Novel Coronavirus Disease Pandemic Research Articles

A Molecular Docking Investigation of SARS- CoV-2’s Main Protease against Phytocomponents of <i>Siddha</i> Formulation <i>Vishasura Kudineer</i>

Background: Covid-19 disease is a Wuhan, China originated acute viral respiratory illness. Even though the development of numerous vaccines, the threat of the Covid-19 virus endures nearly two years after the outbreak. The new mutant strain omicron has now spread to several countries. As a result, newer antiviral therapy is required to overcome this scenario. Objective: This study is aimed at phytocomponents in the Siddha formulation, Vishasura Kudineer (VSK), it is widely used to manage fever and respiratory ailments and may be effective in combating the ongoing pandemic of novel coronavirus disease. Methodology: The principal protease 3CLpro of this new Coronavirus (SARS-CoV-2) is a possible focus for therapeutic development since it plays a major part in disease transmission. Molecular docking investigation for all active Phytocomponents found in the Siddha formulation Vishasura Kudineer with possible targets was carried in the major Protease of SARS-CoV-2 (PDB ID:6LU7). AutoDockTools was used to design and optimize the ligand structures. Results: Molecular docking of the 9 bioactive phytocomponents as Santalic acids (-6.39), Nimbolide (-6.38), Rutin, Aristolochic acid (-6.95), Glabridin (-7.53), Indirubin (-7.23), Sabinene (-5.36), β-vetivenene (-6.79), and Zingiberene (-6.47) from in the Siddha sastric formulation, Vishasura Kudineer performed on the SARS-CoV-2 Main Protease protein’s active site (PDB ID: 6LU7). These phytochemicals had significant molecular interaction with the active residues, indicating their distinct inhibitory potencies. Conclusion: Whether this Siddha formulation could be used to effectively treat and manage COVID-19 and its variants, further research and clinical studies need to be done.

Modelling COVID-19 epidemic with confirmed cases-driven contact tracing quarantine

The pandemic of novel coronavirus disease 2019 (COVID-19) has been a severe threat to public health. The policy of close contract tracing quarantine is an effective strategy in controlling the COVID-19 epidemic outbreak. In this paper, we developed a mathematical model of the COVID-19 epidemic with confirmed case-driven contact tracing quarantine, and applied the model to evaluate the effectiveness of the policy of contact tracing and quarantine. The model is established based on the combination of the compartmental model and individual-based model simulations, which results in a closed-form delay differential equation model. The proposed model includes a novel form of quarantine functions to represent the number of quarantine individuals following the confirmed cases every day and provides analytic expressions to study the effects of changing the quarantine rate. The proposed model can be applied to epidemic dynamics during the period of community spread and when the policy of confirmed cases-driven contact tracing quarantine is efficient. We applied the model to study the effectiveness of contact tracing and quarantine. The proposed delay differential equation model can describe the average epidemic dynamics of the stochastic-individual-based model, however, it is not enough to describe the diverse response due to the stochastic effect. Based on model simulations, we found that the policy of contact tracing and quarantine can obviously reduce the epidemic size, however, may not be enough to achieve zero-infectious in a short time, a combination of close contact quarantine and social contact restriction is required to achieve zero-infectious. Moreover, the effect of reducing epidemic size is insensitive to the period of quarantine, there are no significant changes in the epidemic dynamics when the quarantine days vary from 7 to 21 days.

The effectiveness of the inclusion of hyperbaric oxygenation in the complex therapy of patients with COVID-19: retrospective study

The effectiveness of the inclusion of hyperbaric oxygenation in the complex therapy of patients with COVID-19: retrospective study

