Estimating the effectiveness of routine asymptomatic PCR testing at different frequencies for the detection of SARS-CoV-2 infections.
Estimating the effectiveness of routine asymptomatic PCR testing at different frequencies for the detection of SARS-CoV-2 infections.
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DOI：
10.1186/s12916-021-01982-x
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发表时间：
2021-04-27
期刊：
影响因子：
9.3
通讯作者：
Kucharski AJ
中科院分区：
文献类型：
--
作者：
Hellewell J;Russell TW;SAFER Investigators and Field Study Team;Crick COVID-19 Consortium;CMMID COVID-19 working group;Beale R;Kelly G;Houlihan C;Nastouli E;Kucharski AJ
使用RT-PCR对与脆弱人群（如医院的医务人员或护理院的护理人员）互动的人进行常规无症状检测，以帮助预防脆弱人群中的疫情。虽然RT-PCR的峰值灵敏度可能很高，但检测感染的概率在整个感染过程中会有所不同。因此，常规无症状检测的有效性将取决于检测频率以及PCR检测如何随时间变化。我们拟合贝叶斯统计模型的数据集每周两次PCR测试的英国医护人员进行自我管理的鼻咽拭子，无论症状。我们联合估计了感染次数和感染后一段时间内PCR检测阳性的概率;然后通过计算症状发作前检测到症状感染的概率和感染后7天内检测到无症状感染的概率，比较了无症状检测策略。我们估计PCR检测感染的概率在感染后4天达到峰值77%（54-88%），在感染后10天下降到50%（38-65%）。我们的研究结果表明，感染后1-3天检测到感染的概率大大高于以前发表的估计。我们估计，如果在一天内返回检测结果，每隔一天检测一次将在发病前发现57%（33-76%）的有症状病例，并在7天内发现94%（75-99%）的无症状病例。我们的研究结果表明，常规无症状检测可以在感染早期检测到高比例的感染者，前提是检测频繁，从检测到通知结果的时间足够快。在线版本包含补充材料，可通过10.1186/s12916-021-01982-x获得。
Routine asymptomatic testing using RT-PCR of people who interact with vulnerable populations, such as medical staff in hospitals or care workers in care homes, has been employed to help prevent outbreaks among vulnerable populations. Although the peak sensitivity of RT-PCR can be high, the probability of detecting an infection will vary throughout the course of an infection. The effectiveness of routine asymptomatic testing will therefore depend on testing frequency and how PCR detection varies over time. We fitted a Bayesian statistical model to a dataset of twice weekly PCR tests of UK healthcare workers performed by self-administered nasopharyngeal swab, regardless of symptoms. We jointly estimated times of infection and the probability of a positive PCR test over time following infection; we then compared asymptomatic testing strategies by calculating the probability that a symptomatic infection is detected before symptom onset and the probability that an asymptomatic infection is detected within 7 days of infection. We estimated that the probability that the PCR test detected infection peaked at 77% (54–88%) 4 days after infection, decreasing to 50% (38–65%) by 10 days after infection. Our results suggest a substantially higher probability of detecting infections 1–3 days after infection than previously published estimates. We estimated that testing every other day would detect 57% (33–76%) of symptomatic cases prior to onset and 94% (75–99%) of asymptomatic cases within 7 days if test results were returned within a day. Our results suggest that routine asymptomatic testing can enable detection of a high proportion of infected individuals early in their infection, provided that the testing is frequent and the time from testing to notification of results is sufficiently fast. The online version contains supplementary material available at 10.1186/s12916-021-01982-x.
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影响因子：
19
作者：
Singanayagam, Anika;Patel, Monika;Gopal, Robin
通讯作者：
Gopal, Robin
DOI：
10.1016/s1473-3099(20)30243-7
发表时间：
2020-06-01
期刊：
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