A One Man Army- TrueNat Testing for the Identification of COVID-19 in Firozabad, Uttar Pradesh, India

ABSTRACT

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic has affected the entire world. The need of timely detection of the virus has been of prime importance and the efforts to develop sensitive, specific, rapid, portable and cost effective diagnostic methods promoted the indigenous development of TrueNat testing for viral load in COVID-19 detection which had been previously designed for detection of Tuberculosis and other infectious organisms. Aim: To see the importance of TrueNat testing among symptomatic and asymptomatic cases in different age groups and gender. Materials and Methods: In this retrospective study conducted in the Department of Microbiology, Autonomous State Medical College and SNM Hospital, Firozabad, Uttar Pradesh, India, from June 2020 - May 2021, a total of 4,659 samples were collected from patients (Influenza Like Illness (ILI), Severe Acute Respiratory Illness (SARI), symptomatic, asymptomatic, those seeking hospitalisation, emergency), contacts and travellers and were subjected to testing by TrueNat (Molbio Quattro). The cases were divided into group A of patients who presented with symptoms ≤7 days;group B of patients who presented with signs and symptoms >7 days and group C comprised of asymptomatic patients. The symptoms of patients were associated with the Cycle threshold (Ct) values of the Envelope (E) gene and the RNA-dependent RNA polymerase gene (RdRp) gene. The Chi-square test was done to test the statistical significance of association of symptomatic patients with the outcome of the test. Results: The maximum number of positive cases were found in the people 20-39 years (p-value <0.05). The least positivity was found in the higher (80 years) and lower (below 9 years) age groups. The positivity rates had no significant impact on the gender. The percentage positivity as detected by TrueNat testing was 3.3% and maximum positive patients were found in the group having symptoms <7 days (p<0.05). On association of the Ct values of E gene and RdRp gene with the symptoms it was found that 28.1% and 27.2% of the patients were in the high Ct value group. Conclusion: TrueNat was found to be a portable and easy to perform test which did not require special laboratory set up. The use of Viral Lysis Medium (VLM) reduced the time of RNA extraction which not only rendered it safer to perform but expedited the results.