LHSPred: A web based application for predicting lung health severity

Background and objectivesThe computed tomography (CT) scan facilities are crucial for diagnosis of pulmonary diseases and are overburdened during the current pandemic of novel coronavirus disease 2019 (COVID-19). LHSPred (Lung Health Severity Prediction) is a web based tool that enables users to determine a score that evaluates CT scans, without radiologist intervention, and predict risk of pneumonia with features of blood examination and age of patient. It can help in early assessment of lung health severity of patients without CT-scan results and also enable monitoring of post-COVID lung health for recovered patients. MethodsThis tool uses Support Vector Regression (SVR) and Multi-Layer Perceptron Regression (MLPR), trained on COVID-19 patient data reported in the literature. It allows to compute a score (CT severity score) that evaluates the involvement of lesions in lung lobes and to predict risk of pneumonia. A web application was implemented that uses the trained regression models. ResultsThe application has proven to be effective and user friendly in a clinical setting for pulmonary disease treatment. The SVR model achieved Pearson correlation coefficient (PCC) of 0.77 and mean absolute error (MAE) of 2.239 while determining the computed tomography (CT) severity score. The MLPR model achieved PCC of 0.77 and MAE of 2.309. Thus, it can be applied as a useful tool in predicting pneumonia in the post COVID-19 era. ConclusionLHSPred can be used as a decision support system by the clinicians and as a tool for self-assessment by the patients with only six blood test input features.

A potent human monoclonal antibody with pan-neutralizing activities directly dislocates S trimer of SARS-CoV-2 through binding both up and down forms of RBD

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic of novel coronavirus disease (COVID-19). The neutralizing monoclonal antibodies (mAbs) targeting the receptor-binding domain (RBD) of SARS-CoV-2 are among the most promising strategies to prevent and treat COVID-19. However, SARS-CoV-2 variants of concern (VOCs) profoundly reduced the efficacies of most of mAbs and vaccines approved for clinical use. Herein, we demonstrated mAb 35B5 efficiently neutralizes both wild-type (WT) SARS-CoV-2 and VOCs, including B.1.617.2 (delta) variant, in vitro and in vivo. Cryo-electron microscopy (cryo-EM) revealed that 35B5 neutralizes SARS-CoV-2 by targeting a unique epitope that avoids the prevailing mutation sites on RBD identified in circulating VOCs, providing the molecular basis for its pan-neutralizing efficacy. The 35B5-binding epitope could also be exploited for the rational design of a universal SARS-CoV-2 vaccine.

Should Infectious Diseases Training be Mandatory in a Fellowship Program?

The global pandemic of Novel Coronavirus Disease (COVID-19) has highlighted the importance of clinicians having universal knowledge and skills in infection prevention. Herein, we report the results of a questionnaire survey regarding mandatory training in infectious diseases (ID) in a Japanese residency program. The questionnaire collected information on the gender, post-graduate year, and the necessity and feasibility of, and expectation from the program. Responses were obtained from 127 respondents (74 residents [58.3%] and 53 fellows [41.7%] ). The majority (98.4%) indicated that ID training during a residency program is important, and that its importance was augmented by the COVID-19 pandemic. Notably, 66.1% of the respondents agreed with the need for mandatory ID training; however, 21.3% pointed out the possibility of not being able to receive adequate training in the current programs. To prepare and confront a future ID crisis, it may be time to discuss mandatory ID training in clinical residency programs.

CoviLearn: A Machine Learning Integrated Smart X-Ray Device in Healthcare Cyber-Physical System for Automatic Initial Screening of COVID-19.

The pandemic of novel Coronavirus Disease 2019 (COVID-19) is widespread all over the world causing serious health problems as well as serious impact on the global economy. Reliable and fast testing of the COVID-19 has been a challenge for researchers and healthcare practitioners. In this work, we present a novel machine learning (ML) integrated X-ray device in Healthcare Cyber-Physical System (H-CPS) or smart healthcare framework (called “CoviLearn”) to allow healthcare practitioners to perform automatic initial screening of COVID-19 patients. We propose convolutional neural network (CNN) models of X-ray images integrated into an X-ray device for automatic COVID-19 detection. The proposed CoviLearn device will be useful in detecting if a person is COVID-19 positive or negative by considering the chest X-ray image of individuals. CoviLearn will be useful tool doctors to detect potential COVID-19 infections instantaneously without taking more intrusive healthcare data samples, such as saliva and blood. COVID-19 attacks the endothelium tissues that support respiratory tract, and X-rays images can be used to analyze the health of a patient’s lungs. As all healthcare centers have X-ray machines, it could be possible to use proposed CoviLearn X-rays to test for COVID-19 without the especial test kits. Our proposed automated analysis system CoviLearn which has 98.98% accuracy will be able to save valuable time of medical professionals as the X-ray machines come with a drawback as it needed a radiology expert.

