Norizuki Masataro, Hachiya Masahiko, Motohashi Ayano, Moriya Ataru, Mezaki Kazuhisa, Kimura Moto, Sugiura Wataru, Akashi Hidechika, Umeda Tamami
Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
Microbiology Laboratory, National Center for Global Health and Medicine, Tokyo, Japan.
Glob Health Med. 2021 Apr 30;3(2):107-111. doi: 10.35772/ghm.2020.01109.
The quantitative reverse transcription polymerase chain reaction method using nasopharyngeal swabs (NPS RT-qPCR) is regarded as the reference standard for diagnosing coronavirus disease 2019 (COVID-19). However, when using NPS RT-qPCR at busy airport quarantine stations, there are constraints on testing capacity, time, travelerstolerance, and availability of personal protective equipment for quarantine officers. A feasible alternative is therefore needed to test incoming travelers, especially when passenger numbers increase with the resumption of business, tourism, and economic activities. To explore alternatives to NPS RT-qPCR, we collected nasopharyngeal, anterior nasal, and saliva samples chronologically over days 1-7 from asymptomatic COVID-19 air travelers who were under quarantine at a designated facility, and we then compared test results for 9 different methods, comprising RT-qPCR (including the reference method), loop-mediated isothermal amplification (LAMP), and qualitative and quantitative antigen testing. We evaluated sensitivity for 97 person-day samples independently to evaluate asymptomatic travelers regardless of their testing date and period of asymptomatic status upon entry. Sensitivity of the different tests varied from 46.6% to 81.0%, but this was improved from 72.7% to 100.0% when the viral load was > 10 4 copies/sample on NPS RT-qPCR. Thus, most high-risk asymptomatic travelers with higher viral load would be detected by the tests evaluated. Quantitative antigen testing using saliva samples showed 90.9% sensitivity and provided quicker results, and should be an acceptable alternative to NPS RT-qPCR at busy airport quarantine stations. We discuss the implications of our exploratory findings for establishing a comprehensive and feasible testing strategy for COVID-19 among air passengers.
使用鼻咽拭子的定量逆转录聚合酶链反应方法（NPS RT-qPCR）被视为诊断2019冠状病毒病（COVID-19）的参考标准。然而，在繁忙的机场检疫站使用NPS RT-qPCR时，检测能力、时间、旅行者耐受性以及检疫人员个人防护装备的可用性都存在限制。因此，需要一种可行的替代方法来检测入境旅客，特别是当随着商业、旅游和经济活动的恢复旅客数量增加时。为了探索NPS RT-qPCR的替代方法，我们在第1至7天按时间顺序收集了在指定设施接受检疫的无症状COVID-19航空旅客的鼻咽、前鼻腔和唾液样本，然后比较了9种不同方法的检测结果，包括RT-qPCR（包括参考方法）、环介导等温扩增（LAMP）以及定性和定量抗原检测。我们独立评估了97人日样本的敏感性，以评估无症状旅行者，无论其检测日期和入境时无症状状态的持续时间。不同检测方法的敏感性从46.6%到81.0%不等，但当NPS RT-qPCR的病毒载量>10⁴拷贝/样本时，敏感性从72.7%提高到了100.0%。因此，大多数病毒载量较高的高风险无症状旅行者可以通过所评估的检测方法被检测出来。使用唾液样本的定量抗原检测显示出90.9%的敏感性，并能提供更快的结果，在繁忙的机场检疫站应是NPS RT-qPCR的可接受替代方法。我们讨论了我们的探索性研究结果对为航空旅客建立全面且可行的COVID-19检测策略的意义。
