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425. The Utility of Paired Upper and Lower COVID-19 Sampling in Patients with Artificial Airways
BACKGROUND: The Centers for Disease Control and Prevention (CDC) recommends upper respiratory tract (URT) polymerase chain reaction (PCR) testing as the initial diagnostic test for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Lower respiratory tract (LRT) testing for patients requir...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776659/ http://dx.doi.org/10.1093/ofid/ofaa439.619 |
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author | Kitt, Eimear Sammons, Julia S Chiotos, Kathleen Coffin, Susan E Coffin, Susan E Ballantine, Allison Gallagher, Elizabeth Mojica, Coralee DelValle O’Callaghan, Kevin P Kerman, Caryn Harris, Rebecca Bell, Louis Davis, Daniela Nord, Ellen |
author_facet | Kitt, Eimear Sammons, Julia S Chiotos, Kathleen Coffin, Susan E Coffin, Susan E Ballantine, Allison Gallagher, Elizabeth Mojica, Coralee DelValle O’Callaghan, Kevin P Kerman, Caryn Harris, Rebecca Bell, Louis Davis, Daniela Nord, Ellen |
author_sort | Kitt, Eimear |
collection | PubMed |
description | BACKGROUND: The Centers for Disease Control and Prevention (CDC) recommends upper respiratory tract (URT) polymerase chain reaction (PCR) testing as the initial diagnostic test for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Lower respiratory tract (LRT) testing for patients requiring mechanical ventilation is also recommended. The goal of this study was to evaluate concordance between paired URT and LRT specimens in children undergoing pre-admission/procedure screening or diagnostic testing. We hypothesized that < 10% of paired tests would have discordant results. METHODS: Single center cross-sectional study including children with artificial airways who had paired URT and LRT SARS-CoV-2 PCR testing between 4/1/2020 and 6/8/2020. URT specimens included nasopharyngeal (NP) swabs and aspirates. LRT specimens included tracheal aspirates and bronchoalveolar lavages. URT and LRT specimens were classified as paired if the two specimens were collected within 24 hours. Artificial airways included tracheostomies and endotracheal tubes. Tests were classified as diagnostic versus screening based on the indication selected in the order. RESULTS: 102 paired specimens were obtained during the study period. Fifty-nine were performed for screening and 43 were performed for diagnosis of suspected SARS-CoV-2. Overall, 94 specimens (92%) were concordant, including 89 negative from both sources and 5 positive from both sources. Eight specimens (8%) were discordant, all of which were positive from the URT and negative from the LRT (Figure 1). Among patients undergoing screening, 3 of 4 positive tests were discordant and among symptomatic patients, 5 of 9 positive tests were discordant. There were no instances of a positive LRT specimen with a negative URT specimen. Figure 1. Performance of upper and lower respiratory tract SARS-CoV-2 PCR testing in children with artificial airways [Image: see text] CONCLUSION: Overall, most paired samples from the URT and LRT yielded concordant results with no pairs positive from the LRT and negative from the URT. These data support the CDC recommendation that URT specimens are the preferred initial SARS-CoV-2 test, while LRT specimens should be collected only from mechanically ventilated with suspected SARS-CoV-2. DISCLOSURES: All Authors: No reported disclosures |
format | Online Article Text |
id | pubmed-7776659 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-77766592021-01-07 425. The Utility of Paired Upper and Lower COVID-19 Sampling in Patients with Artificial Airways Kitt, Eimear Sammons, Julia S Chiotos, Kathleen Coffin, Susan E Coffin, Susan E Ballantine, Allison Gallagher, Elizabeth Mojica, Coralee DelValle O’Callaghan, Kevin P Kerman, Caryn Harris, Rebecca Bell, Louis Davis, Daniela Nord, Ellen Open Forum Infect Dis Poster Abstracts BACKGROUND: The Centers for Disease Control and Prevention (CDC) recommends upper respiratory tract (URT) polymerase chain reaction (PCR) testing as the initial diagnostic test for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Lower respiratory tract (LRT) testing for patients requiring mechanical ventilation is also recommended. The goal of this study was to evaluate concordance between paired URT and LRT specimens in children undergoing pre-admission/procedure screening or diagnostic testing. We hypothesized that < 10% of paired tests would have discordant results. METHODS: Single center cross-sectional study including children with artificial airways who had paired URT and LRT SARS-CoV-2 PCR testing between 4/1/2020 and 6/8/2020. URT specimens included nasopharyngeal (NP) swabs and aspirates. LRT specimens included tracheal aspirates and bronchoalveolar lavages. URT and LRT specimens were classified as paired if the two specimens were collected within 24 hours. Artificial airways included tracheostomies and endotracheal tubes. Tests were classified as diagnostic versus screening based on the indication selected in the order. RESULTS: 102 paired specimens were obtained during the study period. Fifty-nine were performed for screening and 43 were performed for diagnosis of suspected SARS-CoV-2. Overall, 94 specimens (92%) were concordant, including 89 negative from both sources and 5 positive from both sources. Eight specimens (8%) were discordant, all of which were positive from the URT and negative from the LRT (Figure 1). Among patients undergoing screening, 3 of 4 positive tests were discordant and among symptomatic patients, 5 of 9 positive tests were discordant. There were no instances of a positive LRT specimen with a negative URT specimen. Figure 1. Performance of upper and lower respiratory tract SARS-CoV-2 PCR testing in children with artificial airways [Image: see text] CONCLUSION: Overall, most paired samples from the URT and LRT yielded concordant results with no pairs positive from the LRT and negative from the URT. These data support the CDC recommendation that URT specimens are the preferred initial SARS-CoV-2 test, while LRT specimens should be collected only from mechanically ventilated with suspected SARS-CoV-2. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7776659/ http://dx.doi.org/10.1093/ofid/ofaa439.619 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Poster Abstracts Kitt, Eimear Sammons, Julia S Chiotos, Kathleen Coffin, Susan E Coffin, Susan E Ballantine, Allison Gallagher, Elizabeth Mojica, Coralee DelValle O’Callaghan, Kevin P Kerman, Caryn Harris, Rebecca Bell, Louis Davis, Daniela Nord, Ellen 425. The Utility of Paired Upper and Lower COVID-19 Sampling in Patients with Artificial Airways |
title | 425. The Utility of Paired Upper and Lower COVID-19 Sampling in Patients with Artificial Airways |
title_full | 425. The Utility of Paired Upper and Lower COVID-19 Sampling in Patients with Artificial Airways |
title_fullStr | 425. The Utility of Paired Upper and Lower COVID-19 Sampling in Patients with Artificial Airways |
title_full_unstemmed | 425. The Utility of Paired Upper and Lower COVID-19 Sampling in Patients with Artificial Airways |
title_short | 425. The Utility of Paired Upper and Lower COVID-19 Sampling in Patients with Artificial Airways |
title_sort | 425. the utility of paired upper and lower covid-19 sampling in patients with artificial airways |
topic | Poster Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776659/ http://dx.doi.org/10.1093/ofid/ofaa439.619 |
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