POS-955 THE INCIDENCE OF END STAGE RENAL DISEASE ON PERITONEAL DIALYSIS HOSPITALISED WITH COVID-19: SINGLE CENTERED STUDY

The pandemic of novel coronavirus disease 2019 (COVID-19) is posing a threat to all populations, including patients with kidney failure who require hemodialysis (HD) or peritoneal dialysis (PD). Our study demonstrated the incidence of patients with PD therapy hospitalised for COVID-19 infection and its outcome.

Chest radiological finding of COVID-19 in patients with and without diabetes mellitus: Differences in imaging finding.

The pandemic of novel coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Diabetes mellitus is a risk factor for developing severe illness and a leading cause of death in patients with COVID-19. Diabetes can precipitate hyperglycaemic emergencies and cause prolonged hospital admissions. Insulin resistance is thought to cause endothelial dysfunction, alveolar capillary micro-angiopathy and interstitial lung fibrosis through pro-inflammatory pathways. Autopsy studies have also demonstrated the presence of microvascular thrombi in affected sections of lung, which may be associated with diabetes. Chest imaging using x-ray (CXR) and computed tomography (CT) of chest is used to diagnose, assess disease progression and severity in COVID-19. This article reviews current literature regarding chest imaging findings in patients with diabetes affected by COVID-19. A literature search was performed on PubMed. Patients with diabetes infected with SARS-CoV-2 are likely to have more severe infective changes on CXR and CT chest imaging. Severity of airspace consolidation on CXR is associated with higher mortality, particularly in the presence of co-morbidities such as ischaemic heart disease. Poorly controlled diabetes is associated with more severe acute lung injury on CT. However, no association has been identified between poorly-controlled diabetes and the incidence of pulmonary thromboembolism in patients with COVID-19.

Factors associated with telemedicine utilization among post-transplant patients at a university kidney and pancreas transplant center.

Telemedicine has become prevalent during the novel-coronavirus disease-2019 (COVID-19) pandemic. The study explored patient factors associated with telemedicine utilization among post-kidney and pancreas transplant patients at a university center. After analyzing 2801 patients and their visits using chi-square test and logistic regression, we found that government-insured (P <.0001) post-kidney and pancreas transplant patients were less likely to use telemedicine. Sex (P = .748), patient race (P = .920), age groups (P = .812), and traveling distance (P = .837) were not associated with telemedicine use. Centers should consider focusing on the subgroup of government-insured patients to improve telemedicine use and future studies should consider exploring barriers for underutilization of telemedicine in this population.

Chinese expert consensus on intestinal microecology and management of digestive tract complications related to tumor treatment (version 2022).

The human gut microbiota represents a complex ecosystem that is composed of bacteria, fungi, viruses, and archaea. It affects many physiological functions including metabolism, inflammation, and the immune response. The gut microbiota also plays a role in preventing infection. Chemotherapy disrupts an organism's microbiome, increasing the risk of microbial invasive infection; therefore, restoring the gut microbiota composition is one potential strategy to reduce this risk. The gut microbiome can develop colonization resistance, in which pathogenic bacteria and other competing microorganisms are destroyed through attacks on bacterial cell walls by bacteriocins, antimicrobial peptides, and other proteins produced by symbiotic bacteria. There is also a direct way. For example, Escherichia coli colonized in the human body competes with pathogenic Escherichia coli 0157 for proline, which shows that symbiotic bacteria compete with pathogens for resources and niches, thus improving the host's ability to resist pathogenic bacteria. Increased attention has been given to the impact of microecological changes in the digestive tract on tumor treatment. After 2019, the global pandemic of novel coronavirus disease 2019 (COVID-19), the development of novel tumor-targeting drugs, immune checkpoint inhibitors, and the increased prevalence of antimicrobial resistance have posed serious challenges and threats to public health. Currently, it is becoming increasingly important to manage the adverse effects and complications after chemotherapy. Gastrointestinal reactions are a common clinical presentation in patients with solid and hematologic tumors after chemotherapy, which increases the treatment risks of patients and affects treatment efficacy and prognosis. Gastrointestinal symptoms after chemotherapy range from nausea, vomiting, and anorexia to severe oral and intestinal mucositis, abdominal pain, diarrhea, and constipation, which are often closely associated with the dose and toxicity of chemotherapeutic drugs. It is particularly important to profile the gastrointestinal microecological flora and monitor the impact of antibiotics in older patients, low immune function, neutropenia, and bone marrow suppression, especially in complex clinical situations involving special pathogenic microbial infections (such as clostridioides difficile, multidrug-resistant Escherichia coli, carbapenem-resistant bacteria, and norovirus).

