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      Clinical Performance of the Point-of-Care cobas Liat for Detection of SARS-CoV-2 in 20 Minutes: a Multicenter Study

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          Abstract

          Highly accurate testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the point of care (POC) is an unmet diagnostic need in emergency care and time-sensitive outpatient care settings. Reverse transcription-PCR (RT-PCR) technology is the gold standard for SARS-CoV-2 diagnostics.

          ABSTRACT

          Highly accurate testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the point of care (POC) is an unmet diagnostic need in emergency care and time-sensitive outpatient care settings. Reverse transcription-PCR (RT-PCR) technology is the gold standard for SARS-CoV-2 diagnostics. We performed a multisite U.S. study comparing the clinical performance of the first U.S. Food and Drug Administration (FDA)-authorized POC RT-PCR for detection of SARS-CoV-2 in 20 min, the cobas Liat SARS-CoV-2 and influenza A/B nucleic acid test, to the most widely used RT-PCR laboratory test, the cobas 68/8800 SARS-CoV-2 test. Clinical nasopharyngeal swab specimens from 444 patients with 357 evaluable specimens at five U.S. clinical laboratories were enrolled from 21 September 2020 to 23 October 2020. The overall agreement between the Liat and 68/8800 systems for SARS-CoV-2 diagnostics was 98.6% (352/357). Using Liat, positive percent agreement for SARS-CoV-2 was 100% (162/162) and the negative percent agreement was 97.4% (190/195). The Liat is an RT-PCR POC test that provides highly accurate SARS-CoV-2 results in 20 min with performance equivalent to that of high-throughput laboratory molecular testing. Rapid RT-PCR testing at the POC can enable more timely infection control and individual care decisions for coronavirus disease 2019.

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          Duration of infectiousness and correlation with RT-PCR cycle threshold values in cases of COVID-19, England, January to May 2020

          Severe acute respiratory syndrome coronavirus 2 viral load in the upper respiratory tract peaks around symptom onset and infectious virus persists for 10 days in mild-to-moderate coronavirus disease (n = 324 samples analysed). RT-PCR cycle threshold (Ct) values correlate strongly with cultivable virus. Probability of culturing virus declines to 8% in samples with Ct > 35 and to 6% 10 days after onset; it is similar in asymptomatic and symptomatic persons. Asymptomatic persons represent a source of transmissible virus.
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            Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19

            Abstract Background There are many pharmacologic therapies that are being used or considered for treatment of COVID-19. There is a need for frequently updated practice guidelines on their use, based on critical evaluation of rapidly emerging literature. Objective Develop evidence-based rapid guidelines intended to support patients, clinicians and other health-care professionals in their decisions about treatment and management of patients with COVID-19. Methods IDSA formed a multidisciplinary guideline panel of infectious disease clinicians, pharmacists, and methodologists with varied areas of expertise. Process followed a rapid recommendation checklist. The panel prioritized questions and outcomes. Then a systematic review of the peer-reviewed and grey literature was conducted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence and make recommendations. Results The IDSA guideline panel agreed on 7 treatment recommendations and provided narrative summaries of other treatments undergoing evaluations. Conclusions The panel expressed the overarching goal that patients be recruited into ongoing trials, which would provide much needed evidence on the efficacy and safety of various therapies for COVID-19, given that we could not make a determination whether the benefits outweigh harms for most treatments.
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              Clinical Evaluation of Three Sample-to-Answer Platforms for Detection of SARS-CoV-2

              Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has now spread across the globe. As part of the worldwide response, many molecular diagnostic platforms have been granted emergency use authorization (EUA) by the Food and Drug Administration (FDA) to identify SARS-CoV-2 positive patients. Our objective was to evaluate three sample-to-answer molecular diagnostic platforms (Cepheid Xpert Xpress SARS-CoV-2 [Xpert Xpress], Abbott ID NOW COVID-19 [ID NOW], and GenMark ePlex SARS-CoV-2 Test [ePlex]) to determine analytical sensitivity, clinical performance, and workflow for the detection of SARS-CoV-2 in nasopharyngeal swabs from 108 symptomatic patients.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                J Clin Microbiol
                J Clin Microbiol
                jcm
                jcm
                JCM
                Journal of Clinical Microbiology
                American Society for Microbiology (1752 N St., N.W., Washington, DC )
                0095-1137
                1098-660X
                25 November 2020
                21 January 2021
                February 2021
                21 January 2021
                : 59
                : 2
                : e02811-20
                Affiliations
                [a ]Department of Pathology and Laboratory Medicine, University of Minnesota, Minneapolis, Minnesota, USA
                [b ]Department of Pathology, Hennepin County Medical Center, Minneapolis, Minnesota, USA
                [c ]Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York, USA
                [d ]Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
                [e ]Department of Pathology, University of Chicago, Chicago, Illinois, USA
                [f ]Department of Pathology and Laboratory Medicine, University of California Davis, California, USA
                [g ]Roche Molecular Systems, Inc., Pleasanton, California, USA
                Boston Children’s Hospital
                Author notes
                Address correspondence to Nam K. Tran, nktran@ 123456UCDAVIS.EDU .

                Glen Hansen, Zi-Xuan Wang, Kathleen G. Beavis, Lars F. Westblade, and Nam K. Tran contributed equally to the study. Order of coauthors was determined based on the timeline and number of positive specimens per cobas SARS-CoV-2 test enrolled in the trial.

                Citation Hansen G, Marino J, Wang Z-X, Beavis KG, Rodrigo J, Labog K, Westblade LF, Jin R, Love N, Ding K, Garg S, Huang A, Sickler J, Tran NK. 2021. Clinical performance of the point-of-care cobas Liat for detection of SARS-CoV-2 in 20 minutes: a multicenter study. J Clin Microbiol 59:e02811-20. https://doi.org/10.1128/JCM.02811-20.

                Author information
                https://orcid.org/0000-0002-5611-6809
                https://orcid.org/0000-0003-1565-0025
                Article
                02811-20
                10.1128/JCM.02811-20
                8111162
                33239382
                9f71a0c6-cced-427e-bc66-27ea0e981d3d
                Copyright © 2021 Hansen et al.

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.

                History
                : 6 November 2020
                : 11 November 2020
                : 23 November 2020
                Page count
                Figures: 1, Tables: 2, Equations: 0, References: 37, Pages: 8, Words: 4952
                Funding
                Funded by: Roche Molecular Systems;
                Award ID: LIA-COV-530
                Award Recipient : Award Recipient : Award Recipient : Award Recipient : Award Recipient : Award Recipient : Award Recipient : Award Recipient : Award Recipient : Award Recipient :
                Categories
                Virology
                Custom metadata
                February 2021

                Microbiology & Virology
                coronavirus disease 2019 (covid-19),cobas 68/8800 sars-cov-2,cobas liat sars-cov-2 and influenza a/b,liat,point-of-care (poc),reverse transcription-polymerase chain reaction (rt-pcr)

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