SARS-CoV-2 RNA

SARS - CoV - 2 RNA
  • 文章类型: Journal Article
    2019年冠状病毒病(COVID-19),由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起,是一种威胁生命的疾病,其发病机理未知。在这里,我们确定了最近从SARS-CoV-2感染中康复的人的玻璃体液中存在SARS-CoV-2特异性核糖核酸(RNA)和病毒相关抗体。
    这项横断面研究纳入了最近从SARS-CoV-2感染中康复的33名患者(33只眼)。测试玻璃体液和血清样品的SARS-CoV-2RNA和病毒相关抗体。
    在33名参与者中,血清和玻璃体液的SARS-CoV-2RNA检测均为阴性。血清中87.88%(29/33)和玻璃体液中6.10%(2/33)检测到SARS-CoV-2特异性IgM;血清中96.97%(32/33)和玻璃体液中81.82%(27/33)检测到SARS-CoV-2特异性IgG。血清和玻璃体液中IgM的表达差异有统计学意义(P<0.01)。而IgG则没有(P=0.11)。IgM阳性血清组和IgG阳性玻璃体液组的恢复天数均比阴性组的恢复天数长(P<0.01)。此外,根据血-视网膜屏障(BRB)衰竭风险的不同分组,玻璃体液中的抗体表达没有统计学差异(IgMP=0.49;IgGP=0.37).
    从COVID-19中恢复后,玻璃体液中未检测到SARS-CoV-2RNA,但在6.1%的参与者玻璃体液样本中检测到抗CoV-2IgM,在约80%的参与者玻璃体液样本中检测到IgG.我们还发现,血清和玻璃体液中SARS-CoV-2特异性抗体的阳性率均与感染后的恢复天数相关。
    UNASSIGNED: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a life-threatening disease with largely unknown intraocular pathogenesis. Herein, we determined the presence of SARS-CoV-2-specific ribonucleic acid (RNA) and virus-associated antibodies in the vitreous humor of people who have recently recovered from SARS-CoV-2 infection.
    UNASSIGNED: This cross-sectional study included 33 patients (33 eyes) who have recently recovered from SARS-CoV-2 infection. Vitreous humor and blood serum samples were tested for the SARS-CoV-2 RNA and virus-associated antibodies.
    UNASSIGNED: Among 33 participants, blood serum and vitreous humor were all tested negative for SARS-CoV-2 RNA. SARS-CoV-2-specific IgM was detected in 87.88 % (29/33) patients in blood serum and 6.10 % (2/33) in vitreous humor; SARS-CoV-2-specific IgG was detected in 96.97 % (32/33) patient in blood serum and 81.82 % (27/33) in vitreous humor. Statistical significance was found for IgM expression between blood serum and vitreous humor (P < 0.01), while IgG was not (P = 0.11). The days after recovery were statistically longer both in IgM-positive blood serum samples group and IgG-positive vitreous humor samples group compared with negative samples of each group (P < 0.01). Additionally, no statistical difference could be detected in antibody expression in vitreous humor between different groups divided on the condition of the risk of blood-retina-barrier (BRB) failure (P = 0.49 for IgM; P = 0.37 for IgG).
    UNASSIGNED: After recovering from COVID-19, no SARS-CoV-2 RNA was detected in vitreous humor, but anti-CoV-2 IgM was detected in 6.1 % and IgG in approximately 80 % of vitreous humor samples of participants. We also found that the positivety rate of SARS-CoV-2-specific antibodies in the blood serum and vitreous humor were both correlated with the days after recovery since the infection.
