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Objective: The reverse transcription-polymerase chain reaction (RT-PCR) analyses method is the most important diagnostic method in the diagnosis of SARS-CoV-2 virus infection. In this research, we aimed to investigate the positivity of SARS-CoV-2 by RT-PCR from distal part of the endotracheal tube (DPET) samples, which have not been investigated in any study yet.
Materials and Methods: A total of 48 patients with a diagnosis of COVID-19 hospitalized in the intensive care unit receiving mechanical ventilation and whose conditions resulted in death or extubation were included in the study. The distal 6 cm part of the orotracheal intubation tube was removed from the patient (including the cuff). DPET samples were mixed with viral transport medium and vortexed; then, it was centrifuged at 4500g for 4 minutes. RNA isolation was performed by taking 400 µl from the supernatant and then SARS-CoV-2 RT-PCR was studied.
Results: In 15 patients (31.25 %) the swab samples were PCR positive, 42 patients (87.5 %) had positive computed tomography finding and 48 patients (100 %) had positive clinical findings. Among the patients whose oropharynx (OP)/nasopharynx (NP) combined swab sample was positive for RT-PCR, the rate of RT-PCR positivity detected in DPET samples was 26.7%. While OP/NP combined swab sample was negative, DPET RT-PCR positivity rate was found to be 9.09%.
Conclusions: Patients with positive DPET RT-PCR are detected when the swab is negative. These findings suggest that DPET can be used as a good lower respiratory sample without the risk of particle spread and transmission to healthcare personnel.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Chan JF, Kok KH, Zhu Z, Chu H, To KK, Yuan S, et al. Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan. Emerg Microbes Infect. 2020 Jan 28;9(1):221-236. doi: 10.1080/22221751.2020.1719902. DOI: https://doi.org/10.1080/22221751.2020.1719902
Zhu J, Zhong Z, Ji P, Li H, Li B, Pang J, et al. Clinicopathological characteristics of 8697 patients with COVID-19 in China: a meta-analysis. Fam Med Community Health. 2020 Apr;8(2):e000406. doi: 10.1136/fmch-2020-000406. DOI: https://doi.org/10.1136/fmch-2020-000406
Wan Z, Zhang Y, He Z, Liu J, Lan K, Hu Y, et al. A Melting Curve-Based Multiplex RT-qPCR Assay for Simultaneous Detection of Four Human Coronaviruses. Int J Mol Sci. 2016 Nov 23;17(11):1880. doi: 10.3390/ijms17111880. DOI: https://doi.org/10.3390/ijms17111880
Imai K, Tabata S, Ikeda M, Noguchi S, Kitagawa Y, Matuoka M, et al. Clinical evaluation of an immunochromatographic IgM/IgG antibody assay and chest computed tomography for the diagnosis of COVID-19. J Clin Virol. 2020 Jul;128:104393. doi: 10.1016/j.jcv.2020.104393. Epub 2020 Apr 30. DOI: https://doi.org/10.1016/j.jcv.2020.104393
Aslan AT, Kiper N. Çocuk Göğüs Hastalıklarında Tanı Yöntemleri. Ecevit IZ. Solunum Yolu Enfeksiyonlarında Mikrobiyolojik Tanı. Ecevit İZ. 95-111.
Team TNCPERE. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19)-China. Zhonghua Liu Xing Bing Xue Za Zhi. 2020; 41(2): 145-151. DOI: https://doi.org/10.46234/ccdcw2020.032
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J. Clinical characteristics of 138 Hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020; 323: 1061-1069. DOI: https://doi.org/10.1001/jama.2020.1585
Sachse K. Specificity and performance of PCR detection assays for microbial pathogens. Mol Biotechnol. 2004 Jan;26(1):61-80. doi: 10.1385/MB:26:1:61. DOI: https://doi.org/10.1385/MB:26:1:61
Valasek MA, Repa JJ. The power of real-time PCR. Adv Physiol Educ. 2005 Sep;29(3):151-9. doi: 10.1152/advan.00019.2005. DOI: https://doi.org/10.1152/advan.00019.2005
Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology. 2020 Aug;296(2):E32-E40. doi: 10.1148/radiol.2020200642. Epub 2020 Feb 26. DOI: https://doi.org/10.1148/radiol.2020200642
Tahamtan A, Ardebili A. Real-time RT-PCR in COVID-19 detection: issues affecting the results. Expert Rev Mol Diagn. 2020 May;20(5):453-454. doi: 10.1080/14737159.2020.1757437. Epub 2020 Apr 22. DOI: https://doi.org/10.1080/14737159.2020.1757437
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020 Feb 20;382(8):727-733. doi: 10.1056/NEJMoa2001017. DOI: https://doi.org/10.1056/NEJMoa2001017
Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020 Feb 6;7(1):4. doi: 10.1186/s40779-020-0233-6. DOI: https://doi.org/10.1186/s40779-020-0233-6
Backer JA, Klinkenberg D, Wallinga J. Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20-28 January 2020. Euro Surveill. 2020 Feb;25(5):2000062. doi: 10.2807/1560-7917.ES.2020.25.5.2000062. DOI: https://doi.org/10.2807/1560-7917.ES.2020.25.5.2000062
Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020 Aug;296(2):E115-E117. doi: 10.1148/radiol.2020200432. DOI: https://doi.org/10.1148/radiol.2020200432
Huang P, Liu T, Huang L, Liu H, Lei M, Xu W, et al. Use of Chest CT in Combination with Negative RT-PCR Assay for the 2019 Novel Coronavirus but High Clinical Suspicion. Radiology. 2020 Apr;295(1):22-23. doi: 10.1148/radiol.2020200330. DOI: https://doi.org/10.1148/radiol.2020200330
Long C, Xu H, Shen Q, Zhang X, Fan B, Wang C, et al. Diagnosis of the Coronavirus disease (COVID-19): rRT-PCR or CT? Eur J Radiol. 2020 May;126:108961. doi: 10.1016/j.ejrad.2020.108961. DOI: https://doi.org/10.1016/j.ejrad.2020.108961
Liu R, Han H, Liu F, Lv Z, Wu K, Liu Y, et al. Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan, China, from Jan to Feb 2020. Clin Chim Acta. 2020 Jun;505:172-175. doi: 10.1016/j.cca.2020.03.009. Epub 2020 Mar 7. DOI: https://doi.org/10.1016/j.cca.2020.03.009