Clinical utility of SARS-CoV-2 subgenomic RT-PCR in a pediatric quaternary care setting
Copyright © 2023 Elsevier B.V. All rights reserved..
BACKGROUND: During active transcription, SARS-CoV-2 generates subgenomic regions of viral RNA. While standard SARS-CoV-2 RT-PCR amplifies region(s) of genomic RNA, it cannot distinguish active infection from remnant viral genomic material. However, screening for subgenomic RNA (sgRNA) by RT-PCR may aid in the determination of actively transcribing virus.
OBJECTIVES: To evaluate the clinical utility of SARS-CoV-2 sgRNA RT-PCR testing in a pediatric population.
STUDY DESIGN: Retrospective analysis was performed on inpatients from February-September 2022 positive for SARS-CoV-2 by RT-PCR with a concomitant order for sgRNA RT-PCR. Chart abstractions were conducted to determine clinical outcomes, management, and infection prevention and control (IPC) practices.
RESULTS: Of 95 SARS-CoV-2 positive samples from 75 unique patients, 27 (28.4%) were positive by sgRNA RT-PCR. A negative sgRNA RT-PCR test allowed for de-isolation in 68 (71.6%) patient episodes. Regardless of age or sex, a positive sgRNA RT-PCR result significantly correlated with disease severity (P = 0.007), generalized COVID-19 symptoms (P = 0.012), hospitalization for COVID-19 (P = 0.019), and immune status (P = 0.024). Moreover, sgRNA RT-PCR results prompted changes in management in 28 patients (37.3%); specifically, therapeutic escalation in 13/27 (48.1%) positives and de-escalation in 15/68 (22.1%) negatives.
CONCLUSIONS: Taken together, these findings underscore the clinical utility of sgRNA RT-PCR testing in a pediatric population as we report significant associations between sgRNA RT-PCR results and clinical parameters related to COVID-19. These findings align with the proposed use of sgRNA RT-PCR testing to guide patient management and IPC practices in the hospital setting.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:164 |
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| Enthalten in: |
Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology - 164(2023) vom: 05. Juli, Seite 105494 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Osborn, Lucas J [VerfasserIn] |
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| Links: |
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| Themen: |
Clinical utility |
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| Anmerkungen: |
Date Completed 09.06.2023 Date Revised 11.06.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jcv.2023.105494 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM357133811 |
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| 100 | 1 | |a Osborn, Lucas J |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clinical utility of SARS-CoV-2 subgenomic RT-PCR in a pediatric quaternary care setting |
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| 500 | |a Date Revised 11.06.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND: During active transcription, SARS-CoV-2 generates subgenomic regions of viral RNA. While standard SARS-CoV-2 RT-PCR amplifies region(s) of genomic RNA, it cannot distinguish active infection from remnant viral genomic material. However, screening for subgenomic RNA (sgRNA) by RT-PCR may aid in the determination of actively transcribing virus | ||
| 520 | |a OBJECTIVES: To evaluate the clinical utility of SARS-CoV-2 sgRNA RT-PCR testing in a pediatric population | ||
| 520 | |a STUDY DESIGN: Retrospective analysis was performed on inpatients from February-September 2022 positive for SARS-CoV-2 by RT-PCR with a concomitant order for sgRNA RT-PCR. Chart abstractions were conducted to determine clinical outcomes, management, and infection prevention and control (IPC) practices | ||
| 520 | |a RESULTS: Of 95 SARS-CoV-2 positive samples from 75 unique patients, 27 (28.4%) were positive by sgRNA RT-PCR. A negative sgRNA RT-PCR test allowed for de-isolation in 68 (71.6%) patient episodes. Regardless of age or sex, a positive sgRNA RT-PCR result significantly correlated with disease severity (P = 0.007), generalized COVID-19 symptoms (P = 0.012), hospitalization for COVID-19 (P = 0.019), and immune status (P = 0.024). Moreover, sgRNA RT-PCR results prompted changes in management in 28 patients (37.3%); specifically, therapeutic escalation in 13/27 (48.1%) positives and de-escalation in 15/68 (22.1%) negatives | ||
| 520 | |a CONCLUSIONS: Taken together, these findings underscore the clinical utility of sgRNA RT-PCR testing in a pediatric population as we report significant associations between sgRNA RT-PCR results and clinical parameters related to COVID-19. These findings align with the proposed use of sgRNA RT-PCR testing to guide patient management and IPC practices in the hospital setting | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Clinical utility | |
| 650 | 4 | |a PCR | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a Subgenomic | |
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| 650 | 7 | |a Subgenomic RNA |2 NLM | |
| 700 | 1 | |a Chen, Pei Ying |e verfasserin |4 aut | |
| 700 | 1 | |a Flores-Vazquez, Jessica |e verfasserin |4 aut | |
| 700 | 1 | |a Mestas, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Salas, Edahrline |e verfasserin |4 aut | |
| 700 | 1 | |a Glucoft, Marisa |e verfasserin |4 aut | |
| 700 | 1 | |a Smit, Michael A |e verfasserin |4 aut | |
| 700 | 1 | |a Costales, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Dien Bard, Jennifer |e verfasserin |4 aut | |
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