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  • 文章类型: Journal Article
    自2019年底以来,由SARS-CoV-2病毒引起的COVID-19大流行已经严重影响了整个世界。现在SARS-CoV-2诊断测试不仅需要对疑似感染者进行筛查,但也已成为一个常规的诊断为所有的人在一个地方出现了新的病例,以控制该地区的疾病传播。由于这些原因,为了避免未被发现的感染,非常需要用于检测SARS-CoV-2的灵敏方法。此外,使用合并标本的样本合并已被常规用作SARS-CoV-2社区监测的时间和成本效益策略。在这方面,个体的每个病毒RNA样品的含量将在检测中进一步稀释;因此,更高的检测灵敏度将是更可取的。在基于核酸的检测方法中,等温核酸扩增被认为是非常有前途的,因为它们通常需要更少的时间来完成测试(甚至少于20分钟),而不需要热循环。因此,它不需要使用高成本的实时PCR机。根据最近公布的等温核酸扩增方法,逆转录重组酶聚合酶扩增(RT-RPA)方法在测试反应中显示出高达单拷贝灵敏度的出色灵敏度。本章将重点介绍如何利用RT-RPA技术灵敏检测SARS-CoV-2RNA。此外,将总结最近发表的基于RT-RPA的检测方法,并比较它们的检测参数以及所用的引物和探针。此外,我们还将重点介绍如何设计超灵敏的RT-RPA检测方法以及进行检测所需的注意事项。此外,根据我们最近的报告,我们还将详细介绍我们开发的使用修饰的RT-RPA检测SARS-CoV-2RNA的方法,或RT-ERA,具有单拷贝灵敏度和超出此方法的可能扩展。
    The occurrence of the COVID-19 pandemic caused by the SARS-CoV-2 virus since the end of 2019 has significantly affected the entire world. Now SARS-CoV-2 diagnostic tests are not only required for screening of suspected infected people for their medical treatment, but have also become a routine diagnosis for all people at a place where new cases have emerged in order to control spread of the disease from that region. For these reasons, sensitive methods for detection of SARS-CoV-2 are highly needed in order to avoid undetected infections. In addition, sample pooling that uses pooled specimens has been routinely employed as a time- and cost-effective strategy for community monitoring of SARS-CoV-2. In this regard, the content of each viral RNA sample of an individual will be further diluted in detection; therefore, higher detection sensitivity would be rather preferred. Among nucleic acid-based detection methods, isothermal nucleic acid amplifications are considered quite promising because they typically take less time to complete the test (even less than 20 min) without the need of thermal cycles. Hence, it does not necessitate the use of highly costly real-time PCR machines. According to recently published isothermal nucleic acid amplification methods, the reverse transcription recombinase polymerase amplification (RT-RPA) approach shows outstanding sensitivity with up to single-copy sensitivity in a test reaction. This chapter will mainly focus on how to employ RT-RPA technology to sensitively detect SARS-CoV-2 RNA. Besides, recently published RT-RPA based detection methods will be summarized and compared regarding their detection parameters and the primers and probes being used. In addition, we will also highlight the key considerations on how to design an ultrasensitive RT-RPA assay and the precautions needed to conduct the assay. Moreover, based on our recent report, we will also detail the methods we developed to detect SARS-CoV-2 RNA using modified RT-RPA, or RT-ERA, with single-copy sensitivity and the possible extensions beyond this method.
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  • 文章类型: Journal Article
    核酸检测有利于防止COVID-19大流行的传播。在这项工作中,我们通过将发夹报告探针锚定在细胞膜上,成功地设计了一种软界面限制的DNA步行器,用于检测SARS-CoV-2变体。在靶RNA的存在下,发夹探针H1和H2之间发生循环自组装反应,目标RNA在细胞膜上的连续行走导致荧光信号逐渐放大。H1在膜上的富集和膜独特的流动性促进了反应过程中DNA链之间的碰撞效率,该方法具有较高的灵敏度。此外,在5%正常人血清中合成RNA的双盲试验表明,该方法具有良好的稳定性和在复杂环境下的抗干扰性,在临床诊断中表现出巨大的潜力。
    Nucleic acid detection is conducive to preventing the spread of COVID-19 pandemic. In this work, we successfully designed a soft interface confined DNA walker by anchoring hairpin reporter probes on cell membranes for the detection of SARS-CoV-2 variants. In the presence of target RNA, the cyclic self-assembly reaction occurred between hairpin probes H1 and H2, and the continuous walking of target RNA on cell membranes led to the gradual amplification of fluorescence signal. The enrichment of H1 on membranes and the unique fluidity of membranes promoted the collision efficiency between DNA strands in the reaction process, endowing this method with high sensitivity. In addition, the double-blind test of synthetic RNA in 5% normal human serum demonstrated the good stability and anti-interference in complex environment of this method, which exhibited great potential in clinical diagnostics.
