Literature DB >> 34145082

Interpretation of pooled sample testing of COVID-19 for efficient use of resources.

Niraj Kumar1, Kamran Zaman1, Brij Ranjan Misra1, Rajni Kant1.   

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Year:  2021        PMID: 34145082      PMCID: PMC8555586          DOI: 10.4103/ijmr.IJMR_4465_20

Source DB:  PubMed          Journal:  Indian J Med Res        ISSN: 0971-5916            Impact factor:   2.375


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Sir, We read with interest the article by Prahraj et al1. The authors have concluded that the pooling of five COVID-19 suspected samples for SARS-CoV-2 detection by real-time reverse transcription polymerase chain reaction (RT-PCR) may be an acceptable strategy without much loss of sensitivity (88%) even for low viral loads compared to higher number of false negatives with 10-sample pools. Based on the current evidence, we would like to offer our additional inputs on the interpretation of the five-sample pool testing strategy for efficient detection of cases to limit missing out of positive cases. In India, the first case of COVID-19 was reported on January 30, 2020 from Kerala2. Following which, a seropositivity rate of 0.73 per cent was observed (6,468,388 adult infections) during May 11 to June 4, 20203. As of now (April 13, 2021), a total of 13,689, 453 cases with 1.25 per cent mortality is reported4. The percentage of positivity is still low (7.0%). Hence, the pooling strategy of five samples will be more helpful in country like India having a large population with minimal resources. Prahraj et al1, have shown that an average Ct value obtained with the five-sample pools exceeds an individual sample testing by 2.18±1.86 cycles, while Ct value obtained with 10-sample pooling exceeds an individual sample testing by 3.81±2.26 cycles. At ICMR-Regional Medical Research Centre, Gorakhpur, India, a total of 206,232 samples were tested for SARS-CoV-2, with around 2.5 per cent positivity. Ct value of 100 pools of five-sample pools and their respective individual samples were analyzed. It was observed that an average Ct value obtained with the five-sample pooled testing exceeded an individual sample testing by 2.62±1.40 and 2.76±1.63 with E and ORF1ab genes, respectively (unpublished data), which was concordant with the findings of Prahraj et al1. Hence, while determining the positive pools for segregation, the cut-off value should be adjusted as RT-PCR kit recommended Ct cut-off value plus four cycles in case of five-sample pools for interpretation of the real-time RT-PCR results. This recommendation may help reduce the possibility of missing COVID-19–positive cases. An elucidation from the authors about the results and interpretations taking into account the above observations will benefit the scientific community.
  3 in total

1.  COVID-19 in India: Moving from containment to mitigation.

Authors:  George M Varghese; Rebecca John
Journal:  Indian J Med Res       Date:  2020 Feb & Mar       Impact factor: 2.375

2.  Prevalence of SARS-CoV-2 infection in India: Findings from the national serosurvey, May-June 2020.

Authors:  Manoj V Murhekar; Tarun Bhatnagar; Sriram Selvaraju; Kiran Rade; V Saravanakumar; Jeromie Wesley Vivian Thangaraj; Muthusamy Santhosh Kumar; Naman Shah; R Sabarinathan; Alka Turuk; Parveen Kumar Anand; Smita Asthana; Rakesh Balachandar; Sampada Dipak Bangar; Avi Kumar Bansal; Jyothi Bhat; Debjit Chakraborty; Chethana Rangaraju; Vishal Chopra; Dasarathi Das; Alok Kumar Deb; Kangjam Rekha Devi; Gaurav Raj Dwivedi; S Muhammad Salim Khan; Inaamul Haq; M Sunil Kumar; Avula Laxmaiah; Amarendra Mahapatra; Anindya Mitra; A R Nirmala; Avinash Pagdhune; Mariya Amin Qurieshi; Tekumalla Ramarao; Seema Sahay; Y K Sharma; Marinaik Basavegowdanadoddi Shrinivasa; Vijay Kumar Shukla; Prashant Kumar Singh; Ankit Viramgami; Vimith Cheruvathoor Wilson; Rajiv Yadav; C P Girish Kumar; Hanna Elizabeth Luke; Uma Devi Ranganathan; Subash Babu; Krithikaa Sekar; Pragya D Yadav; Gajanan N Sapkal; Aparup Das; Pradeep Das; Shanta Dutta; Rajkumar Hemalatha; Ashwani Kumar; Kanwar Narain; Somashekar Narasimhaiah; Samiran Panda; Sanghamitra Pati; Shripad Patil; Kamalesh Sarkar; Shalini Singh; Rajni Kant; Srikanth Tripathy; G S Toteja; Giridhara R Babu; Shashi Kant; J P Muliyil; Ravindra Mohan Pandey; Swarup Sarkar; Sujeet K Singh; Sanjay Zodpey; Raman R Gangakhedkar; D C S Reddy; Balram Bhargava
Journal:  Indian J Med Res       Date:  2020 Jul & Aug       Impact factor: 2.375

3.  Pooled testing for COVID-19 diagnosis by real-time RT-PCR: A multi-site comparative evaluation of 5- & 10-sample pooling.

Authors:  Ira Praharaj; Amita Jain; Mini Singh; Anukumar Balakrishnan; Rahul Dhodapkar; Biswajyoti Borkakoty; Munivenkatappa Ashok; Pradeep Das; Debasis Biswas; Usha Kalawat; Jyotirmayee Turuk; A P Sugunan; Shantanu Prakash; Anirudh K Singh; Rajamani Barathidasan; Subhra Subhadra; Jyotsnamayee Sabat; M J Manjunath; Poonam Kanta; Nagaraja Mudhigeti; Rahul Hazarika; Hricha Mishra; Kumar Abhishek; C Santhalembi; Manas Ranjan Dikhit; Neetu Vijay; Jitendra Narayan; Harmanmeet Kaur; Sidhartha Giri; Nivedita Gupta
Journal:  Indian J Med Res       Date:  2020 Jul & Aug       Impact factor: 2.375

  3 in total

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