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Analysis of a persistent viral shedding patient infected with SARS-CoV-2 by RT-qPCR, FilmArray Respiratory Panel v2.1, and antigen detection.
J Infect Chemother. 2021 Feb; 27(2):406-409.JI

Abstract

Various diagnostic tests utilizing different principles are currently under development for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, these tests can occasionally produce discrepant results, causing confusion in their interpretation. Here, we evaluated the performance and features of three diagnostic assays: quantitative reverse transcription polymerase chain reaction (RT-qPCR), FilmArray Respiratory Panel (RP) v2.1, and the LUMIPULSE antigen test. Twenty-seven serial nasopharyngeal swabs were collected from a prolonged viral shedding patient who had been hospitalized for 51 days. We examined the SARS-CoV-2 detection rates of the three tests. The overall agreement rate was 81% between RT-qPCR and FilmArray RP v2.1, 63% between the antigen test and FilmArray RP v2.1, and 59% between the antigen test and RT-qPCR. We obtained concordant results in samples with high viral loads (low threshold cycle values) by all three tests. RT-qPCR and FilmArray RP v2.1 accurately detected SARS-CoV-2 at the early to intermediate phases of infection, but the results varied at the late phase. The antigen test also produced a positive result at the early phase but varied at the intermediate phase and consistently produced negative results at late phase of infection. These results demonstrated FilmArray RP v2.1 could detect SARS-CoV-2 with accuracy comparable to RT-qPCR. Further, there were discrepant results using different types of diagnostic tests during the clinical course of prolonged viral shedding patient. We provided insights into how to utilize different types of kits to assess and manage SARS-CoV-2 infections.

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Authors+Show Affiliations

Hirotsu Y
Genome Analysis Center, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan. Electronic address: hirotsu-bdyu@ych.pref.yamanashi.jp.
Maejima M
Division of Microbiology in Clinical Laboratory, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan.
Shibusawa M
Division of Microbiology in Clinical Laboratory, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan.
Amemiya K
Division of Genetics and Clinical Laboratory, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan.
Nagakubo Y
Division of Microbiology in Clinical Laboratory, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan; Division of Genetics and Clinical Laboratory, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan.
Hosaka K
Division of Microbiology in Clinical Laboratory, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan.
Sueki H
Division of Microbiology in Clinical Laboratory, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan.
Hayakawa M
Central Clinical Laboratory, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan.
Mochizuki H
Genome Analysis Center, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan; Central Clinical Laboratory, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan; Department of Gastroenterology, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan.
Tsutsui T
Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan.
Kakizaki Y
Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan.
Miyashita Y
Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan.
Omata M
Department of Gastroenterology, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, Japan; The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.

MeSH

Antigens, ViralCOVID-19COVID-19 TestingHumansMultiplex Polymerase Chain ReactionNasopharynxRNA, ViralReverse Transcriptase Polymerase Chain ReactionSARS-CoV-2Sensitivity and SpecificityViral LoadVirus Shedding

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33183963

Citation

Hirotsu, Yosuke, et al. "Analysis of a Persistent Viral Shedding Patient Infected With SARS-CoV-2 By RT-qPCR, FilmArray Respiratory Panel V2.1, and Antigen Detection." Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy, vol. 27, no. 2, 2021, pp. 406-409.
Hirotsu Y, Maejima M, Shibusawa M, et al. Analysis of a persistent viral shedding patient infected with SARS-CoV-2 by RT-qPCR, FilmArray Respiratory Panel v2.1, and antigen detection. J Infect Chemother. 2021;27(2):406-409.
Hirotsu, Y., Maejima, M., Shibusawa, M., Amemiya, K., Nagakubo, Y., Hosaka, K., Sueki, H., Hayakawa, M., Mochizuki, H., Tsutsui, T., Kakizaki, Y., Miyashita, Y., & Omata, M. (2021). Analysis of a persistent viral shedding patient infected with SARS-CoV-2 by RT-qPCR, FilmArray Respiratory Panel v2.1, and antigen detection. Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy, 27(2), 406-409. https://doi.org/10.1016/j.jiac.2020.10.026
Hirotsu Y, et al. Analysis of a Persistent Viral Shedding Patient Infected With SARS-CoV-2 By RT-qPCR, FilmArray Respiratory Panel V2.1, and Antigen Detection. J Infect Chemother. 2021;27(2):406-409. PubMed PMID: 33183963.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Analysis of a persistent viral shedding patient infected with SARS-CoV-2 by RT-qPCR, FilmArray Respiratory Panel v2.1, and antigen detection. AU - Hirotsu,Yosuke, AU - Maejima,Makoto, AU - Shibusawa,Masahiro, AU - Amemiya,Kenji, AU - Nagakubo,Yuki, AU - Hosaka,Kazuhiro, AU - Sueki,Hitomi, AU - Hayakawa,Miyoko, AU - Mochizuki,Hitoshi, AU - Tsutsui,Toshiharu, AU - Kakizaki,Yumiko, AU - Miyashita,Yoshihiro, AU - Omata,Masao, Y1 - 2020/10/29/ PY - 2020/08/09/received PY - 2020/10/20/revised PY - 2020/10/26/accepted PY - 2020/11/14/pubmed PY - 2021/1/30/medline PY - 2020/11/13/entrez KW - Antigen KW - COVID-19 KW - FilmArray KW - RT-qPCR KW - SARS-CoV-2 SP - 406 EP - 409 JF - Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy JO - J Infect Chemother VL - 27 IS - 2 N2 - Various diagnostic tests utilizing different principles are currently under development for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, these tests can occasionally produce discrepant results, causing confusion in their interpretation. Here, we evaluated the performance and features of three diagnostic assays: quantitative reverse transcription polymerase chain reaction (RT-qPCR), FilmArray Respiratory Panel (RP) v2.1, and the LUMIPULSE antigen test. Twenty-seven serial nasopharyngeal swabs were collected from a prolonged viral shedding patient who had been hospitalized for 51 days. We examined the SARS-CoV-2 detection rates of the three tests. The overall agreement rate was 81% between RT-qPCR and FilmArray RP v2.1, 63% between the antigen test and FilmArray RP v2.1, and 59% between the antigen test and RT-qPCR. We obtained concordant results in samples with high viral loads (low threshold cycle values) by all three tests. RT-qPCR and FilmArray RP v2.1 accurately detected SARS-CoV-2 at the early to intermediate phases of infection, but the results varied at the late phase. The antigen test also produced a positive result at the early phase but varied at the intermediate phase and consistently produced negative results at late phase of infection. These results demonstrated FilmArray RP v2.1 could detect SARS-CoV-2 with accuracy comparable to RT-qPCR. Further, there were discrepant results using different types of diagnostic tests during the clinical course of prolonged viral shedding patient. We provided insights into how to utilize different types of kits to assess and manage SARS-CoV-2 infections. SN - 1437-7780 UR - https://www.unboundmedicine.com/medline/citation/33183963/Analysis_of_a_persistent_viral_shedding_patient_infected_with_SARS_CoV_2_by_RT_qPCR_FilmArray_Respiratory_Panel_v2_1_and_antigen_detection_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1341-321X(20)30396-2 DB - PRIME DP - Unbound Medicine ER -