Comparison of Severe Acute Respiratory Syndrome Coronavirus 2 Screening Using Reverse Transcriptase–Quantitative Polymerase Chain Reaction or CRISPR-Based Assays in Asymptomatic College Students

Rauch, Jennifer N.; Valois, Eric; Ponce-Rojas, José Carlos; Aralis, Zach; Lach, Ryan S.; Zappa, Francesca; Audouard, Morgane; Solley, Sabrina C.; Vaidya, Chinmay; Costello, Michael S.; Smith, Holly; A, Javanbakht; B, Malear; Polito, Laura; Comer, Stewart; Arn, Katherine E; Kosik, Kenneth S.; Acosta‐Alvear, Diego; Wilson, Maxwell Z.; Fitzgibbons, Lynn; Arias, Carolina

doi:10.1001/jamanetworkopen.2020.37129

Cited by 13 publications

(10 citation statements)

References 33 publications

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“…Thirty-two studies, including 9,121 infected people, were done in the United States (S3 Table). At time of the latest search date, 17 records were preprints, 14 of which had been published in peer-reviewed journals by 23 November 2021 [7, 49, 55, 89, 92, 98, 102, 105, 125, 126, 128, 133, 141, 145] and 3 were still preprints [95, 96, 144]. In all included studies, 86 followed participants for seven days or more, 19 followed participants for at least 14 days after a known exposure, 27 followed participants until they had at least one negative RT-PCR test and 29 studies used more than one method of follow-up (Table 1, S2 Table).…”

Section: Resultsmentioning

confidence: 99%

“…In 54 screening studies, the IQR for estimates from individual studies was 18-59% and the prediction interval from random-effects meta-analysis was 3-95% [39-48, 50-52, 54, 56-59, 61, 63, 64, 69, 70, 72, 75-80, 88, 89, 94-97, 99, 100, 102, 104, 106-110, 113, 118, 124-127, 131, 134, 135]. We distinguished three settings in which screening studies were conducted; people in a community setting (17 studies, prediction interval 1-97%), institutional settings such as nursing homes (23 studies, prediction interval 5-95%), and occupational settings such as amongst groups of healthcare workers (13 studies, prediction interval 2-95%) (S3 Fig).…”

Section: Resultsmentioning

confidence: 99%

“…In 84 screening studies, the IQR for estimates from individual studies was 20-65% and the prediction interval was 4-94% [41-48,50-54,56,58-63,67,69-71,73,74,79,83,86,88-97,99-101,103-105,107,109,110,114-117,119,120,122,124-126,128,130,133-138,143-145,147,150-156,158-164]. The ranges of estimates were similar in three settings in which screening studies were conducted; people in a community setting (23 studies, IQR 20-53%, prediction interval 2-96%), institutional settings such as nursing homes (43 studies, IQR 26-67%, prediction interval 5-93%), and occupational settings such as amongst groups of healthcare workers (18 studies, IQR 17-64%, prediction interval 3-95%) (S2 Fig).…”

Section: Resultsmentioning

confidence: 99%

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Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: update of a living systematic review and meta-analysis

Buitrago-Garcia

Ipekci

Heron

et al. 2022

Preprint

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BACKGROUND Debate about the level of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection continues. The amount of evidence is increasing and study designs have changed over time. We conducted a living systematic review to address three questions: (1) Amongst people who become infected with SARS-CoV-2, what proportion does not experience symptoms at all during their infection? (2) What is the infectiousness of asymptomatic and presymptomatic, compared with symptomatic, SARS-CoV-2 infection? (3) What proportion of SARS-CoV-2 transmission in a population is accounted for by people who are asymptomatic or presymptomatic? METHODS AND FINDINGS The protocol was first published on 1 April 2020 and last updated on 18 June 2020. We searched PubMed, Embase, bioRxiv and medRxiv, aggregated in a database of SARS-CoV-2 literature, most recently on 2 February 2021. Studies of people with PCR-diagnosed SARS-CoV-2, which documented symptom status at the beginning and end of follow-up, or mathematical modelling studies were included. Studies restricted to people already diagnosed, of single individuals or families, or without sufficient follow-up were excluded. One reviewer extracted data and a second verified the extraction, with disagreement resolved by discussion or a third reviewer. Risk of bias in empirical studies was assessed with a bespoke checklist and modelling studies with a published checklist. All data syntheses were done using random effects models. Review question (1): We included 94 studies. Heterogeneity was high and we could not reliably estimate values for the proportion of asymptomatic infections overall (interquartile range 13-45%, prediction interval 2-89%), or in studies based on screening of defined populations (interquartile range 18-59%, prediction interval 3-95%). In screening studies at low risk of information bias, the prediction interval was 4-69% (summary proportion 23%, 95% CI 14-35%). In 40 studies based on contact or outbreak investigations, the summary proportion asymptomatic was 18% (95% CI 14-24%, prediction interval 3-64%) and, in studies at low risk of selection bias, 25% (95% CI 18-33%, prediction interval 5-66%). (2) The secondary attack rate in contacts of people with asymptomatic infection compared with symptomatic infection was 0.43 (95% CI 0.05-3.44, 5 studies). (3) In 11 modelling studies fit to data, the proportion of all SARS-CoV-2 transmission from presymptomatic individuals was higher than from asymptomatic individuals. Limitations of the evidence include high heterogeneity in studies that were not designed to measure persistently asymptomatic infection, high risks of selection and information bias, and the absence of studies about variants of concern or in people who have been vaccinated. CONCLUSIONS This review does not provide a summary estimate of the proportion of asymptomatic SARS-CoV-2 across all study designs. In studies based on contact and outbreak investigation, most SARS-CoV-2 infections were not persistently asymptomatic. Summary estimates from meta-analysis may be misleading when variability between studies is extreme. Without prospective longitudinal studies with methods that minimise selection and measurement biases, further updates with the study types included in this living systematic review are unlikely to be able to provide a reliable summary estimate of the proportion of asymptomatic infections caused by wild-type SARS-CoV-2.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: update of a living systematic review and meta-analysis

