Posterior Oropharyngeal Saliva for the Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2).

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has put tremendous pressure on the healthcare system worldwide. Diagnostic testing remained one of the limiting factors for early identification and isolation of infected patients. This study aimed to evaluate posterior oropharyngeal saliva (POPS) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection among patients with confirmed or suspected COVID-19. METHODS: The laboratory information system was searched retrospectively for all respiratory specimens and POPS requested for SARS-CoV-2 RNA detection between 1 February 2020 and 15 April 2020. The agreement and diagnostic performance of POPS against NPsp were evaluated. RESULTS: A total of 13772 specimens were identified during the study period, including 2130 POPS and 8438 nasopharyngeal specimens (NPsp). Two hundred and twenty-nine same-day POPS-NPsp paired were identified with POPS and NPsp positivity of 61.5% (95% confidence interval [CI] 55.1-67.6%) and 53.3% (95% CI 46.8-59.6%). The overall, negative and positive percent agreement were 76.0% (95% CI 70.2-80.9%), 65.4% (95% CI 55.5-74.2%), 85.2% (95% CI 77.4-90.8%). Better positive percent agreement was observed in POPS-NPsp obtained within 7 days (96.6%, 95% CI 87.3-99.4%) compared with after 7 days of symptom onset (75.0%, 95% CI 61.4-85.2%). Among the 104 positive pairs, the mean difference in Cp value was 0.26 (range: 12.63 to -14.74), with an overall higher Cp value in NPsp (Pearson coefficient 0.579). No significant temporal variation was noted between the 2 specimen types. CONCLUSIONS: POPS is an acceptable alternative specimen to nasopharyngeal specimen for the detection of SARS-CoV-2.

GP management of osteoarthritic pain in Hong Kong.

BACKGROUND: Limited information is available about general practitioners' knowledge, attitude and practice in treating osteoarthritis. This study sought to better understand GPs' management of mild to moderate osteoarthritis in Hong Kong. METHODS: A cross sectional survey of GPs using a structured questionnaire mailed in three stages. RESULTS: A total of 225 questionnaires were returned. Paracetamol was considered to be an analgesic with lower toxicity and cost, and fewer drug interactions than others; it was also seen to have poor efficacy, short duration of action, and low patient compliance. Most GPs would consider nonselective nonsteroidal anti-inflammatory drugs as first line treatment, followed by paracetamol. Cyclooxygenase-2 inhibitors, physiotherapy and exercise were favoured as second line treatments. Most GPs would choose paracetamol for patients with comorbid conditions. DISCUSSION: General practitioners in Hong Kong have positive views on using simple analgesia and nonpharmacological treatments. Use of paracetamol was particularly preferred for older people and those with comorbidities.