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  • 文章类型: Journal Article
    生物流体中的核酸是用于疾病的分子诊断的新兴生物标志物。但是由于缺乏灵敏的检测方法,它们的临床应用受到了阻碍。在这里,我们报告了通过将具有内切核酸酶能力的催化DNAzyme合理设计成统一的单链变构生物传感器,开发了一种名为SPOT(用于核酸检测的灵敏环启动的DNAzyme生物传感器)的灵敏核酸检测方法。一旦特定序列的核酸靶标结合到其变构模块,SPOT就被激活,以使得分子报道分子的连续切割成为可能。SPOT为敏感、低丰度核酸的方便和成本有效的检测。为了进行临床验证,我们证明了SPOT可以检测血清miRNA,用于诊断乳腺癌,胃癌和前列腺癌。此外,SPOT对来自临床拭子的SARS-CoV-2RNA表现出有效的检测性能,具有高灵敏度和特异性。最后,SPOT与诸如侧流测定的护理点测试模式兼容。因此,我们设想SPOT可作为一种稳健的检测方法,用于灵敏检测多种核酸靶标,从而实现临床分子诊断.
    Nucleic acids in biofluids are emerging biomarkers for the molecular diagnostics of diseases, but their clinical use has been hindered by the lack of sensitive detection assays. Herein, we report the development of a sensitive nucleic acid detection assay named SPOT (sensitive loop-initiated DNAzyme biosensor for nucleic acid detection) by rationally designing a catalytic DNAzyme of endonuclease capability into a unified one-stranded allosteric biosensor. SPOT is activated once a nucleic acid target of a specific sequence binds to its allosteric module to enable continuous cleavage of molecular reporters. SPOT provides a highly robust platform for sensitive, convenient and cost-effective detection of low-abundance nucleic acids. For clinical validation, we demonstrated that SPOT could detect serum miRNAs for the diagnostics of breast cancer, gastric cancer and prostate cancer. Furthermore, SPOT exhibits potent detection performance over SARS-CoV-2 RNA from clinical swabs with high sensitivity and specificity. Finally, SPOT is compatible with point-of-care testing modalities such as lateral flow assays. Hence, we envision that SPOT may serve as a robust assay for the sensitive detection of a variety of nucleic acid targets enabling molecular diagnostics in clinics.
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  • 文章类型: Journal Article
    提高严重急性呼吸道综合征冠状病毒2(SARS-CoV-2)RNA标本的检测能力和效率对于预防和控制2019年冠状病毒病(COVID-19)的爆发非常重要。在这项研究中,我们评估了2022年4月和7月流程重组前后两次COVID-19暴发的检测能力和效率.
    这项回顾性横断面研究涉及359,845例SARS-CoV-2RNA标本,这些标本在4月和7月两次COVID-19爆发前2周和2周后。数字,标本的运输时间和检测时间,采用SPSS软件对24h以上的报告数进行分析。
    虽然16.84%的人选择了鼻咽拭子(NPS)标本,83.16%选择口咽拭子(OPS)标本检测SARS-CoV-2RNA。从过程重新设计前的4月到过程重新设计后的7月,10个样本合并(P-10)的百分比呈显着上升趋势(p<0.001)。与四月相比,7月标本数量不仅在COVID-19爆发前2周,而且在爆发后2周也显着增加,分别增加了35.46和93.94%,分别。在重新设计流程之后,7月COVID-19爆发前后2周超过24小时的报告数量明显低于流程重新设计前的4月(0%vs.0.06%和0vs.0.89%,两者p<0.001)。
    本研究表明,加强多部门在流程再造中的合作,特别是使用P-10策略和全过程信息化可以提高SARS-CoV-2RNA标本的检测能力和效率。
    Improving the detection capability and efficiency of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA specimens is very important for the prevention and control of the outbreak of Coronavirus disease 2019 (COVID-19). In this study, we evaluated the detection capability and efficiency of two outbreaks of COVID-19 before and after the process re-engineering in April and July 2022.
    This retrospective cross-sectional study involved 359,845 SARS-CoV-2 RNA specimens 2 weeks before and 2 weeks after the two outbreaks of COVID-19 in April and July. The number, transportation time and detection time of specimens, and the number of reports of more than 24 h were analyzed by SPSS software.
    While 16.84% of people chose nasopharyngeal swabs (NPS) specimens, 83.16% chose oropharyngeal swabs (OPS) specimens to detect SARS-CoV-2 RNA. There were significant upward trends in the percentage of 10 sample pooling (P-10) from April before process re-engineering to July after process re-engineering (p < 0.001). Compared with April, the number of specimens in July increased significantly not only 2 weeks before but also 2 weeks after the outbreak of COVID-19, with an increase of 35.46 and 93.94%, respectively. After the process re-engineering, the number of reports more than 24 h in the 2 weeks before and after the outbreak of COVID-19 in July was significantly lower than that in April before process re-engineering (0% vs. 0.06% and 0 vs. 0.89%, both p < 0.001).