Impact of COVID-19 on Liver Enzymes: A Retrospective Study

Introduction: The global pandemic of novel Coronavirus Disease- 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has spread worldwide crippling the healthcare system. Besides the respiratory system, COVID-19 patients show signs of various degrees of liver damage, the mechanism and implication yet undeciphered. Hence, in this study, we aim to find out pattern and trend of derangement in liver functions in COVID-19 patients. Aim: To depict the pattern and trend of liver enzymes in COVID- 19 admitted patients without history of liver disease. Materials and Methods: The study was conducted as a single centred, retrospective, observational study, from June 2020 till December 2020. It included 1909 admitted COVID-19 positive patients diagnosed via either nasopharyngeal or oropharyngeal swab by Real-Time Reverse Transcription-Polymerase Chain Reaction (RT-PCR). The COVID-19 positive patients were divided into four groups Group I: Age- 15-20 years; 150 patients, Group II: Age 21-40 years; 645 patients, Group III: Age 41-60 years; 560 patients, Group IV: Age &gt;60 years; 554 patients. Abnormality in liver tests was defined as greater than three times of upper limit of normal reference range Alanine Transaminase (ALT) &gt;120 U/L, Aspartate Transaminase (AST) &gt;120 U/L as Hepatocellular injury, greater than two times of upper limit of normal reference range Alkaline Phosphatase (ALP) &gt;250 U/L as Cholestatic Injury (CSI). The statistical analysis was done by the Statistical Package for Social Sciences (SPSS) version 25.0. Results: It was found that with respect to ALT levels, males in age 21-60 years, whereas females in two extremes of age 15-20 and &gt;60 years age were the most affected. Whereas, females in age group &lt;40 years were more affected with higher AST activity. With respect to abnormal ALP levels female in age group &lt;40 years were most affected but males were most affected in age group &gt;40 years. Conclusion: Irrespective of age and gender, abnormality in liver enzymes was observed. Liver Function Tests (LFT) are a part of routine investigations carried out at the time of admission; its abnormalities may guide us in devising strategy to prioritise patient management in correlation with inflammatory markers.

Tuberculosis and COVID 19 Coinfection

The ongoing pandemic of novel corona-virus disease 2019 (COVID-19) has received worldwide attention by becoming a major global health threat. The tuberculosis and SARS-COV2 co-infection has not been frequently reported. The purpose of this work is to establish a focus on Tuberculosis and SARS-COV2 co-infection, to study the impact of HIV infection on the occurrence of COVID-19, and evaluate the place of BCG vaccination in reducing the morbidity and mortality linked to Covid-19. We reported three cases of co-infection tuberculosis and covid 19, in one case an HIV infection was noticed. The tuberculosis was pleural in the first case, multifocal in the second case and a miliary in the third case. The treatment consisted of antibacillaries, azithromycin and hydroxychloroquine with a favorable evolution. through published studies, we noticed that persons with active or latent TB have increased susceptibility for SARS-CoV–2 infection associated with rapid progression and severe involvement. Patients with severe immune-deficiencies, may be at risk for a severe course of COVID-19 disease. Regarding efficiency of BCG vaccination, limited data are available and does not confirm the existence of a protective effect of BCG against COVID-19.

Sensitivity of SARS-CoV-2 Variants to Neutralization by Convalescent Sera and a VH3-30 Monoclonal Antibody.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic of novel coronavirus disease (COVID-19). Though vaccines and neutralizing monoclonal antibodies (mAbs) have been developed to fight COVID-19 in the past year, one major concern is the emergence of SARS-CoV-2 variants of concern (VOCs). Indeed, SARS-CoV-2 VOCs such as B.1.1.7 (UK), B.1.351 (South Africa), P.1 (Brazil), and B.1.617.1 (India) now dominate the pandemic. Herein, we found that binding activity and neutralizing capacity of sera collected from convalescent patients in early 2020 for SARS-CoV-2 VOCs, but not non-VOC variants, were severely blunted. Furthermore, we observed evasion of SARS-CoV-2 VOCs from a VH3-30 mAb 32D4, which was proved to exhibit highly potential neutralization against wild-type (WT) SARS-CoV-2. Thus, these results indicated that SARS-CoV-2 VOCs might be able to spread in convalescent patients and even harbor resistance to medical countermeasures. New interventions against these SARS-CoV-2 VOCs are urgently needed.

