Evidence map›Paper›PMID 33892014›Full record

ArticleThe Journal of infection2021

Sensitivity of SARS-CoV-2 RNA polymerase chain reaction using a clinical and radiological reference standard.

Alexander J Stockdale, Fred Fyles, Catriona Farrell, Joe Lewis, David Barr, Kathryn Haigh, Michael Abouyannis, Beth Hankinson, Diana Penha, Rashika Fernando and 17 more

Open access · hybridAbstract read
In one paragraph

Article in The Journal of infection, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. When to test for COVID-19 using real-time reverse transcriptase polymerase chain reaction: a systematic review.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022
    Pooled it
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors at 2 institutions in 1 country.

Alexander J StockdaleTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, United Kingdom. Electronic address: a.stockdale@liverpool.ac.uk.
Fred FylesTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Catriona FarrellDepartment of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Joe LewisTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, United Kingdom.
David BarrTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, United Kingdom.
Kathryn HaighTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, United Kingdom.
Michael AbouyannisTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Beth HankinsonDepartment of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Diana PenhaDepartment of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Rashika FernandoDepartment of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Rebecca WilesDepartment of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Sheetal SharmaDepartment of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Nuria SantamariaDepartment of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Vijay ChindambaramDepartment of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Cairine ProbertDepartment of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Muhammad Shamsher AhmedTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
James CruiseTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Imogen FordhamTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Rory HicksTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Alice MaxwellTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Nick MoodyTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Tamsin PatersonTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Katharine StottTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom.
Meng-San WuTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Michael BeadsworthTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Stacy ToddTropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Elizabeth JoekesDepartment of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
Aintree University Hospitals NHS Foundation Trust · GBUniversity of Liverpool · GB

Funding

Wellcome Trust
6 · The paper itself

Abstract

objectivesDiagnostic 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.

methodsBetween 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.

results901 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).

conclusionsIn 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.

Indexed as

COVID-19SARS-CoV-2Diagnostic Tests, RoutineHumansPolymerase Chain ReactionReference StandardsRNA, ViralSensitivity and SpecificityRNA, ViralCOVID-19Diagnostic testingDiagnostic X-RayRadiologyReal-time polymerase chain reactionSARS-CoV-2Sensitivity and specificity

Identifiers

PMID33892014
PMCPMC8057690
OpenAlexW3154596395

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.