    The present study shows that strengthening the cooperation of multi-departments in process re-engineering, especially using the P-10 strategy and whole process informatization can improve the detection capability and efficiency of SARS-CoV-2 RNA specimens.
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  • 文章类型: Journal Article
    对非人类灵长类动物的研究,野生型和转基因小鼠已经显示出SARS-CoV-2RNA成分在大脑中的存在。尽管血脑屏障(BBB)提供保护,但是关于SARS-CoV-2如何穿过BBB的证据较少。鉴于Omicron的再感染率增加,传播率和参与导致神经功能障碍,我们假设研究Omicron变异体(B.1.1.529)如何在结构上与关键的BBB维持蛋白结合,从而可能挑战其完整性和转运至大脑.通过使用分子动力学模拟方法,我们检查了Omicron变体(B.1.1.29)与位于BBB的不同结构和转运蛋白的相互作用。我们的结果表明,在ZonaOcludin1-RBD复合物中,我们观察到一个独特的模式。Omicron的对接评分为-88.9±6.8kcal/mol,有6个相互作用,而野生型(WT)的分数更高,为-94.0±2.3kcal/mol,形成八种互动。比较亲和力,WT-RBD对Claudin-5表现出更强的偏好,拥有-110.2±3.0的对接分数和9个相互作用,与Omicron-RBD相比,参与度略有降低,对接评分为-105.6±0.2,有7个相互作用。有趣的是,Omicron变体在与葡萄糖转运蛋白和ABC转运蛋白的相互作用中表现出更高的稳定性,注册对接得分-110.6±1.9和-112.0±3.6kcal/mol,分别。这超过了WT各自的分数-95.2±2.2和-104.0±6.2kcal/mol,反映了独特的互动概况。严格的分子动力学模拟验证了我们的发现。我们的研究强调了Omicron变体对转运蛋白的亲和力增加,阐明对血脑屏障完整性和脑运输的潜在影响。虽然这些见解提供了一个有价值的框架,全面的实验验证是全面理解不可缺少的。
    Studies on nonhuman primates, wild-type and transgenic mice have shown the presence of SARS-CoV-2 RNA components in the brains. Despite the Blood-Brain Barrier (BBB) provides protection there are less evidences on how the SARS-CoV-2 crosses the BBB. Given that there is an increase of Omicron reinfection rates, transmissibility rate and involvement to cause neurological dysfunctions, we hypothesized to investigate how the Omicron variant (B.1.1.529) binds structurally to key BBB-maintaining proteins and thus can possibly challenge the integrity and transportation to the brain. By using molecular dynamics simulation approaches we examined the interaction of Omicron variant (B.1.1.529) with different structural and transporter proteins located at the BBB. Our results show that in Zona Ocludin 1-RBD complex, we observe a distinct pattern. Omicron demonstrates a docking score of -88.9 ± 6.8 kcal/mol and six interactions, while the wild type (WT) presents a higher score of -94.0 ± 2.3 kcal/mol, forming eight interactions. Comparing affinities, the WT-RBD displays a stronger preference for Claudin-5, boasting a docking score of -110.2 ± 3.0 and nine interactions, versus Omicron-RBD\'s slightly reduced engagement, with a docking score of -105.6 ± 0.2 and seven interactions. Interestingly, the Omicron variant exhibits heightened stability in interactions with Glucose Transporter and ABC transporters, registering docking scores of -110.6 ± 1.9 and -112.0 ± 3.6 kcal/mol, respectively. This surpasses the WT\'s respective scores of -95.2 ± 2.2 and -104.0 ± 6.2 kcal/mol, reflecting a unique interaction profile. Rigorous molecular dynamics simulations validate our findings. Our study emphasizes the Omicron variant\'s increased affinity towards transporter proteins, illuminating potential implications for BBB integrity and brain transportation. While these insights offer a valuable framework, comprehensive experimental validation is indispensable for a comprehensive understanding.
