Rapid Implementation of Severe Acute Respiratory Syndrome Coronavirus 2 Emergency Use Authorization RT-PCR Testing and Experience at an Academic Medical Institution.

TitleRapid Implementation of Severe Acute Respiratory Syndrome Coronavirus 2 Emergency Use Authorization RT-PCR Testing and Experience at an Academic Medical Institution.
Publication TypeJournal Article
Year of Publication2021
AuthorsVelu P, Craney A, Ruggiero P, Sipley J, Cong L, Hissong EM, Loda M, Westblade LF, Cushing M, Rennert H
JournalJ Mol Diagn
Volume23
Issue2
Pagination149-158
Date Published2021 02
ISSN1943-7811
KeywordsAcademies and Institutes, Adolescent, Adult, Aged, Aged, 80 and over, Biological Assay, Child, Child, Preschool, Cohort Studies, COVID-19, COVID-19 Testing, Female, Humans, Infant, Infant, Newborn, Limit of Detection, Male, Middle Aged, Nasopharynx, Reproducibility of Results, Reverse Transcriptase Polymerase Chain Reaction, SARS-CoV-2, Sensitivity and Specificity, Sputum, Young Adult
Abstract

An epidemic caused by an outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China in December 2019 has since rapidly spread internationally, requiring urgent response from the clinical diagnostics community. We present a detailed overview of the clinical validation and implementation of the first laboratory-developed real-time RT-PCR test offered in the NewYork-Presbyterian Hospital system following the Emergency Use Authorization issued by the US Food and Drug Administration. Nasopharyngeal and sputum specimens (n = 174) were validated using newly designed dual-target real-time RT-PCR (altona RealStar SARS-CoV-2 Reagent) for detecting SARS-CoV-2 in upper respiratory tract and lower respiratory tract specimens. Accuracy testing demonstrated excellent assay agreement between expected and observed values and comparable diagnostic performance to reference tests. The limit of detection was 2.7 and 23.0 gene copies per reaction for nasopharyngeal and sputum specimens, respectively. Retrospective analysis of 1694 upper respiratory tract specimens from 1571 patients revealed increased positivity in older patients and males compared with females, and an increasing positivity rate from approximately 20% at the start of testing to 50% at the end of testing 3 weeks later. Herein, we demonstrate that the assay accurately and sensitively identifies SARS-CoV-2 in multiple specimen types in the clinical setting and summarize clinical data from early in the epidemic in New York City.

DOI10.1016/j.jmoldx.2020.10.019
Alternate JournalJ Mol Diagn
PubMed ID33285285
PubMed Central IDPMC7718583
Related Faculty: 
Hanna Rennert, Ph.D. Lars Westblade, Ph.D. Massimo Loda, M.D. Melissa Cushing, M.D. Priya Velu, M.D., Ph.D.

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