ΠΦΥ -Εκπαίδευση > Συζητήσεις πάνω σε ιατρικά θέματα

Κορονοϊός ( COVID-19 )

<< < (123/171) > >>

Argirios Argiriou:
January 25, 2021

For SARS-CoV-2 Detection, Saliva Performed as Well as Nasopharyngeal Swabs
Daniel Kaul, MD reviewing Butler-Laporte G et al. JAMA Intern Med 2021 Jan 15

Systemic review and meta-analysis showed that NAAT had >80% sensitivity for detecting SARS-CoV-2 in saliva samples.

Assessing nasopharyngeal (NP) swabs with nucleic acid amplification testing (NAAT) is considered the gold standard for detecting SARS-CoV-2, but proper sample collection requires trained personnel and is uncomfortable. Saliva, by contrast, is easily self-collected. In a meta-analysis and systemic review, researchers evaluated NAAT testing of saliva versus NP swab specimens. Sixteen studies were included; of these, 10 exclusively tested outpatients and 2 involved population screenings in which participants were not required to show symptoms of COVID-19.

In all, 5922 subjects underwent NAAT testing of saliva and NP swabs; 4981 had negative tests for both samples and 941 had positive tests for one or both samples. The pooled sensitivity and specificity was 83.2% and 99.2%, respectively (saliva), and 84.8% and 98.9% (NP swab). Similar results were seen in a sensitivity analysis limited to outpatients undergoing a single test with each assay.

COMMENT
Routine serial screening for SARS-CoV-2 is central to a comprehensive strategy for controlling the pandemic in universities, K-12 schools, and other settings where social distancing is difficult to achieve. This study provides evidence that using easy-to-collect saliva specimens rather than NP swabs will not significantly compromise such efforts.

EDITOR DISCLOSURES AT TIME OF PUBLICATION
Disclosures for Daniel Kaul, MD at time of publication
Consultant/Advisory Board   TSRL Incorporated
Grant/Research Support   Chimerix; Merck & Co.; National Institute of Allergy and Infectious Diseases; Shire
CITATION(S):
Butler-Laporte G et al. Comparison of saliva and nasopharyngeal swab nucleic acid amplification testing for detection of SARS-CoV-2: A systematic review and meta-analysis. JAMA Intern Med 2021 Jan 15; [e-pub]. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος

Argirios Argiriou:
January 28, 2021

Allergic Reactions to the Pfizer-BioNTech and Moderna COVID-19 Vaccines: Early Reports
Stephen G. Baum, MD reviewing CDC COVID-19 Response Team and Food and Drug Administration MMWR Morb Mortal Wkly Rep 2021 Jan 15 CDC COVID-19 Response Team and Food and Drug Administration MMWR Morb Mortal Wkly Rep 2021 Jan 22

The CDC's reports in late December 2020 and January 2021 indicated rates of 11.1 and 2.5 anaphylaxis cases per million vaccine doses of the Pfizer-BioNTech and Moderna vaccines, respectively, with no fatalities.

An initial CDC report detailed adverse reactions (including anaphylaxis) during the first 10 days of administration of the Pfizer-BioNTech COVID-19 vaccine. During that period (December 14–23, 2020), 1,893,360 first doses of vaccine (encompassing multiple lots) were given and 4393 adverse reactions (0.2%) were reported. Twenty-one of these cases were subsequently defined as anaphylaxis (median age, 40; 90% women), for an incidence of 11.1 per million vaccinations. Median onset of anaphylaxis was 13 minutes (range, 2–150 minutes), with 71% of reactions occurring within 15 minutes (the recommended observation period), 14% within 15–30 minutes, and an additional 14% after 30 minutes. Epinephrine (primarily intramuscular) was administered and no deaths were reported. Eighty-one percent of cases had a documented history of allergies and 33% had experienced anaphylaxis before. Other reactions included pruritis, scratchy throat, mild respiratory symptoms, and rash.

For the Moderna vaccine (released several weeks later), assessment of allergic reactions after administration of 4,041,396 first doses revealed 10 cases meeting criteria for anaphylaxis, yielding a rate of 2.5 such incidents per million vaccinations. Of the patients experiencing this severe reaction, 9 had a previous history of allergies (5 involving anaphylaxis). Female recipients predominated and multiple lots were represented. Nonanaphylactic allergic reactions were similar to those seen with the Pfizer-BioNTech vaccine. Most anaphylaxis occurred within 15 minutes, but one episode occurred at 30 minutes. No deaths occurred.

COMMENT
Although life-threatening anaphylaxis is rare, awareness of its possibility (and availability of epinephrine) is critical, especially as vaccination is extended to nonhospital sites. Because some of these anaphylactic reactions occurred beyond 15 minutes, observing vaccine recipients for at least 30 minutes is judicious.

EDITOR DISCLOSURES AT TIME OF PUBLICATION
Disclosures for Stephen G. Baum, MD at time of publication
Consultant/Advisory Board   Clinical Infectious Diseases
Equity   Select Medical Holdings Corp. (no annual income is derived from this equity holding)
Editorial Boards   Medical Letter
CITATION(S):
CDC COVID-19 Response Team and Food and Drug Administration Allergic reactions including anaphylaxis after receipt of the first dose of Pfizer-BioNTech COVID-19 vaccine — United States, December 14–23, 2020. MMWR Morb Mortal Wkly Rep 2021 Jan 15; 70:46. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

CDC COVID-19 Response Team and Food and Drug Administration Allergic reactions including anaphylaxis after receipt of the first dose of Moderna COVID-19 vaccine — United States, December 21, 2020–January 10, 2021. MMWR Morb Mortal Wkly Rep 2021 Jan 22; [e-pub]. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος

Δ. Κουναλάκης:
Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος

Argirios Argiriou:
25-01-2021

Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος

Argirios Argiriou:


Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος

Πλοήγηση

[0] Λίστα μηνυμάτων

[#] Επόμενη σελίδα

[*] Προηγούμενη σελίδα