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  • 文章类型: Journal Article
    Inadequate sampling approaches to wastewater analyses can introduce biases, leading to inaccurate results such as false negatives and significant over- or underestimation of average daily viral concentrations, due to the sporadic nature of viral input. To address this challenge, we conducted a field trial within the University of Tennessee residence halls, employing different composite sampling modes that encompassed different time intervals (1 h, 2 h, 4 h, 6 h, and 24 h) across various time windows (morning, afternoon, evening, and late-night). Our primary objective was to identify the optimal approach for generating representative composite samples of SARS-CoV-2 from raw wastewater. Utilizing reverse transcription-quantitative polymerase chain reaction, we quantified the levels of SARS-CoV-2 RNA and pepper mild mottle virus (PMMoV) RNA in raw sewage. Our findings consistently demonstrated that PMMoV RNA, an indicator virus of human fecal contamination in water environment, exhibited higher abundance and lower variability compared to pathogenic SARS-CoV-2 RNA. Significantly, both SARS-CoV-2 and PMMoV RNA exhibited greater variability in 1 h individual composite samples throughout the entire sampling period, contrasting with the stability observed in other time-based composite samples. Through a comprehensive analysis of various composite sampling modes using the Quade Nonparametric ANCOVA test with date, PMMoV concentration and site as covariates, we concluded that employing a composite sampler during a focused 6 h morning window for pathogenic SARS-CoV-2 RNA is a pragmatic and cost-effective strategy for achieving representative composite samples within a single day in wastewater-based epidemiology applications. This method has the potential to significantly enhance the accuracy and reliability of data collected at the community level, thereby contributing to more informed public health decision-making during a pandemic.
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  • 文章类型: Journal Article
    严重急性呼吸系统综合症冠状病毒2(SARS-CoV-2)可能通过空气传播途径传播,特别是当气溶胶颗粒保留在通风不足的封闭空间中时。由于分析前和技术方面的限制,没有标准的推荐方法来确定空气中的病毒。此外,空气样本中病毒载量低可能导致假阴性。我们的研究旨在探讨使用液滴数字聚合酶链反应(ddPCR)检测空气样品中SARS-CoV-2核糖核酸(RNA)的可行性。在2021年12月至2022年2月之间进行了主动和被动空气采样,在两家医院和巴生谷的一个检疫中心发现了COVID-19确诊病例,马来西亚。使用ddPCR和实时逆转录酶聚合酶链反应(RT-PCR)检测和定量空气中的SARS-CoV-2RNA。还研究了两种不同的数字PCR平台(QX200和QIAcuity)与RT-PCR的可比性。另外,进行负染色透射电子显微镜以可视化病毒超微结构。使用ddPCR检测空气样品中SARS-CoV-2的检出率高于RT-PCR,分别为15.2%(22/145)和3.4%(5/145),分别。ddPCR的敏感性和特异性分别为100%和87%,分别。在QX200和QIAcuity排除17个阴性样本(50%)后,发现15%的样品(5/34)为ddPCR和dPCR均为阳性。有23.5%(8/34)的样品通过ddPCR检测为阳性,但通过dPCR检测为阴性。相比之下,dPCR检测阳性但ddPCR阴性的样本占11.7%(4/34)。通过ddPCR的SARS-CoV-2检测方法精确且对病毒RNA检测具有较高的灵敏度。它可以在确定空气样本中的低病毒滴度以减少假阴性报告方面提供进展,这可以补充RT-PCR的检测。
    Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) may transmit through airborne route particularly when the aerosol particles remain in enclosed spaces with inadequate ventilation. There has been no standard recommended method of determining the virus in air due to limitations in pre-analytical and technical aspects. Furthermore, the presence of low virus loads in air samples could result in false negatives. Our study aims to explore the feasibility of detecting SARS-CoV-2 ribonucleic acid (RNA) in air samples using droplet digital polymerase chain reaction (ddPCR). Active and passive air sampling was conducted between December 2021 and February 2022 with the presence of COVID-19 confirmed cases in two hospitals and a quarantine center in Klang Valley, Malaysia. SARS-CoV-2 RNA in air was detected and quantified using ddPCR and real-time reverse transcriptase-polymerase chain reaction (RT-PCR). The comparability of two different digital PCR platforms (QX200 and QIAcuity) to RT-PCR were also investigated. Additionally negative staining transmission electron microscopy was performed to visualize virus ultrastructure. Detection rates of SARS-CoV-2 in air samples using ddPCR were higher compared to RT-PCR, which were 15.2% (22/145) and 3.4% (5/145), respectively. The sensitivity and specificity of ddPCR was 100 and 87%, respectively. After excluding 17 negative samples (50%) by both QX200 and QIAcuity, 15% samples (5/34) were found to be positive both ddPCR and dPCR. There were 23.5% (8/34) samples that were detected positive by ddPCR but negative by dPCR. In contrast, there were 11.7% (4/34) samples that were detected positive by dPCR but negative by ddPCR. The SARS-CoV-2 detection method by ddPCR is precise and has a high sensitivity for viral RNA detection. It could provide advances in determining low viral titter in air samples to reduce false negative reports, which could complement detection by RT-PCR.
