ArticleOpen forum infectious diseases2021
Quantifying the Impact of Nasopharyngeal Specimen Quality on Severe Acute Respiratory Syndrome Coronavirus 2 Test Performance.
Article in Open forum infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 27 citations in OpenAlex.
- Swiss community-based surveillance of respiratory virus co-occurrence in 2022-2024.Microbiology spectrum · 2026Article
- Subgenomic RNA and Limited Cross-Reactive Neutralising Antibodies Point to Potential Improvements in SARS-CoV-2 Clinical Handling.International journal of molecular sciences · 2025Article
- Key Insights into Respiratory Virus Testing: Sensitivity and Clinical Implications.Microorganisms · 2025Review
- Cycle threshold of SARS-CoV-2 RT-PCR as a driver of retesting.Scientific reports · 2024Article
- Development of Enzyme-Linked Immunosorbent and Immunochromatography Assays for DiagnosingInsects · 2024Article
- Digital PCR to Measure SARS-CoV-2 RNA, Variants, and Outcomes in Youth.Journal of the Pediatric Infectious Diseases Society · 2023Article
- MICaFVi: A Novel Magnetic Immuno-Capture Flow Virometry Nano-Based Diagnostic Tool for Detection of Coronaviruses.Biosensors · 2023Article
- Investigation of Blood Plasma Viral Nucleocapsid Antigen as a Marker of Active Severe Acute Respiratory Syndrome Coronavirus 2 Omicron Variant Infection.Open forum infectious diseases · 2023Article
- Article
- Converting to an international unit system improves harmonization of results for SARS-CoV-2 quantification: Results from multiple external quality assessments.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2023Article
- Considerations regarding Interpretation of Positive SARS-CoV-2 Molecular Results with Late Cycle Threshold Values.Journal of clinical microbiology · 2022Review
- Rapid Antigen Assays for SARS-CoV-2: Promise and Peril.Clinics in laboratory medicine · 2022Review
- SARS-CoV-2 cycle threshold (Ct) values predict future COVID-19 cases.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2022Article
- Longitudinal SARS-CoV-2 Testing among the Unvaccinated Is Punctuated by Intermittent Positivity and Variable Rates of Increasing Cycle Threshold Values.Microbiology spectrum · 2022Article
- Performance of lateral flow assays for SARS-CoV-2 compared to RT-qPCR.The Journal of infection · 2022Article
- Development, Analytical, and Clinical Evaluation of Rapid Immunochromatographic Antigen Test for SARS-CoV-2 Variants Detection.Diagnostics (Basel, Switzerland) · 2022Article
- Prolonged SARS-CoV-2 Positivity in Immunocompetent Patients: Virus Isolation, Genomic Integrity, and Transmission Risk.Microbiology spectrum · 2021Article
- Clinical performance evaluation of SARS-CoV-2 rapid antigen testing in point of care usage in comparison to RT-qPCR.EBioMedicine · 2021Article
- Article
- Clinical Outcome of PCR-Negative COVID-19 Patients: A Retrospective Study.Turkish thoracic journal · 2021Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse-transcription polymerase chain reaction (RT-PCR) cycle threshold (Ct) has been used to estimate quantitative viral load, with the goal of targeting isolation precautions for individuals with coronavirus disease 2019 (COVID-19) and guiding public health interventions. However, variability in specimen quality can alter the Ct values obtained from SARS-CoV-2 clinical assays. We sought to define how variable nasopharyngeal (NP) swab quality impacts clinical SARS-CoV-2 test sensitivity.
methodsWe performed amplification of a human gene target (β-actin) in parallel with a clinical RT-PCR targeting the SARS-CoV-2
resultsLow-quality NP swabs are less likely to detect SARS-CoV-2 (odds ratio, 0.607 [95% credible interval {CrI}, .487-.753]). We observed a positive linear relationship between SARS-CoV-2 and β-actin Ct values (slope, 0.181 [95% CrI, .097-.264]), consistent with a reduction in detection of 0.181 cycles for each additional cycle of the β-actin target. COVID-19 disease severity was not associated with β-actin Ct values.
conclusionsVariability in NP specimen quality significantly impacts the performance of clinical SARS-CoV-2 assays, and caution should be taken when interpreting quantitative SARS-CoV-2 Ct results. If unrecognized, low-quality NP specimens, which are characterized by a low level of amplifiable human DNA target, may limit the successful application of SARS-CoV-2 Ct values to direct infection control and public health interventions.
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