Novel coronavirus vulnerability: metabolic derangements and altered dehydrogenase enzyme activities are central to the virus pathogenesis in human, bat and other animals

The ongoing pandemic of novel coronavirus disease (COVID-19) has killed millions across the globe. This paper hypothesizes anaerobic glycolysis and dehydrogenase enzymes as the focal points of SARS-CoV-2 pathogenesis that ensure virus survival and replication in humans and the reservoir host bat. Metabolic alterations in hypertension, diabetes, obesity, and higher reliance on anaerobic glycolysis for energy generation make males and aged people more vulnerable to the disease. The bat has a low level of vitamin D, greater metabolic dependence on anaerobic glycolysis, and low dehydrogenase activities which might predispose this mammal to persistent infection. Similarities of the bat metabolism with the metabolic changes brought by SARS-CoV-2 in humans suggest possible evolution of the coronavirus targeting the host metabolic processes for its replication and survival. Further research on host-pathogen interactions at the metabolism levels would unravel the pathogenesis of coronavirus and several other viruses. © 2021, Exploratory Animal and Medical Research. All Rights Reserved.

Deployment of Infectious Disease Experts and Prevalence of Antimicrobial Resistance in Okayama: A Call for Training of Specialists.

ObjectiveDuring the ongoing global pandemic of novel coronavirus disease 2019 (COVID-19), an emerging infectious disease, the implementation and execution of infection prevention and control (IPC) is of paramount importance. In this study, we aimed to assess the current deployment of infection control medical personnel in Okayama prefecture, who are supposed to play an essential role to prevent the outbreak of infectious diseases, and the current prevalence of antimicrobial-resistant (AMR) bacteria isolated in Okayama.Materials and methodsThis was a descriptive study using publicly available data. The numbers of infectious disease (ID)-doctors and the certified nurses in infection control (CNIC) per 100,000 population in 47 prefectures in Japan were calculated. We then compared the detected proportions of AMR pathogens among the prefectures in 2019 to be employed as a comparative parameter, which was obtained from Japan Nosocomial Infections Surveillance (JANIS) data.ResultsThe number of ID-doctors was the 11th highest in Japan; however, they were unevenly distributed in southern Okayama, particularly at three tertiary hospitals. While the deployment of CNIC was geographically less uneven in the prefecture, their number was lower than the domestic average. According to the JANIS data, isolation rates of AMR pathogens were high in Okayama compared to other prefectures in Japan: vancomycin-resistant Enterococcus faecium (the third-worst); cefotaxime-resistant Escherichia coli and Klebsiella pneumoniae (the third-worst and the second-worst, respectively); and meropenem-resistant Pseudomonas aeruginosa (the worst).ConclusionsOur assessment provides underlying data and reinforces the need for educating multi-professional experts in the field of infectious diseases to prevent future public health threats in Okayama.

AN APPROACH TOWARDS THE DIAGNOSIS AND MANAGEMENT OF COVID 19 AS PER AYURVEDA

The world community is facing an unprecedented pandemic of novel coronavirus disease (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV- 2). SARS CoV-2, a highly infectious causative agent of this disease is transmitted through droplets, contact routes and aerosols. Even the most developed nations are having trouble limiting its spread and the disease is still spreading at an alarming rate. For filling the gaps and lacunas in the healthcare system this is high time to integrate different healthcare systems available to meet the ever-emerging health challenges. Despite worldwide efforts to contain it, the pandemic is continuing to spread for want of a clinically proven prophylaxis and therapeutic strategy. Even though no system of medicine has any evi- dence-based treatment for COVID-19 yet, clinical interventions are required to be put in place. Ayurveda has documented the first reference of epidemics as Janapadodhwamsa (“Jana” means “people” whereas the word “Pada” means “place of habitation” of Jana, any disease or conditions like natural calamities or disasters affected a Janpad, it was called Janpandodhwansa) and has given a scientific insight into its causes, effect, and prevention along with management strategies. The clinical profile of COVID-19 matches with Vata-Kapha dominant Sannipataja Jwara (Fever caused by Tridoshas) for which detailed treatment guidelines and an array of pharma- ceutical preparations are described in Ayurvedic literature which is being practised by qualified Ayurvedic physi- cians effectively for a long. This paper highlights the Ayurvedic perspective of the COVID-19 along with its aeti- ology, prevention, prophylaxis, and management strategies through Ayurveda. Keywords: COVID-19, SARS CoV-2, Ayurveda, Vata-Kaphaja Jwar,Janapadodhwamsa.

