TY - JOUR
T1 - Test, trace, isolate
T2 - Evidence for declining SARS-CoV-2 PCR sensitivity in a clinical cohort
AU - Bergmans, Barbara J.M.
AU - Reusken, Chantal B.E.M.
AU - Van Oudheusden, Anne J.G.
AU - Godeke, Gert-Jan
AU - Bonačić Marinović, Axel A.
AU - De Vries, Esther
AU - Kluiters-de Hingh, Yvette C.M.
AU - Vingerhoets, Ralf
AU - Berrevoets, Marvin A.H.
AU - Verweij, Jaco J.
AU - Nieman, An-Emmie
AU - Reimerink, Johan
AU - Murk, Jean-Luc.
AU - Swart, Arno
PY - 2021
Y1 - 2021
N2 - Real-time reverse transcription-polymerase chain reaction (RT-PCR) on upper respiratory tract (URT) samples is the primary method to diagnose SARS-CoV-2 infections and guide public health measures, with a supportive role for serology. We reinforce previous findings on limited sensitivity of PCR testing, and solidify this fact by statistically utilizing a firm basis of multiple tests per individual. We integrate stratifications with respect to several patient characteristics such as severity of disease and time since onset of symptoms. Bayesian statistical modelling was used to retrospectively determine the sensitivity of RT-PCR using SARS-CoV-2 serology in 644 COVID-19-suspected patients with varying degrees of disease severity and duration. The sensitivity of RT-PCR ranged between 80% − 95%; increasing with disease severity, it decreased rapidly over time in mild COVID-19 cases. Negative URT RT-PCR results should be interpreted in the context of clinical characteristics, especially with regard to containment of viral transmission based on ‘test, trace and isolate’.
AB - Real-time reverse transcription-polymerase chain reaction (RT-PCR) on upper respiratory tract (URT) samples is the primary method to diagnose SARS-CoV-2 infections and guide public health measures, with a supportive role for serology. We reinforce previous findings on limited sensitivity of PCR testing, and solidify this fact by statistically utilizing a firm basis of multiple tests per individual. We integrate stratifications with respect to several patient characteristics such as severity of disease and time since onset of symptoms. Bayesian statistical modelling was used to retrospectively determine the sensitivity of RT-PCR using SARS-CoV-2 serology in 644 COVID-19-suspected patients with varying degrees of disease severity and duration. The sensitivity of RT-PCR ranged between 80% − 95%; increasing with disease severity, it decreased rapidly over time in mild COVID-19 cases. Negative URT RT-PCR results should be interpreted in the context of clinical characteristics, especially with regard to containment of viral transmission based on ‘test, trace and isolate’.
KW - SARS-CoV-2
KW - rt-pcr
KW - serology
KW - SENSITIVITY
KW - Public Health
U2 - 10.1016/j.diagmicrobio.2021.115392
DO - 10.1016/j.diagmicrobio.2021.115392
M3 - Article
SN - 0732-8893
VL - 101
JO - Diagnostic Microbiology and Infectious Disease
JF - Diagnostic Microbiology and Infectious Disease
IS - 2
M1 - 115392
ER -