Rapid, early and accurate SARS-CoV-2 detection using RT-qPCR in primary care: a prospective cohort study (REAP-1)
Objectives We explore the importance of SARS-CoV-2 sentinel surveillance testing in primary care during a regional COVID-19 outbreak in Austria.Design Prospective cohort study.Setting A single sentinel practice serving 22 829 people in the ski-resort of Schladming-Dachstein.Participants All 73 patie...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2021-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/8/e045225.full |
| _version_ | 1818455788054642688 |
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| author | Jasmina Panovska-Griffiths Chris Griffiths Andrea Siebenhofer Christoph Bock Werner Leber Karin Stiasny Oliver Lammel Monika Redlberger-Fritz Maria Elisabeth Mustafa-Korninger Reingard Christina Glehr Jeremy Camp Benedikt Agerer Alexander Lercher Alexandra Popa Jakob-Wendelin Genger Thomas Penz Stephan Aberle Andreas Bergthaler Eva-Maria Hochstrasser Christian Hoellinger |
| author_facet | Jasmina Panovska-Griffiths Chris Griffiths Andrea Siebenhofer Christoph Bock Werner Leber Karin Stiasny Oliver Lammel Monika Redlberger-Fritz Maria Elisabeth Mustafa-Korninger Reingard Christina Glehr Jeremy Camp Benedikt Agerer Alexander Lercher Alexandra Popa Jakob-Wendelin Genger Thomas Penz Stephan Aberle Andreas Bergthaler Eva-Maria Hochstrasser Christian Hoellinger |
| author_sort | Jasmina Panovska-Griffiths |
| collection | DOAJ |
| description | Objectives We explore the importance of SARS-CoV-2 sentinel surveillance testing in primary care during a regional COVID-19 outbreak in Austria.Design Prospective cohort study.Setting A single sentinel practice serving 22 829 people in the ski-resort of Schladming-Dachstein.Participants All 73 patients presenting with mild-to-moderate flu-like symptoms between 24 February and 03 April, 2020.Intervention Nasopharyngeal sampling to detect SARS-CoV-2 using real-time reverse transcriptase-quantitative PCR (RT-qPCR).Outcome measures We compared RT-qPCR at presentation with confirmed antibody status. We split the outbreak in two parts, by halving the period from the first to the last case, to characterise three cohorts of patients with confirmed infection: early acute (RT-qPCR reactive) in the first half; and late acute (reactive) and late convalescent (non-reactive) in the second half. For each cohort, we report the number of cases detected, the accuracy of RT-qPCR, the duration and variety of symptoms, and the number of viral clades present.Results Twenty-two patients were diagnosed with COVID-19 (eight early acute, seven late acute and seven late convalescent), 44 patients tested SARS-CoV-2 negative and 7 were excluded. The sensitivity of RT-qPCR was 100% among all acute cases, dropping to 68.1% when including convalescent. Test specificity was 100%. Mean duration of symptoms for each group were 2 days (range 1–4) among early acute, 4.4 days (1–7) among late acute and 8 days (2–12) among late convalescent. Confirmed infection was associated with loss of taste. Acute infection was associated with loss of taste, nausea/vomiting, breathlessness, sore throat and myalgia; but not anosmia, fever or cough. Transmission clusters of three viral clades (G, GR and L) were identified.Conclusions RT-qPCR testing in primary care can rapidly and accurately detect SARS-CoV-2 among people with flu-like illness in a heterogeneous viral outbreak. Targeted testing in primary care can support national sentinel surveillance of COVID-19. |
| first_indexed | 2024-12-14T22:16:20Z |
| format | Article |
| id | doaj.art-e01625da1827485099aa773e68ed83e3 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-12-14T22:16:20Z |
| publishDate | 2021-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-e01625da1827485099aa773e68ed83e32022-12-21T22:45:37ZengBMJ Publishing GroupBMJ Open2044-60552021-08-0111810.1136/bmjopen-2020-045225Rapid, early and accurate SARS-CoV-2 detection using RT-qPCR in primary care: a prospective cohort study (REAP-1)Jasmina Panovska-Griffiths0Chris Griffiths1Andrea Siebenhofer2Christoph Bock3Werner Leber4Karin Stiasny5Oliver Lammel6Monika Redlberger-Fritz7Maria Elisabeth Mustafa-Korninger8Reingard Christina Glehr9Jeremy Camp10Benedikt Agerer11Alexander Lercher12Alexandra Popa13Jakob-Wendelin Genger14Thomas Penz15Stephan Aberle16Andreas Bergthaler17Eva-Maria Hochstrasser18Christian Hoellinger19Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UKWolfson Institute of Population Health, Centre for Primary Care, Queen Mary University of