CoBiD-net: a tailored deep learning ensemble model for time series forecasting of covid-19

The pandemic of novel coronavirus disease 2019 (Covid-19) has left the world to a standstill by creating a calamitous situation. To mitigate this devastating effect the inception of artificial intelligence into medical health care is mandatory. This study aims to present the educational perspective of Covid-19 and forecast the number of confirmed and death cases in the USA, India, and Brazil along with the discussion of endothelial dysfunction in epithelial cells and Angiotensin-Converting Enzyme 2 receptor (ACE2) with the Covid-19. Three different deep learning based experimental setups have been framed to forecast Covid-19. Models are (i) Bi-directional Long Short Term Memory (LSTM) (ii) Convolutional LSTM (iii) Proposed ensemble of Convolutional and Bi-directional LSTM network are known as CoBiD-Net ensemble. The educational perspective of Covid-19 has been given along with an architectural discussion of multi-organ failure due to intrusion of Covid-19 with the cell receptors of the human body. Different classification metrics have been calculated using all three models. Proposed CoBiD-Net ensemble model outperforms the other two models with respect to accuracy and mean absolute percentage error (MAPE). Using CoBiD-Net ensemble, accuracy for Covid-19 cases ranges from 98.10 to 99.13% with MAPE ranges from 0.87 to 1.90. This study will help the countries to know the severity of Covid-19 concerning education in the future along with forecasting of Covid-19 cases and human body interaction with the Covid-19 to make it the self-replicating phenomena.Supplementary InformationThe online version contains supplementary material available at 10.1007/s41324-021-00408-3.

Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States

BackgroundThe widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs), such as non-essential business closures and gathering bans, to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is greatly needed to assist in guiding individualized decision making for adjustment of interventions in the US and around the world. However, the impacts of these approaches remain uncertain.MethodsBased on the reported cases, the effective reproduction number (Rt) of COVID-19 epidemic for 50 states in the US was estimated. Measurements on the effectiveness of nine different NPIs were conducted by assessing risk ratios (RRs) between Rt and NPIs through a generalized linear model (GLM).ResultsDifferent NPIs were found to have led to different levels of reduction in Rt. Stay-at-home contributed approximately 51% (95% CI 46–57%), wearing (face) masks 29% (15–42%), gathering ban (more than 10 people) 19% (14–24%), non-essential business closure 16% (10–21%), declaration of emergency 13% (8–17%), interstate travel restriction 11% (5–16%), school closure 10% (7–14%), initial business closure 10% (6–14%), and gathering ban (more than 50 people) 7% (2–11%).ConclusionsThis retrospective assessment of NPIs on Rt has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.

Approach to Assessment of New Swabs and Viral Transport Media for SARS-CoV-2 Testing.

In light of the present pandemic of novel coronavirus disease 2019 (COVID-19) and the unprecedented high demand for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing worldwide, there are shortages of established specimen collection devices for respiratory viral testing for diagnostic microbiology laboratories. This creates the need to validate unverified collection devices from manufacturers that may not be a registered supplier for medical devices. As clinical laboratories do not routinely perform quality control of established collection devices, there is a need to have a systematic, robust approach to the assessment of substitute unregistered collection swabs and viral transport media (VTM). A discussion of the aspects requiring consideration when determining the suitability and implementation of new collection devices is presented. These specific assessment criteria include an inspection of device integrity, determination of swab and VTM sterility and in vitro performance, VTM stability, and examination of the clinical performance of the device. This method was used in a front-line medical microbiology laboratory on swabs and VTM from an unregistered manufacturer, with suboptimal results that precluded implementation. As the pandemic continues, it will be important for diagnostic laboratories to adopt a flexible and streamlined approach to maintaining adequate supply chains for testing reagents and materials.