RESUMEN
Real-time polymerase chain reaction (PCR) for SARS-CoV-2 is the mainstay of COVID-19 diagnosis, yet there are conflicting reports on its diagnostic performance. Wide ranges of false-negative PCR tests have been reported depending on clinical presentation, the timing of testing, specimens tested, testing method, and reference standard used. We aimed to estimate the frequency of discordance between initial nasopharyngeal (NP) PCR and repeat NP sampling PCR and serology in acutely ill patients admitted to the hospital. Panel diagnosis of COVID-19 infection is further utilized in discordance analysis. Included in the study were 160 patients initially tested by NP PCR with repeat NP sampling PCR and/or serology performed. The percent agreement between initial and repeat PCR was 96.7%, while the percent agreement between initial PCR and serology was 98.9%. There were 5 (3.1%) cases with discordance on repeat testing. After discordance analysis, 2 (1.4%) true cases tested negative on initial PCR. Using available diagnostic methods, discordance on repeat NP sampling PCR and/or serology is a rare occurrence.
Asunto(s)
COVID-19/diagnóstico , COVID-19/virología , Nasofaringe/virología , SARS-CoV-2/genética , Adulto , Prueba de COVID-19/métodos , Femenino , Humanos , Masculino , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Estándares de Referencia , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Sensibilidad y Especificidad , Manejo de Especímenes/métodosAsunto(s)
Antipsicóticos/efectos adversos , Betacoronavirus , Clozapina/efectos adversos , Infecciones por Coronavirus/etiología , Neumonía Viral/etiología , Esquizofrenia/complicaciones , Esquizofrenia/tratamiento farmacológico , Antipsicóticos/uso terapéutico , COVID-19 , Prueba de COVID-19 , Técnicas de Laboratorio Clínico , Clozapina/uso terapéutico , Consenso , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Humanos , Neutropenia/inducido químicamente , Neutropenia/complicaciones , Pandemias , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , SARS-CoV-2 , Esquizofrenia/sangreAsunto(s)
Clozapina , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Betacoronavirus , COVID-19 , Humanos , SARS-CoV-2RESUMEN
Depression is a common and highly disabling condition in older adults. It is a heterogenous disorder and there is emerging evidence of a link between inflammation and depression in older patients, with a possible inflammatory subtype of depression. Persistent low-level inflammation, from several sources including psychological distress and chronic disease, can disrupt monoaminergic and glutaminergic systems to create dysfunctional brain networks. Despite the evidence for the role of inflammation in depression, there is insufficient evidence to recommend use of any putative anti-inflammatory agent in the treatment of depression in older adults at this stage. Further characterisation of markers of inflammation and stratification of participants with elevated rates of inflammatory markers in treatment trials is needed.