{"pk":14005,"title":"Practical Diagnostic Accuracy of Nasopharyngeal Swab Testing for Novel Coronavirus Disease 2019 (COVID-19)","subtitle":null,"abstract":"Introduction:\n The novel coronavirus (SARS-CoV-2) is the cause of COVID-19, which has had a devastating international impact. Prior reports of testing have reported low sensitivities of nasopharyngeal polymerase chain reaction (PCR), and reports of viral co-infections have varied from 0-20%. Therefore, we sought to determine the accuracy of nasopharyngeal PCR for COVID-19 and rates of viral co-infection.\nMethods: \nWe conducted a retrospective chart review of all patients who received viral testing between March 1, 2020–April 28, 2020. Test results of a complete viral pathogen panel and COVID-19 testing were abstracted. We compared patients with more than one COVID-19 test for diagnostic accuracy against the gold standard of chart review.\nResults:\n We identified 1950 patients, of whom 1024 were tested for COVID-19. There were 221 repeat tests for COVID-19. Among patients with a repeat test, COVID-19 swabs had a sensitivity of 84.6% (95% confidence interval (CI), 69.5-94.4%) and a specificity of 99.5% (95%CI, 97-100%) compared to a clinical and radiographic criterion reference by chart review. We found viral co-infection rates of 2.3% in patients without COVID-19 and 6.1% in patients with COVID-19. Rates of co-infection appeared to be related to base rates of infection in the community and not a specific property of COVID-19.\nConclusion: \nCOVID-19 nasopharyngeal PCR specimens are accurate but have imperfect sensitivity. Repeat testing for high-risk patients should be considered, and presence of an alternative virus should not be used to limit testing for COVID-19 for patients where it would affect treatment or isolation.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"COVID-19"},{"word":"coronavirus"},{"word":"PCR"},{"word":"diagnostic accuracy"},{"word":"polymerase chain reaction"},{"word":"SARS-CoV-2"},{"word":"nasopharyngeal"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6ds395fq","frozenauthors":[{"first_name":"Ravindra","middle_name":"","last_name":"Gopaul","name_suffix":"","institution":"Penn State Hershey Medical Center, Department of Emergency Medicine, Hershey, Pennsylvania","department":"None"},{"first_name":"Joshua","middle_name":"","last_name":"Davis","name_suffix":"","institution":"Vituity, Department of Emergency Medicine, Wichita, Kansas","department":"None"},{"first_name":"Linda","middle_name":"","last_name":"Gangai","name_suffix":"","institution":"Penn State Hershey Medical Center, Department of Emergency Medicine, Hershey, Pennsylvania","department":"None"},{"first_name":"Lianna","middle_name":"","last_name":"Goetz","name_suffix":"","institution":"Penn State Hershey Medical Center, Department of Anatomic and Clinical Pathology, Hershey, Pennsylvania","department":"None"}],"date_submitted":"2020-05-30T01:30:05+05:30","date_accepted":"2020-05-30T01:30:05+05:30","date_published":"2020-11-04T13:30:00+05:30","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/14005/galley/7267/download/"}]}