London, London, UKInstitute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, AustriaCeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, AustriaWolfson Institute of Population Health, Centre for Primary Care, Queen Mary University of London, London, UKCenter for Virology, Medical University of Vienna, Vienna, AustriaPraxis Dr Lammel, Ramsau am Dachstein, AustriaCenter for Virology, Medical University of Vienna, Vienna, AustriaMedizinisch-chemisches Labor Dr. Mustafa OG, Salzburg, AustriaInstitute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, AustriaCenter for Virology, Medical University of Vienna, Vienna, AustriaCeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, AustriaCeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, AustriaCeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, AustriaCeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, AustriaCeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, AustriaCenter for Virology, Medical University of Vienna, Vienna, AustriaCeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, AustriaPraxis Dr Lammel, Ramsau am Dachstein, AustriaParacelsus Medical Private University, Salzburg, AustriaObjectives We explore the importance of SARS-CoV-2 sentinel surveillance testing in primary care during a regional COVID-19 outbreak in Austria.Design Prospective cohort study.Setting A single sentinel practice serving 22 829 people in the ski-resort of Schladming-Dachstein.Participants All 73 patients presenting with mild-to-moderate flu-like symptoms between 24 February and 03 April, 2020.Intervention Nasopharyngeal sampling to detect SARS-CoV-2 using real-time reverse transcriptase-quantitative PCR (RT-qPCR).Outcome measures We compared RT-qPCR at presentation with confirmed antibody status. We split the outbreak in two parts, by halving the period from the first to the last case, to characterise three cohorts of patients with confirmed infection: early acute (RT-qPCR reactive) in the first half; and late acute (reactive) and late convalescent (non-reactive) in the second half. For each cohort, we report the number of cases detected, the accuracy of RT-qPCR, the duration and variety of symptoms, and the number of viral clades present.Results Twenty-two patients were diagnosed with COVID-19 (eight early acute, seven late acute and seven late convalescent), 44 patients tested SARS-CoV-2 negative and 7 were excluded. The sensitivity of RT-qPCR was 100% among all acute cases, dropping to 68.1% when including convalescent. Test specificity was 100%. Mean duration of symptoms for each group were 2 days (range 1–4) among early acute, 4.4 days (1–7) among late acute and 8 days (2–12) among late convalescent. Confirmed infection was associated with loss of taste. Acute infection was associated with loss of taste, nausea/vomiting, breathlessness, sore throat and myalgia; but not anosmia, fever or cough. Transmission clusters of three viral clades (G, GR and L) were identified.Conclusions RT-qPCR testing in primary care can rapidly and accurately detect SARS-CoV-2 among people with flu-like illness in a heterogeneous viral outbreak. Targeted testing in primary care can support national sentinel surveillance of COVID-19.https://bmjopen.bmj.com/content/11/8/e045225.full |
| spellingShingle | Jasmina Panovska-Griffiths Chris Griffiths Andrea Siebenhofer Christoph Bock Werner Leber Karin Stiasny Oliver Lammel Monika Redlberger-Fritz Maria Elisabeth Mustafa-Korninger Reingard Christina Glehr Jeremy Camp Benedikt Agerer Alexander Lercher Alexandra Popa Jakob-Wendelin Genger Thomas Penz Stephan Aberle Andreas Bergthaler Eva-Maria Hochstrasser Christian Hoellinger Rapid, early and accurate SARS-CoV-2 detection using RT-qPCR in primary care: a prospective cohort study (REAP-1) BMJ Open |
| title | Rapid, early and accurate SARS-CoV-2 detection using RT-qPCR in primary care: a prospective cohort study (REAP-1) |
| title_full | Rapid, early and accurate SARS-CoV-2 detection using RT-qPCR in primary care: a prospective cohort study (REAP-1) |
| title_fullStr | Rapid, early and accurate SARS-CoV-2 detection using RT-qPCR in primary care: a prospective cohort study (REAP-1) |
| title_full_unstemmed | Rapid, early and accurate SARS-CoV-2 detection using RT-qPCR in primary care: a prospective cohort study (REAP-1) |
| title_short | Rapid, early and accurate SARS-CoV-2 detection using RT-qPCR in primary care: a prospective cohort study (REAP-1) |
| title_sort | rapid early and accurate sars cov 2 detection using rt qpcr in primary care a prospective cohort study reap 1 |
| url | https://bmjopen.bmj.com/content/11/8/e045225.full |
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