchell D. Ramuta,Cecilia G. Shortreed,Anna S. Heffron,Molly A. Accola,William M. Rehrauer,Thomas C. Friedrich,David H. O’Connor +9 more
TL;DR: In this article, a fluorescence-based RT-LAMP test using direct nasopharyngeal swab samples and show consistent detection in clinically confirmed primary samples with a limit of detection (LOD) of ~625 copies/μl, approximately 100fold lower sensitivity than qRT-PCR.
Journal ArticleDOI
Enhancing CRISPR-Cas-Mediated Detection of Nucleic Acid and Non-nucleic Acid Targets Using Enzyme-Labeled Reporters.
TL;DR: Adenosine triphosphate (ATP) binding to an aptamer can activate CRISPR-Cas and trigger a colorimetric readout, enabling the analysis of ATP in human serum samples with sensitivity on par with that of several commercially available kits.
Journal ArticleDOI
Modelling the impact of presemester testing on COVID-19 outbreaks in university campuses.
TL;DR: Presemester screening is necessary to avert early and large surges of active COVID-19 infections and should be implemented in conjunction with effective mitigation strategies to significantly reduce outbreak size and preserve isolation bed capacity.
Journal ArticleDOI
Higher Viral Load Drives Infrequent Severe Acute Respiratory Syndrome Coronavirus 2 Transmission Between Asymptomatic Residence Hall Roommates.
Kristen K. Bjorkman,Tassa K Saldi,Erika Lasda,Leisha Conners Bauer,Jennifer Kovarik,Patrick K. Gonzales,Morgan R Fink,Kimngang L Tat,Cole R Hager,Jack C Davis,Christopher D Ozeroff,Gloria R Brisson,Daniel B. Larremore,Leslie A. Leinwand,Matthew B. McQueen,Roy Parker,Roy Parker +16 more
TL;DR: In this paper, the authors analyzed longitudinal data from 6408 students and identified 116 likely transmission events in which a second roommate tested positive within 14 days of the index roommate, and provided strong correlative evidence that viral load is proportional to transmission probability.
References
More filters
Journal ArticleDOI
Virological assessment of hospitalized patients with COVID-2019.
Roman Wölfel,Victor M. Corman,Wolfgang Guggemos,M Seilmaier,Sabine Zange,Marcel A. Müller,Daniela Niemeyer,Terry Jones,Terry Jones,Patrick Vollmar,Camilla Rothe,Michael Hoelscher,Tobias Bleicker,Sebastian Brünink,Julia Schneider,Rosina Ehmann,Katrin Zwirglmaier,Christian Drosten,Clemens M. Wendtner +18 more
TL;DR: Detailed virological analysis of nine cases of coronavirus disease 2019 (COVID-19) provides proof of active replication of the SARS-CoV-2 virus in tissues of the upper respiratory tract.
Journal ArticleDOI
The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application.
Stephen A. Lauer,Kyra H. Grantz,Qifang Bi,Forrest K. Jones,Qulu Zheng,Hannah R. Meredith,Andrew S. Azman,Nicholas G. Reich,Justin Lessler +8 more
TL;DR: The results support current proposals for the length of quarantine or active monitoring of persons potentially exposed to SARS-CoV-2, although longer monitoring periods might be justified in extreme cases.
Journal ArticleDOI
Temporal dynamics in viral shedding and transmissibility of COVID-19.
Xi He,Eric H. Y. Lau,Peng Wu,Xilong Deng,Jian Wang,Xinxin Hao,Yiu Chung Lau,Jessica Y. Wong,Yujuan Guan,Xinghua Tan,Xiaoneng Mo,Yanqing Chen,Baolin Liao,Weilie Chen,Fengyu Hu,Qing Zhang,Mingqiu Zhong,Yanrong Wu,Lingzhai Zhao,Fuchun Zhang,Benjamin J. Cowling,Fang Li,Gabriel M. Leung +22 more
TL;DR: It is estimated that 44% (95% confidence interval, 25–69%) of secondary cases were infected during the index cases’ presymptomatic stage, in settings with substantial household clustering, active case finding and quarantine outside the home.
Journal ArticleDOI
Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study.
Kelvin K. W. To,Owen Tak Yin Tsang,Wai Shing Leung,Anthony Raymond Tam,Tak Chiu Wu,David Christopher Lung,Cyril C. Y. Yip,Jian Piao Cai,Jacky Man Chun Chan,Thomas Shiu Hong Chik,Daphne Pui-Ling Lau,Chris Yau Chung Choi,Lin Lei Chen,Wan Mui Chan,Kwok-Hung Chan,Jonathan Daniel Ip,Anthony Chin-Ki Ng,Rosana W.S. Poon,Cui Ting Luo,Vincent C.C. Cheng,Jasper Fuk-Woo Chan,Jasper Fuk-Woo Chan,Ivan Hung,Zhiwei Chen,Honglin Chen,Kwok-Yung Yuen +25 more
TL;DR: The serial respiratory viral load of SARS-CoV-2 in posterior oropharyngeal saliva samples from patients with COVID-19, and serum antibody responses from patients infected with severe acute respiratory syndrome coronavirus 2 are ascertained.
Journal ArticleDOI
Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR
TL;DR: In a series of 51 patients with chest CT and real-time polymerase chain reaction assay (RT-PCR) performed within 3 days, the sensitivity of CT for 2019 novel coronavirus infection was 98% and that ...
Related Papers (5)
Virological assessment of hospitalized patients with COVID-2019.
Roman Wölfel,Victor M. Corman,Wolfgang Guggemos,M Seilmaier,Sabine Zange,Marcel A. Müller,Daniela Niemeyer,Terry Jones,Terry Jones,Patrick Vollmar,Camilla Rothe,Michael Hoelscher,Tobias Bleicker,Sebastian Brünink,Julia Schneider,Rosina Ehmann,Katrin Zwirglmaier,Christian Drosten,Clemens M. Wendtner +18 more
Temporal dynamics in viral shedding and transmissibility of COVID-19.
Prevalence of Asymptomatic SARS-CoV-2 Infection : A Narrative Review.
Daniel P Oran,Eric J. Topol +1 more
Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR.
Victor M. Corman,Olfert Landt,Marco Kaiser,Richard Molenkamp,Adam Meijer,Daniel K.W. Chu,Tobias Bleicker,Sebastian Brünink,Julia Schneider,Marie Luisa Schmidt,Daphne G.J.C. Mulders,Bart L. Haagmans,Bas van der Veer,Sharon van den Brink,Lisa Wijsman,Gabriel Goderski,Jean Louis Romette,Joanna Ellis,Maria Zambon,Malik Peiris,Herman Goossens,Chantal B.E.M. Reusken,Marion Koopmans,Christian Drosten +23 more