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  • 文章类型: Journal Article
    严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)感染已被证明可在受感染个体的血液中检测到。尽管RNA血症的频率通常很低,潜在感染性病毒的存在可能会在输血过程中造成传播风险。
    从献血者收集存档的血浆样本,这些献血者后来报告可能感染了野生型菌株的SARS-CoV-2,Delta变体,或Omicron变体。这是基于他们捐赠后2周内的症状发作或阳性测试。测试了捐赠的SARS-CoV-2RNA,在捐赠后访谈期间收集了有关症状和检测结果的信息。
    在测试的518个存档血浆样品中,发现19(3.7%)具有可检测水平的SARS-CoV-2RNA。在Delta(10/141[7.1%])和Omicron(9/162[5.6%])波期间捐赠的供体中检测到SARS-CoV-2RNA。在野生型波期间捐赠的供体中未检测到SARS-CoV-2RNA(0/215)。19个RNAemic捐赠者中有17个在捐赠后2天内报告了症状发作或阳性测试。在无症状或有症状的献血者中检测到SARS-CoV-2RNA。
    尽管RNA血症与SARS-CoV-2疾病严重程度相关,在无症状或症状前献血者中检测到RNA血症。
    UNASSIGNED: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been shown to be detectable in blood from infected individuals. Though RNAemia frequencies are typically low, the presence of potentially infectious virus potentially poses a transmission risk during blood transfusion.
    UNASSIGNED: Archived plasma samples were collected from blood donors who later reported possible SARS-CoV-2 infection with the wild-type strain, Delta variant, or Omicron variant. This was based on either symptom onset or a positive test within 2 weeks from their donation. Donations were tested for SARS-CoV-2 RNA, and information on symptoms and testing results were gathered during postdonation interview.
    UNASSIGNED: Of 518 archived plasma samples tested, 19 (3.7%) were found to have detectable levels of SARS-CoV-2 RNA. SARS-CoV-2 RNA was detected in donors who donated during the Delta (10/141 [7.1%]) and Omicron (9/162 [5.6%]) waves. SARS-CoV-2 RNA was not detected in donors who donated during the wild-type wave (0/215). Seventeen of 19 RNAemic donors reported symptom onset or a positive test within 2 days of donating. SARS-CoV-2 RNA was detected in asymptomatic or presymptomatic blood donors.
    UNASSIGNED: Despite RNAemia being correlated with SARS-CoV-2 disease severity, RNAemia was detected in asymptomatic or presymptomatic blood donors.
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  • 文章类型: Clinical Trial
    大多数评估2019年冠状病毒病(COVID-19)疗法的临床试验包括抗病毒活性的评估。在最近完成的门诊试验中,鼻部严重急性呼吸综合征冠状病毒2(SARS-CoV-2)RNA水平相对于基线的变化通常使用协方差分析(ANCOVA)或重复测量混合模型(MMRM)进行评估,结果低于测定定量下限(LLoQ).用单个估算值分析病毒RNA水平的变化可能导致对治疗效果的偏倚估计。在这篇文章中,使用ACTIV-2试验中的一个说明性例子,当使用ANCOVA或MMRM方法时,我们强调了潜在的填补陷阱,并说明在考虑值 Most clinical trials evaluating coronavirus disease 2019 (COVID-19) therapeutics include assessments of antiviral activity. In recently completed outpatient trials, changes in nasal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA levels from baseline were commonly assessed using analysis of covariance (ANCOVA) or mixed models for repeated measures (MMRM) with single imputation for results below assay lower limits of quantification (LLoQ). Analyzing changes in viral RNA levels with singly imputed values can lead to biased estimates of treatment effects. In this article, using an illustrative example from the ACTIV-2 trial, we highlight potential pitfalls of imputation when using ANCOVA or MMRM methods, and illustrate how these methods can be used when considering values
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