Selected article for: "binomial regression and confidence interval"
Author: Stockdale, Alexander J; Fyles, Fred; Farrell, Catriona; Lewis, Joe; Barr, David; Haigh, Kathryn; Abouyannis, Michael; Hankinson, Beth; Penha, Diana; Fernando, Rashika; Wiles, Rebecca; Sharma, Sheetal; Santamaria, Nuria; Chindambaram, Vijay; Probert, Cairine; Ahmed, Muhammad Shamsher; Cruise, James; Fordham, Imogen; Hicks, Rory; Maxwell, Alice; Moody, Nick; Paterson, Tamsin; Stott, Katharine; Wu, Meng-San; Beadsworth, Michael; Todd, Stacy; Joekes, Elizabeth
Title: Sensitivity of SARS-CoV-2 RNA polymerase chain reaction using a clinical and radiological reference standard: Clinical sensitivity of SARS-CoV-2 PCR
  • Cord-id: 5cq7vglz
  • Document date: 2021_4_20
    • ID: 5cq7vglz
    Snippet: OBJECTIVES: Diagnostic tests for SARS-CoV-2 are important for epidemiology, clinical management, and infection control. Limitations of oro-nasopharyngeal real-time PCR sensitivity have been described based on comparisons of single tests with repeated sampling. We assessed SARS-CoV-2 PCR clinical sensitivity using a clinical and radiological reference standard. METHODS: Between March-May 2020, 2060 patients underwent thoracic imaging and SARS-CoV-2 PCR testing. Imaging was independently double- o
    Document: OBJECTIVES: Diagnostic tests for SARS-CoV-2 are important for epidemiology, clinical management, and infection control. Limitations of oro-nasopharyngeal real-time PCR sensitivity have been described based on comparisons of single tests with repeated sampling. We assessed SARS-CoV-2 PCR clinical sensitivity using a clinical and radiological reference standard. METHODS: Between March-May 2020, 2060 patients underwent thoracic imaging and SARS-CoV-2 PCR testing. Imaging was independently double- or triple-reported (if discordance) by blinded radiologists according to radiological criteria for COVID-19. We excluded asymptomatic patients and those with alternative diagnoses that could explain imaging findings. Associations with PCR-positivity were assessed with binomial logistic regression. RESULTS: 901 patients had possible/probable imaging features and clinical symptoms of COVID-19 and 429 patients met the clinical and radiological reference case definition. SARS-CoV-2 PCR sensitivity was 68% (95% confidence interval 64-73), was highest 7-8 days after symptom onset (78% (68-88)) and was lower among current smokers (adjusted odds ratio 0.23 (0.12-0.42) p<0.001). CONCLUSIONS: In patients with clinical and imaging features of COVID-19, PCR test sensitivity was 68%, and was lower among smokers; a finding that could explain observations of lower disease incidence and that warrants further validation. PCR tests should be interpreted considering imaging, symptom duration and smoking status.

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