Is it enough for COVID-19 screening test? Limitation of swab test and general characteristics of mild symptom patients.

Publisher: SAGE Publications Country of Publication: England NLM ID: 0411361 Publication Model: Print Cited Medium: Internet ISSN: 2047-7163 (Electronic) Linking ISSN: 00368504 NLM ISO Abbreviation: Sci Prog Subsets: MEDLINE

Publication: <2019-> : [London] : SAGE Publications
Original Publication: Oxford, Blackwell Scientific Publications [etc.]

COVID-19/*diagnosis ; COVID-19 Nucleic Acid Testing/*standards ; Patient Discharge/*statistics & numerical data ; SARS-CoV-2/*genetics ; Specimen Handling/*methods; Adult ; Asymptomatic Diseases ; COVID-19/epidemiology ; COVID-19/virology ; Community Health Centers/organization & administration ; Female ; Humans ; Male ; Mass Screening/methods ; Nasopharynx/virology ; Pharynx/virology ; Quarantine/methods ; Republic of Korea/epidemiology ; Retrospective Studies ; Severity of Illness Index ; Sputum/virology

The most common method for SARS-CoV-2 testing is throat or nasal swabbing by real-time reverse transcription polymerase chain reaction (RT-PCR) assay. In South Korea, drive-through swab test is used for screening system and community treatment centers (CTCs), which admit and treat confirmed COVID-19 patients with mild symptoms, are being used. This retrospective study was conducted on patients admitted to a CTC on March 6, 2020. A total of 313 patients were admitted. The nasal and throat swabs were collected from the upper respiratory tract, and a sputum test was performed to obtain lower respiratory samples. The positive rate of the first set of test, sputum test was higher than that of the swab test ( p  = 0.011). In the second set of test, 1 week after the first ones, the rate of positive swab tests was relatively high ( p  = 0.026). In the first set of test, 66 of 152 (43.4%) patients showed 24-h consecutive negative swab test results, when the sputum test results were considered together, that number fell to 29 patients (19.1%) ( p  < 0.001). Also, in the second set of test, 63 of 164 (38.4%) patients met the discharge criteria only when the swab test was considered; that number fell to 30 (18.3%) when the sputum test results were also considered ( p  < 0.001). Using the swab test alone is insufficient for screening test and discharge decision. Patients who may have positive result in the sputum test can be missed.

Epidemiol Health. 2020;42:e2020007. (PMID: 32035431)
JAMA Intern Med. 2020 Nov 01;180(11):1447-1452. (PMID: 32780793)
SN Compr Clin Med. 2020;2(11):2419-2422. (PMID: 33103062)
Lancet Infect Dis. 2020 Apr;20(4):411-412. (PMID: 32105638)
Pediatrics. 2020 Jun;145(6):. (PMID: 32179660)
JAMA. 2020 Apr 14;323(14):1406-1407. (PMID: 32083643)
Lancet. 2020 Feb 15;395(10223):497-506. (PMID: 31986264)
China CDC Wkly. 2020 Feb 21;2(8):113-122. (PMID: 34594836)
Radiology. 2020 Aug;296(2):E32-E40. (PMID: 32101510)
EMBO Mol Med. 2020 Jun 8;12(6):e12661. (PMID: 32379923)
Clin Chem Lab Med. 2020 Jun 25;58(7):1089-1094. (PMID: 32301745)
J Korean Med Sci. 2020 Apr 06;35(13):e140. (PMID: 32242347)
Radiology. 2020 Aug;296(2):E41-E45. (PMID: 32049601)
Lancet Infect Dis. 2020 Jun;20(6):655-656. (PMID: 32171389)
Lancet. 2020 May 16;395(10236):1545-1546. (PMID: 32359402)
Acta Paediatr. 2020 Jun;109(6):1088-1095. (PMID: 32202343)
J Med Virol. 2021 Jan;93(1):97-98. (PMID: 32525558)
J Med Virol. 2021 Apr;93(4):2281-2286. (PMID: 33230819)
J Med Virol. 2014 Dec;86(12):2122-7. (PMID: 24797344)
PLoS One. 2020 Dec 10;15(12):e0242958. (PMID: 33301459)
Eur J Clin Microbiol Infect Dis. 2020 Oct;39(10):1997-2000. (PMID: 32462501)
Nat Rev Immunol. 2020 Jun;20(6):335-337. (PMID: 32393823)
Lancet Respir Med. 2020 Dec;8(12):1167-1168. (PMID: 33007240)

Keywords: COVID-19; RT-PCR; SARS-CoV-2; community treatment center; drive-through

Date Created: 20210618 Date Completed: 20210707 Latest Revision: 20230829

20230830

PMC10454889

10.1177/00368504211026152

34143699