Author(s): Vinh, Daniel B; Zhao, Xiao; Kiong, Kimberley L; Guo, Theresa; Jozaghi, Yelda; Yao, Chris; Kelley, James M; Hanna, Ehab Y | Abstract: BackgroundTesting for SARS-CoV-2 is important for decision making prior to surgery in otolaryngology. An understanding of current and developing testing methods is important for interpreting test results.MethodsWe performed a literature review of current evidence surrounding SARS-CoV-2 diagnostic testing highlighting its utility, limitations, and implications for otolaryngologists.ResultsThe currently accepted RT-PCR test for SARS-CoV-2 has varying sensitivity according to which subsite of the aerodigestive tract is sampled. Nasal swab sensitivities appear to be about 70%. Chest CT imaging for screening purposes is not currently recommended.ConclusionDue to the current sensitivity of RT-PCR based testing for SARS-CoV-2, a negative test cannot rule out COVID-19. Full PPE should be worn during high-risk procedures such as aerosol generating procedures even if testing is negative. Patients who test positive during screening should have their surgeries postponed if possible until asymptomatic and have tested negative for SARS-CoV-2.

/pdf/overview-of-covid-19-testing-and-implications-for-3vrhvv9c1f.pdf

Overview of COVID-19 testing and implications for otolaryngologists.

Objective: To assess whether there is a knowledge gap about the use of test kits for residents and to explore the knowledge, attitudes, and practices of using test kits in China during the coronavirus disease 2019 (COVID-19) epidemic. Method: An online-based, nationwide, and cross-sectional study was conducted. A total of 1,167 respondents were recruited from June 19 to July 2, 2020. All participants completed a validated questionnaire written in Chinese. Electronic consent was obtained from all participants upon their agreement to commence the questionnaire. Perceived efficacy, safety, and their attitudes toward the use of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing kits were measured. Result: The majority of the study respondents were female [749 (64.2%)], aged 31-40 years old [372 (31.9%)], and located in mainland China [1,137 (97.4%)]. The majority of the respondents held a positive view toward the introduction of the fast-track approval policy for novel coronavirus testing products (6.16 ± 1.30) as well as toward putting more investment in scientific research and biomedicine to improve the detection accuracy of detection kits (5.94 ± 1.55) in China. The respondents valued the detection accuracy more as opposed to the detection time of the testing kits (4.66 ± 2.00), whereas few participants agreed that in the research and development process, detection accuracy could be sacrificed to speed up production and coverage capacity (3.02 ± 2.04). Conclusion: The majority of the participants have a basic knowledge of the detection methods of the SARS-CoV-2 virus and the types of test kits, as well as great confidence in China's domestic production of test kits and decisions. However, how basic knowledge, high compliance, and positive attitudes play a role in easing the tension of the pandemic still remains unknown.

/pdf/perceived-effectiveness-safety-and-attitudes-toward-the-use-3zsnf4e71i.pdf

Perceived Effectiveness, Safety, and Attitudes Toward the Use of Nucleic Tests of SARS-CoV-2 Among Clinicians and General Public in China.

Coronavirus Disease-19: Challenges Associated with the Treatment of Head and Neck Oncology and Laryngology Patients in the Coronavirus Disease-19 Era.

In this paper, a formula for estimating the prevalence ratio of a disease in a population that is tested with imperfect tests is given. The formula is in terms of the fraction of positive test results and test parameters, i.e., probability of true positives (sensitivity) and the probability of true negatives (specificity). The motivation of this work arises in the context of the COVID-19 pandemic in which estimating the number of infected individuals depends on the sensitivity and specificity of the tests. In this context, it is shown that approximating the prevalence ratio by the ratio between the number of positive tests and the total number of tested individuals leads to dramatically high estimation errors, and thus, unadapted public health policies. The relevance of estimating the prevalence ratio using the formula presented in this work is that precision increases with the number of tests. Two conclusions are drawn from this work. First, in order to ensure that a reliable estimation is achieved with a finite number of tests, testing campaigns must be implemented with tests for which the sum of the sensitivity and the specificity is sufficiently different than one. Second, the key parameter for reducing the estimation error is the number of tests. For a large number of tests, as long as the sum of the sensitivity and specificity is different than one, the exact values of these parameters have very little impact on the estimation error.

https://hal.inria.fr/hal-02633844/document

On the True Number of COVID-19 Infections: Effect of Sensitivity, Specificity and Number of Tests on Prevalence Ratio Estimation.

Background : Testing for SARS-CoV-2 is important for decision making prior to surgery in otolaryngology. An understanding of current and developing testing methods is important for interpreting test results.Methods : We performed a literature review of current evidence surrounding SARS-CoV-2 diagnostic testing highlighting its utility, limitations, and implications for otolaryngologists.Results : The currently accepted RT-PCR test for SARS-CoV-2 has varying sensitivity according to which subsite of the aerodigestive tract is sampled. Nasal swab sensitivities appear to be about 70%. Chest CT imaging for screening purposes is not currently recommended.Conclusion : Due to the current sensitivity of RT-PCR based testing for SARS-CoV-2, a negative test cannot rule out COVID-19.  Full PPE should be worn during high risk procedures such as aerosol generating procedures even if testing is negative. Patients who test positive during screening should have their surgeries postponed if possible until asymptomatic and have tested negative for SARS-CoV-2.

/pdf/an-overview-of-covid-19-testing-and-implications-for-301p9w99o4.pdf

An Overview of COVID-19 Testing and Implications for Otolaryngologists

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Overview of COVID-19 testing and implications for otolaryngologists.