Buitrago-Garcia

Ipekci

Heron

et al. 2022

Preprint

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“…Additionally, we conducted 463 analyses instead of 1195, reducing testing resources by more than 60% without lengthening diagnosis time and without significant losses in sensitivity. Although this saving can be further optimized by refining the pooling strategy set-up and improving analysis methods, this approach can contribute significantly to the rational use of human and material resources, especially in the context of public screening or for the implementation of environmental surveillance measures repeated over time in educational settings [ 6 , 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Sample-Pooling Strategy for SARS-CoV-2 Detection among Students and Staff of the University of Sannio

et al. 2021

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Since the beginning of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic, it has been clear that testing large groups of the population was the key to stem infection and prevent the effects of the coronavirus disease of 2019, mostly among sensitive patients. On the other hand, time and cost-sustainability of virus detection by molecular analysis such as reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) may be a major issue if testing is extended to large communities, mainly asymptomatic large communities. In this context, sample-pooling and test grouping could offer an effective solution. Here we report the screening on 1195 oral-nasopharyngeal swabs collected from students and staff of the Università degli Studi del Sannio (University of Sannio, Benevento, Campania, Italy) and analyzed by an in-house developed multiplex RT-qPCR for SARS-CoV-2 detection through a simple monodimensional sample pooling strategy. Overall, 400 distinct pools were generated and, within 24 h after swab collection, five positive samples were identified. Out of them, four were confirmed by using a commercially available kit suitable for in vitro diagnostic use (IVD). High accuracy, sensitivity and specificity were also determined by comparing our results with a reference IVD assay for all deconvoluted samples. Overall, we conducted 463 analyses instead of 1195, reducing testing resources by more than 60% without lengthening diagnosis time and without significant losses in sensitivity, suggesting that our strategy was successful in recognizing positive cases in a community of asymptomatic individuals with minor requirements of reagents and time when compared to normal testing procedures.

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“…CRISPR-based assays provide a robust and sensitive alternative for the detection of SARS-CoV-2 genomes. These assays use common and widely available reagents and are adaptable to minimal instrumentation and infrastructure (Rauch et al, 2021). An antibody test looks for antibodies that are made by immune system in response to a threat (a specific virus like COVID-19).…”

Section: Screening/testsmentioning

confidence: 99%

Screening, Prevention and Treatment of COVID-19 with Special Reference to African-Americans

Mandal¹

2021

BTBP

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Viruses mutate all the time, and the coronavirus that causes COVID-19 is no exception. As new variants of the COVID-19 emerge, a slew of new studies suggest that some may be able to evade immune responses triggered by a previous infection or by a vaccine. The novel variants of SARS-CoV-2 including those seen in the UK (2OI/5O1Y.V1/B.1.1.7), South Africa (2OH/5O1Y.V2/B.1.351), Brazil (P.1/2OJ/5O1Y.V3/B.1.1.248) have emerged with the concern of increased infectivity and virulence. Scientists are working to learn more about the characteristics of these strains whether they could cause more severe illness, and whether currently authorized vaccines will protect people against them. All viruses naturally mutate and evolve over time. For example, flu virus change often, which is why doctors recommend that you get a flu shot every year. Various mRNA vaccine platforms have been developed in recent years and validated in studies of immunogenicity and efficacy.

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Comparison of Severe Acute Respiratory Syndrome Coronavirus 2 Screening Using Reverse Transcriptase–Quantitative Polymerase Chain Reaction or CRISPR-Based Assays in Asymptomatic College Students

Cited by 13 publications

References 33 publications

Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: update of a living systematic review and meta-analysis

Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: update of a living systematic review and meta-analysis

Sample-Pooling Strategy for SARS-CoV-2 Detection among Students and Staff of the University of Sannio

Screening, Prevention and Treatment of COVID-19 with Special Reference to African-Americans

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